HomeMy WebLinkAbout10196428 - Permit-
Cify of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CAg27o2 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 1IJ196424
Pin #: 36945
a'lProject Address: 3031 S Orange Ave
Assessor's Parcel: 411-O21-O8 Lot 8
Unit: B Bldg: Address Range Suite Range:
Zoning: M1Block. NA Tracl.8473 Historic: No
Building Use:
Job Type:
Nature of Work:
Existang Bldg. & Use
Proposed Use:
lndustrial
Tenant lmprovement
TI
lndustrial/Storage
Occupancy:
Constr Type
Code:
Flood Zone:
# of Stories:
B, S.1
t B
cBc 2016
x-0602320278J
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area
Total:
Patio:
T LArea:
Yards Req'd:
Valuation:
2000
3@60
$15,000.00
0
Description of Work: lnterior Tl for unit B only.
Bc[ch+!44469 - 6/25/2ti1E ID3 LRoSALESolfice: CTYH Tr.nnsir iir 2 0t ?Ac':t+: FrpI +: I I I l9A4?s
Owner-Builder
Engineer
Addressl
Ript+i(r?30327? - r
Trons(l,:I ion Totc]
?:i,'?|]1Ei Srlir Pn* 4,?.5Owner:
Address
Phone:
Tenant:
Carman Group - Blake Elliott
3031 S ORANGE AVE
Santa Ana, CA 927074247
(7't4) 556-3813
Airlink Distribution lnc
Contractor:
Address:(:0rfion Group - P,1:1.: Lt I ,r,l I
Phonel
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policy #:
Expires:
Genencl Plqn Updotp Fec
01 1 1 6tt0?- I 1 6t-rr:rfrlru-
Building
01r160f'2- 516111(xtr:r-
Blds Stds Reyo lv ins
01 1 16110?- 51t1?0ur.r-
lloster Card
C(:+ : **r*r*+II+*r4 I i:,
_ 3?1.?5
_ t53?.?8
_ t1.rt0
ts14.26
AUth+rrr2t196
Phone:
License #
Architecl /
Desiqner:
Address:
Phone:
License #
Planning Approval By: Arabe, Jill
Plan Checked By: So. Anson
Permit lssued By l /-f Amsden. Julie'/t
NPDES lnsp Req'd: ' - No
Date: 05/14/20'18 Misc. Receipt: 70968
Date: 0612512018 Misc. Receipt;
Dale: 06/25/2018 Misc. Receiptl
Subject to Field.
07776002
07776002
0 77 76002
0 777600 2
07776002
57607
s3600
57672
51600
57607
Permit Fee
Plan Check Fee
Bldg. Stds. Revolving
General Plan Update
lssLlance
$480.00
$680.00
$1.00
$21.25
$52.98
$1,235 23
$680 00
$555.23
PWA lnsp. Req'd: No
Planning lnsp. Req'd: No
Fire lnsp. Req'd:
Police lnsp. Req'd
No
No Account#Total
Landscaping lnsp. Req'd: No Flood Zone Cert. Req'd: No
Every petmit issued shall become invalid unless the work on the site authotized by
such permit is commenced withn 180 days aftet its issuance or tf the wotu authoized
on the site by such permit is suspended or abandoned lot a period of180 days after
the tifie the wotk is commenced
lnspector MID#: 2018-143338
01 I '16002 5'1600
011 16002 51601
01116002 51612
$21 .25
$532.98
$1 00
Fee Total:
Paid to Datel
Balance Due:
Planning Conditions:
SITE-WORK DATE rD/slq.COMMENTS/ASet Backs
Forms/Steel/Holdowns K-1-/ [It"wli)
Erection Pads
UFER Ground
SLAB Floor
Sublloor/Vent/l nsulation
Rool Sheathinq
Shear Wall //)
Framinq Kl.ld D,V-L]U
lnsu lation/Enerqy u \./)
Drywall 7-z( -/g .lr)uSdfu &//
Ext./lnt. Lath
Brown Coat
l\4aso n ry
T-Bar
Handicap Req.
Depuly Final Report
Engineer Final Report
I
FINAL 4)hlt{'(Y7r\Ue Vst)
Certif icate of Occupancy ( l r U!
Notes, Remarks, Etc.
BUILDING- INSPECTOR RECORD
li.rd hr r |trnir \uhjccr\ rhc af!lnrnrh u.iviltctrxlry.ln.r.xtrcrhrtr fiv. Iundrctldolh^ ls5(x))
l..sowmroirhcporcny.ormy.mployccswilhwtScs$llEt\n.\nnPcnsrrion-willdolhework nd llL (n'durc is nor
dcndcd or ollcrcd io' uE l Sd 7(N,l. Bu\irrcs tnd l'rolt\\ion\ C{xh Thc (bntrcr{r \ l-itci\c ti! dG! noi rPlyro osncrol
or irrDrous rtcE,n. rd who des suh *nl* him\cllor krsclfor rhmuSh hi\ o. hcr.encmplotcc\.
n['.vci]nsrrcNtrrcndcd.r{ntirslfttr\rLltho{cqr.rrf,ln,ildi',!o'inr|lortiE n{rldsirhi',on.}tn,
ihc O{ncr AuiUcr srllh{rc rtL hu',lcn of lr,!i',! rh r lr.r Lh. did f,or tdild.r i'nF,c rhc fmrny
is owncr ol rhc lropcdy. amcx.lusivclycontrlclin3 sirh licciccd.onrrrroslo.l,nndd tle lmr.rt (Scc 704'1. Busincs\
t'i.fcssio.C.dc Thc (nnr6cior's t-ic.n\. Lrw docs n.r inPly ro an o*n$ o r rhrl. y sh. nuikl\or i'nfolcs thcrco.
rn(l uho.ontxrr\ktrnrhtnoIr^*irhr(nntrxtrr\)lL.r'MdDU,{rrnlr)rlt{i)i'r((n'\1tr!'s.lx$]
;:U[4,e-"'
DEEIdBAIII]N
I h.Lbv Jllin, Lndc' .cnakvo, ffiru^ onc ol rlre lcll, s tr's JftlJrJrFn.
1K",,". *'".,":.:nincrcnrc'r( h scr;rNu. ror workcrr.o.,!cnsarion. N pmvidcd ro, hv ssrion.r?m or$c
tryfr"o". r, rt. s rt.nrunc nr,h. q,1l r.' uh'.h rhc ncan i. i.suc'rf-#
Ull-hlF,nd wrll rinratr' wnrlc.' c.mFnsahntr insursnce. as reqnhcrl hy Secrion .!?00 or rhc btnr Codc. fu rhe FYti'rmn'cor
ih. work lor which rhk pdrnil is isssd Mysorkcn .dmFnqri{ insuruncc orict d B,li.y nun$cr sc
Caricr.-
nfr'r.colrtu$orktur$htlrrhrt1(rtrirn\!Lc.l\lllltrrr.DIn.)rni-Pcnfrrtrr'!n'xnN'
!) 6r.h.cotrr{r6lc.rrnrhc\orkcr(.D rf.r\rii(,n htr\oIC lil(ntrir. rl rlrcc rhrr if I \k{ld h.onk n'hicr t, rlk
q.rk.6 ..nrpcn\rri0n pn)vi\ii
'q'.
k,ycr h.rimi'[lIr ri$ rtrd
nrg$ rs po('dcd lnr llr
Ltcr\suD 11)N {,\c l()R
l]}l(I BrlUali
I hcrcby 0lljrnundcr penalryorpcrjurylhor I lnr lien\.d lnder pn vkiotr olChaPicr 9 (.onmncirs silh sc.rid: 1D0) oi Divi\ ion .r
of rh. Bu\ikss atrd Prcic\sionr Codt, ,lrd m, llccnsc h in full tut& rd cllal
I ic.tr\. Numh(r
CI}IIIBIICIQNII,NI.UNG.EGEN.CI
I hcrh, aflirm undcr lcMlryofpcrJuryrhar rhcrc G r coNruclion lcndnrt aScmy fu rhc p.rronMme ofrhc *ork lar $hrh lhi\ lcnir i\
isucd (Scc :1097,Civ. C ).
lxnd0'\ AJd,-.s
-
APPLICAN]' DF( II ARATION
I ns$y anim u.dd pctrrlty oircrjrry.trc ofrhc folloqin8 dcchrlrions:
Dcmlirion Pcrnih Astrslos Nolincari6. Fcd.irrl RcEulrlio"s ('l'irlc 40. Pd6)
_Rcqutrd hn.rof Norif c.lior
h)vc irfonnr(i0i i(.otrccl I
rchyaurl(trtrc rcllc€nhr
rholc trrnrioncd lrop.ny ior
A0plionl dr A,rcnr sitnllur.
-fF€
rlutw ryUEry
Pool Fence
Flood Zone Certif .
OWNER BUILDEI DELCARATION
I h.tuby,rfirnr nndcr tcnrlry or p.rjury rhar I nm cxemPl frorn rhc ai,nta.ro^ Li.cnsc tj$ ru rhc rollowin8.ca$n (st.70:11.5
Businc$ nnrl Prot$n,n Cdl.)r Atry ciry or Counly which rcquircs a !.mir ro conntucr' rlrcr. in{rovc. dcnoliril .r rcp.ir anv
srrucrulc. prinb irs hsurncc..lso rcqunesrhc qrpli. r tnr su.h Pcflnilro lilc ! \isncd {.tcnf,nr rhal tEor shc ( li.cntd Nrur
!, rh. Eovhio.s ofltr Conrla.rofr Liccnscd ti* (Chllnrcr 9, G'm!ftn.in8 wilh Scclion 7m0 or DivGion I or rh' BD{in's r'a
Plofcsrion\ Code) or rhd 1.. or shc hcrcn, rhcreli. rndih.hrhlbrrhclllcgcdcrc'nprion AnyviolalionolSc.rion70.11.5hvan,
I.cniryrhd t[.ltdcralrgulrri(,ns rcanlilr3 rstc{os rcnmvrlsc n, rDnli.]hlc ro rhir trojcr
---I_
MAYOR
MiguelA. Pulido
IVAYOR PRO TEIV
l\4ichele N4artinez
COUNCILMEIVIBERS
P. David Benavides
Vicente Sarmiento
Jose Solorio
SalTinajero
Juan Villegas
ACTING CIIY MANAGER
Gerardo Mouet
CITY ATTORNEY
Sonia R. Carvalho
CLERK OF THE COUNCIL
l\.4aria D. Huizar
CITY OF SANTA ANA
PLANNINC & BUILDIN6 ACENCY
20 Civic Center Plaza
P.O. Box 1988 . Santa Ana, California 92702
www. santa-an a.org / pba
NOTICE TO PROPERTY OWNER
Dear Property Owner
An application for a building
improvements specified at
permit has been subm
3oll S ot
itted in your name listing you rself as the builder of the property
(uu\*t,rA-u*4zz{
We are providing you with an Owner-Builder Acknowledoment and lnformation Verification Form to make you aware of
your responsibilities and possible risk you may incur by having this permit issued in your names as the Owner-Builder.
We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned
this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property
owner, obtain the prior approval of the permitting authority.
OWNER'S AC KNOWLEDGMENT AND VERIFICATION OF INFORMATON
ECTIONS: Read and initial each statement below to signify you undersland or verify this information.
1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder"
g permit that erroneously implies that the property owner is providing his or her own labor and material personally. l,ld in
as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed
person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for
those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to
workers on m y property
2. I understand building permits are not required to be signed by property owners unless they are responsible for
construction and are nol hiring a licensed Contractor to assume this responsibility
3. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may
tect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her namep
instead of m own
humbers
I understand Contractors are required by law to be licensed and bonded in California and to list their license
on permits and conlracts.
5 I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the
total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an
"employer" under state and federal law.
i)!15/ understand if I am considered an "employer' under state and Federal law, I must register with the state and
" federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to
unemployment compensation of each "employee." I also understand my failure to abide by these laws may subject me to
serious financial risk.
6t"v)r'{ I understand under California Contractors' State License Law, an Owner-Builder who builds single-family
residential structures cannot legally build them with the intent to offer them for sale, unless a//work is performed by
SANTA ANA CITY COUNCIL
moulido@sanla-ana oro
Mayor Pro Tern. ward 2
mr0a.rinez@sanla-a.a oro
Vicente Sarmiento
vsarmientorasanta an6.oro Eolono@sanla-aoa oro dbenav'des@sanla'3na.oro rvilleoas@sanl3-ana oro sl.aiero@sanla ana.o.o
licensed subcontractors and the number of structures does not exceed four within any calendar years, or all of the work is
performed under contract with a licensed general bu ilding Contractor
8. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any
financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects ,n the
workmanship or materials.
a>rru
I \' L L l understand I may obtain more information regarding my obligations as an "employer" from the lnternal Revenue
Service, the United States Small Business Administration, the California Department of Benefit Payments, and the
California Division of lndustrial Accidents. I also understand I may contact the California Contractors' State License Board
(QSLB!at 1-800-321-CSLB (2752) or www.cslb.ca.oov for more information about licensed contractors.
*), .4\Y ,O.l am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am
the party legally and financially responsible for proposed construction activity at the foltowing
address:
a ll app
11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by
licable laws and requirements that govern Owner-Builders as well as employers.
I agree to notify the ,ssuer of this form immediately of any additions, deletions, or changes to any of the
information I have provided on this form.
Licensed contractors are regulated by laws designed to protect the public. lf you contract with someone who does not
have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain
as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. lt is also important for
you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your
property, you may be held liable for damages. lf you obtain a permit as Owner-Builder and wish to hire Contactors, you will
be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers'
compensation insurance coverage.
Before a building permit can be issued, this form must be completed and signed by the property owner and
returned to the agency responsible for issuing th ermit.: A coDv of the DroDetfu owner's driver's license,
form notarization or other a bt ented when the it is
Signature of Property Ow
Print name of Owner
Date
/
('t0rariltl
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the
following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner-Builder Permit for my
project.
Scope of Construction Project (or Description of Work)
Project Location or Address
Name of Authorized Aqent:
Address of Authorized Agent:_
Phone Number of Authorized Agent
I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above
information and certify its accuracy.
Property Owners Slgnature Dale
Print Name of Owner
Note: A copy of the owner's driver's license, form nolarization, or other verification acceptable lo the agency is required to
be presented when the permit is issued lo verify the propedy owner's signature.
SANTA ANA CITY COUNCIL
s,nat
Mayor Pro Tem, Ward 2
mrmartrnez@sanla'6.a.oro
V'cente Samrenro
vsarmrenro@sanra-a.a orq Eolono@santa-ana oro
P Davrd B€navrdes
dbenav des@sa.ta-ana.oro rvrl eoas@santa-ana oro st na eroosanla an3.rq