HomeMy WebLinkAbout10191679 - PermitCity of Santa Ana 20 Civic Center Plaza (M -1 9), Santa Ana, CA 92702 Building Permit#: 10191679
Permit Counter: (714) 647-5800 Inspection Requests: (714) 667-2738 Inspector Section: (714) 647-5853 Pin#: 59439
Project Address: 715 N Harbor Blvd Unit: 106 Bldg: Address Range: Suite Range:
Assessor's Parcel:
Building Use:
Job Type:
198-162-50
Commercial
Signs
Nature of Work: Sign-illuminated
Lot: 7, 8, 9, 10
Existing Bldg. & Use: Commercial/Restaurant
Proposed Use:
Block: C
Occupancy:
Constr Type:
Code:
Fl ood Zone:
# of Stories:
Tract: 490
B
VB, SPK
CBC 2013
X-0602320143J
Historic: No
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area:
Total:
Zoning : SP2
Patio:
T.I.Area:
Yards Req'd:
Valuation: $1,700.00
Description of Work: Install (1) led-illuminated channel letter wall sign for "Asia Cafeteria", bond posted on M'"68978 ......... _
Planning Conditions:
Owner : Golden Star Management
Address: P O Box 9084
Fountain Valley, CA 92728
Phone: (714) 244-8544
Tenant: Asia Cafeteria
Planning Approva l By : Guerra , Pamela
Plan Checked By: CcrAmsden , Julie
Permit Issued By: Amsden, Julie
NPDES lnsp. Req'd: 0
Contractor:
Address:
Phone:
State Lie#:
Lie Type:
Bus. Lie#:
Y2K Signs
Midway City, C
(714) 328-273
761709
C-45
188081
Workers' Compensation Insurance:
Carrier: Exempt
Policy#:
Expires :
Date: 12/19/2016
Date: 12/20/2016
Date: 12/21/2016
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
PWA lnsp. Req'd: No
Planning ln sp . Req'd : No
Fire lnsp. Req'd : No
Police lnsp. Req'd: No Account#
Landscaping ln sp. Req'd: No Flood Z one 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 is commenced.
Inspector MID#: 2016-133540
01116002 51600
01116002 51601
01116002 51612
01116002 53600
Engineer:
DesiQner:
Address:
Phone :
License#:
Total
$20.56
$200 .51
$1 .00
$103.46
"
01116002 51601
01116002 53600
01116002 51612
01116002 51600
01116002 51601
• : ' ,r
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Perm it Fee
Plan Check Fee
Bldg. Stds. Revolving
General Plan Update
Issuance
Fee T otal:
Paid to Date:
Balance Due:
$14 9.25
$1 03.46
$1.00
$20 .56
$51 .26
$325.53
$0 .00
$325.53
BUILD ING-INSPECTOR RECORD
SITE-WORK DATE ID/S IG. .. COMMENTS Owner-Builder Declaration
I hereby affirm under penally of perjury that I am exc mp l form the Contractors· License Law for the following reason (sec , 7031.5 Business
Set Backs :md Profession Code): Any City or County wh ich requires a permit to construe!. alter. improve. demolish or repair any strncturc. prior to its
issuance. a lso requires the applicant for such permit to file a signed statement that he or she is licensed pursua nt to the provisions of the
Form s/Stee l/Holdowns Contractor's L icensed Law (Chapter 9, Commencing with Section 7000 of D ivision 3 of the Bus iness and Professions Code) or 1hat he or
she is exempt therefrom and the basis for the alleged exemption .Any violation of Sect io n 7031.5 by any applicant for a pcnn it subjec1s the
Erecti on Pads applicant to a civi l penalty ofnol more than five hundred dollars ($500).
UFER Ground _I. as owner of the propeny. or my employees w ith wages as their so le compensation. will do the work and the struclure is not intended
or offered for sale ( Sec. 7044, Bus iness and Professions Code: The Con tractor's License Law docs not a pply to an owner of the p ro perty
SLAB Floor who builds or improves thereon. and who docs such work himself or herself or through his or her own employees. provided tha1 such
improvements are not intended or ofTered for sale. If. however. the building or improvement is sold within one year o f completion. the
Subfloor/Vent/lnsul. Owner-Builder will have the burden of prov ing that he or s he not build or im p rove for the purpose of sale).
Roof Sheathi ng _I. as owner of the propc11y. am exclusively comracting with licensed contractors to constnict the projecl ( Sec. 7044. Business a nd
Profession Code: T he Contractor's License Law docs not a pply to nn owner of property who buikls or improves thereon. and who
Shear Wall contracts for s uch projects with a Contrnctor(s) licensed p ursuant 10 the Contractor's L ice nse Lnw.)
Framing _, ~m exempt under Section .B. & P.C. for this reason.
Date:~ In sulation/E nergy Owner:
D rywa ll WORKERS COMPENSATION DECLARATION
I hereby affirm under penalty of perjury o ne of the following declarations:
Ex t./l nt. Lath _I have and will maintain a Certilicale of Consent to Self-Insure for workers' compensa1ion. as provided fo r by Section 3700 of the
Brown Coat Labor Code. for the performance of the work for which the permit is issued,
Masonry _I hav e :l.nd will ma intain workers' compensation insu rance. as required by Section 3700 of the L1bor Code. for the performance of the
work for which this permit is i~sucd. My workers ' compensation insurance carrier and policy number are:
Poo l Fence Carrier:
T-Bar Policy Number: Expires:
Handicap Req. (This section need not be completed if the permit is for One hundred dollars IS i OOJ or less)
Deputy Fina l Report ~ cc11ify that in 1hc performance of the work for which 1his permi1 is issued. I shall not employ any person in a ny manner so as to
became subject lo the workers ' compensation laws of C:difo rn ia , and agree that if I should become subject to the workers'
Eng ineer Fin a l Report compensation provisions of Section 3700 of the Labor Code. I shall. forthwith comply with those provisions ..
Fl ood Zone Certif. Date: t/Z Li. 6//i( Applic ant: ~ I
\\'AR NING: Failure to secure workers' compcnsa1ion covcrngc is unlawful, and shall subject an employer to criminal penalties a nd civil
lines up to o ne hundred thousand dollars ($100.000).in a ddition to 1hc cos1 of compensation. damages as provided for the Section 3076 of
the Labor Code, interest and attorney's fees.
FINAL LI CENSED CO NTRACTORS DECL ARA TJON
I hereby affirm under penally or perjury that I am licensed under p rov ision of Chapter 9 (c:onuncncing with Section 7000) of Di vision 3 of
Certificate of Occupancy 1hc Business and Professions Code. and my license is in full force and effect.
Notes, Remarks , Etc. License C lass : C-4 ~ License Number 7cC__/ 7C> q.
/,2_/_u/~
I
Dille: Contractor:
7 I V.:;> .if.
I
<;'/~ '
CO NSTRU!;TION LENDI NG AGENCY
I hereby affirm under penalty of perjury that there is a construct ion le nd ing agency for !he perfonnance o f the work for which this permit is
issued (Sec. 3097. Civ. C.).
Lender's Name
Le ,,der·s Address:
APPLICANT S DECLARATION
Dcmo li1ion Pcnni1s-Asbestos Notirication Federal Regulations (Title 40. Part 6)
_ Required LctterofNotifica1ion
_l cenify 1ha1 the federal regulations regarding asbestos removal are no t applicable to th is project.
_ I certify that I have read this application and stnle that the above infonnation is correct. I agree to comply with all City and Counly
ordinances And State Laws relating to buildin g construction, and hereby authorize representatives of this Ci1y and County 10 enter upon the
above menlioned propeny for inspection purposes.
/~?7 -L.Ll~ 11(/ ~ Applicant or agent sig.: Date:
Pcrmittee n;une {print): 11 t..J.rv-0 & ,l):;/L))/4.t ._,..
M.\WP511Perm,t-lnspecllon Forms\Bu1ld1ng-lnspect1on Record.doc 03.31.06