HomeMy WebLinkAbout10190535 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building Permit#: 10190535
Permit Counter: (714) 647-5800 Inspection Requests: (714) 667-2738 Inspector Section: (714) 647-5853 Pin#: 15190
Project Address: 3321 3/4 S Yale St Unit: WCC01 Bldg : Address Range: Suite Range :
Assessor's Parcel:
Building Use:
Job Type:
414-141-07
Other
Alteration
Lot: POR 3
Nature of Work: Replace Antennas
Existing Bldg. & Use: Cellsite
Proposed Use:
Block: NA
Occupancy:
Constr Type:
Code:
Flood Zone:
# of Stories:
Tract: WILLIAMS
u
N/A
CBC 2013
X-0602320258J
Historic: No
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area:
Total:
Zoning : M1
Patio:
T.I.Area:
Yards Req'd:
Valuation: $20,000 .00
Description of Work: Remove (3) existing antenna and install (3) new panel anntena with coordinating equipment
Planning Conditions:
Owner : Thomas Greubel
Address: PO Box 782
Rancho Santa Fe, CA 920670782
Phone:
Tenant: · ~ -L .... D
c_ ei ""'TY-uc.-\-() ~
. \ i R \ \,t)
~1rr AL:~
Planning Approval By: '-lr Orozco, Ivan
Plan Checked By: \i \\,-So, Anson
Permit Issued By: ,lJ' Hernandez, Kathy
NPDES ln sp. Req'd: No
~
Contractor: Amatel Inc
Address:
Phone:
1017 S Mountain Avenue
Monrovia, CA 91016
(323) 801-0199
State Lie#: 854654
Lie Type: B, C-7, A
Bus. Lie#: 346623
Workers' Compensation Insurance:
Carrier: State Fund
Policy #: , 9019599-2015
Expires: 09/21/2016
Date: 08/03/2016
Date: 08/29/2016
Date: 09/12/2016
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
PWA ln sp. Req'd: No Fire lnsp. Req'd : No
Account# Planning ln sp . Req'd : No Police ln sp. Req'd : No
Landscaping lnsp. Req'd: No Flood Zone Cert. Req'd: No
Every permit issued shall become invalid unless the work on the site authorized by
such permit is commenced within 180 days after its issuance.or if the work authorized
on the site by such permit is suspended or abandoned for a period of180 days after
the time the work i s commenced.
Inspector MID#: 2016-130835
01116002 51600
01116002 51601
01116002 51612
01116002 57770
Enginee r:
Address:
Phone :
License#:
Architect /
DesiQner:
Address :
Phone :
License#:
68434
T otal
$20.56
$349.76
$1.00
$35.00
Batch;:35440 -9/12/2016 ID: ERUBIO
1ransv: ~1 o
A~ct:: Ref~: 10190535
RcPt;:01627665 -9/12/2016 1:39 PM
Transa c tion Total $406 .32
G~neral Plan UPdute Fee
m.square~1EN~tfEERS 600000-
Loyall W t-ta'rt6 Fi i 119
1387 Cal'J1*~~}io ~-1~01000--
San Cle ·' :te,, fr~~2~7'"3'0 ~ ':' ( 1~9
(619) 997:_ 1,i-,~ :'--.. ,l cLUUU-·
II c·ot I lm & Do c uMents
01116002-57770000-
J. -.·L ' .. ,IJ ~t_h -,L I_.,.:: J. --f·
01116002 51601 Permit Fee
01116002 53600 Plan Check Fee
01116002 57770 Microfilm Records
0111 6 002 51612 Bldg. Stds. Revolving
01116002 51600 General Plan Update
01116002 51601 Issuance
Fee Total:
Paid t o Date:
Balance Due:
$20.56
$349.76
H.00
$35 .00
$298.5 0
$41 3.82
$35 .0 0
$1 .0 0
$20 .56
$51 .26
$820.14
$41 3 .82
$406.32
SITE-WORK DATE ID/SIG.
Set Backs
Forms/Steel/Holdowns
Erection Pad s
UFER Ground
SLAB Floor
Subfloor/Vent/lnsulation
Roof Sheathing
Shear Wall
Framinq
Insulation/Energy
Drvwall
Ext.l int. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req .
Deputy Final Report
Enqineer Final Report
Flood Zone Certif.
FINAL
Certificate of Occupancy
Notes, Remarks , Etc .
BUILDING-INSPECTOR RECORD
COMMENTS OWNER UU IU>E R IJ ELCARATION
I hereby affirm un der pe nalt y o f pc1jury 1hm I am exempt from the Con1rac1011i License Law fo r 1hc follow ing reason (Scc.7031.5
Business and Profession Code): Any C'il y or Coun ty whic h requires a pcnnit to constmct. a lter. improve. demolis h or repair ;my
stniclllre. prio r to its issuance. ;11s0 requires the nppli cant fo r such permit 10 fi le a s igned sta teme nt tlml he or she i.c; licensed p ursuant
to the provisions o f the Cont ractor's Licensed Law (Chapter 9. Comm encing with Section 7000 of Di vision 3 ., .. f tl1e Business an d
Profess io ns Code) or that he or she is exempt therefrom and the basis fo r th e alleg.cd exemption. Any vio lal ion o f Section 7m l .. ~-½y any
applicant for a pennil subjects the applicant to a civil pen.i.lty of not more th an fi ve hundred doll ars ($500}.
_I. as owner oft he property. or my employees with wnges as their sole compensa1ion, wil l do the wo rk ,·md the struct ure is not
int ended or offered for sale (Sa:. 7044. Bu siness nn d Profess io ns Code: The Cont ra ctor"s License Law does not apply to an owner of
the pro pci1y who bui ld,; or improves thereo n. and who does such work hims e lf or herself or t hrough hi s or her own employe~.
provided that such improvements are not imended or offered for sale. If. however. the bu ild ing or i1nproveme nt is sokl wit hin one year
of complet ion. the Owner Builder will have the burden of proving th.it he or she d id not build or improve 1he proj)Cl1y for the p11rµoscof •
sale),
_I. as owner of the propeny. am c:..;:cl us i\·cly contrn cling with licensed conl ract ors to conslruct the project (Sec. 704<1. Business
and Pro fession Code: The Contract or's Lice11se La w does 11ot apply to an owner ofprnpcr1y who builds or impro,·cs thereon.
a nd who con1rncts for suc h projects with a Co111rac101~s) licensed purs11at11 to th e ('ontrr1c1or·s License Lnw ).
_1 mn exemp t un der Section ________ • R & P.C. for this reason.
D 1Hc: __________ Owner: _______________________ _
WORKlcRS' CO~I PENSATION
llECL A RATION
I hereby affirm under penalt y of perjury one of the fo llowing declar ations:
_1 have and will main ta in a Certificate ofC011scnt to Sclf•lns ure fo r workers· co mpensat io n. as provid ed for by Sect io n .HOO of the
Labor Code. for the perfonnance of the work for whi ch the pennit is issued.
_I ha ve anti will maint ain workers' compensation ins urance. as requi red by Sec1 ion 3700 of th e L1bor Code. for the performa nce of
the work for wh ich this pennit is iss ued. My workers· compensation insu ra nce cmTier and po lic y number .i re :
Carrier ~,. "l'!::-(oN 1~'r ~Hl) \)~
Policy Num ber: ~ 0 \ ~? " l\ ~ I!:;
::;'\JJ'IO
~xpir••= -~-l-=zC.L., _,__J_,-"',b-
_I ce1tify 1hat in the performance of the work fo r wh ich this permit is issued . I slm.11 no t employ any person in an y rn a1111er
so as to become subject to the workers' compensation laws of Califomin. and agree that i fl should become subjccl to the
workers' compensat io n provisions of Sect ion 3700 of the Labor Code. I shal l. fort hwith comply with those pnwisi(l llS.
WARNING: Failure to secure workers' compensation covcrnge is unlawfu l. and shall subject an employer to crim inal penalties and
civil liucs up 10
11
,onc hundred thousand dollars ($!00.000). in ndd it ion 10 the cost of compcnsr11ion, damages as provit.l cd for the
Section 3076 oftl • Labo,Codc, interest and attomcy·s ~fees. n \f\. .
IJ ale: q \ "2 / / l,. A p1>lica11t: ~ ~ ~ """--"' "I-'-'
U C •NS)m C O NTllACTOll
IJEC LA RATION
I hereby amrm under penally of perjury tha t I am li censed 1111der provision o f Chapter 9 (comme11cii1g wi1h Sect ion 700 0) of Div ision 3
o f the l3 usin ess an d Pro fessions Code. an d my lic ense is in run force and effect.
CONSTRUC TION LENIJING AGENCY
I he reby affirm m1dcr penalt y o f pc1jury t hat there is a constrnctio n lending agency fo r the perfon nnm:e of t he wo rk for which this permit i.,;
iss ued (Sec. 3097. Civ. C.).
Lender's Name: _________________________ _
Lend cr ·s Address: _________________________ _
A PPLICANT llECLARATION
I hereby affi1111 under penalty of perj ury one o f the following dcclarn tions :
Demoli 1ion Permits-Asbestos Noti ficat io n Federal Regu!Jl ions (Til le 40. Par16)
_Required Le11erofNotificnt ion
_I ce11ify t hat the federal regulations regardin g asbestos removal are not a ppli cnble to this proj ect.
_I certify that I have read th1s app\1ca11011 and state 1hn.1 the nbo\e 111 fonnnt1on 1s correct I rig.ice 10 com1>ly w11h nil City .ind County
oidmanccs and State Laws relating to bu1ld1ng. cons1mc11011. and hereby autho1 1 e reprcscntat1vcs oftlus City an d~\u1nty:1 1e11ter upo n the
above mc ntJoncd prope11y for ms~t17 n ~cs.
Applirant orAgcnt S ignalu1 c ~ ~....,,,._, ~~",;__;::., Oal c ~ lZ )-1,
t--------------------------------------------------~ Permilee11a111e (pri111): __ ~ __ cc:f'--'~'-'\S_\.c.>--_L-'--_M __ 0_'(1 __ ~_1V __ () ______________ _