HomeMy WebLinkAbout10197505 - PermitCity of Santa Ana 20 Civac Center Plaza (M-19), Santa Ana, CAg27o2 Building
Permit Counter: (714) 647-5800 lnspection Requestsr i,714]| 667-2738 lnspector Section: (714) 647-5853
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Project Address: 3384 S Bristol St
Assessor's Parcel 412-141-22 Lot, NA
Bldg Address Range: 3300-3398
Historic: No
Suite Range:
Zoning: C4Block: NA
Building Use: Commercial Occupancy: B 1st FL Area: O Patiol
Job Type: Tenant lmprovement Constr Type: V B, SPK 2nd FL Area: O T.l.Area: i6OO
Nature of Work: T.l. Code: CBC 2016 Other Areas; O yards Req,d:
Existing Bldg. & User Commercial Flood Zone: X-0602320259J Garage Area: Valuation: $57,440.00
Proposed Use: lce Cream Shop # of Stories: , ,o,r,, 0
Description of Work: T.l. - New partitions to create counter/service area, moveable seating for customers, accessible restroom, partitions to create prep
area, new equipment. No roof mounted equipment or facade alterations. '.GRAVITY GREASE INTERCEPTOR NOT REQUIRED PER
PW MEMO--
Planning Conditions:
Owner.
Address
CP Bristl SA LLc
'17870 Skypark Cir. Ste. 108
lrvine, CA 92614
Contractor: HathawayConstruction
Address: 141 N La Salle St
Redlands, CA 92374
Phone: (95115224037
State Lic #: 1033527
Lic Type: B
Bus. Lic #: 370560
Workers' Compensation lnsurance
Carrier: Exempt
Policy #:
Expires:
Engineer
Address
Phone:
Tenant: La Michoacana Universal
P hone.
License #
Architect /
Desiqner:
Address:
Phone:
License #
Planning Approval By: Orozco, lvan Dale: 1011712O1a Masc. Receipt
Plan Checked By: Mazaii, Zac Date: 10/15/2018 Misc. Receipt
Permit lssued By: Chavez, Dave - Date: 1112012018 Misc Receipt
NPDES lnsp. Req'd: No -V-e- Subject to Field:
0 777 60 02
07775002
077760 0 2
0 77760 0 2
o777500 2
077760 0 2
57607
53500
57?70
57672
s 7600
57607
$400.00
$s60.00
$3.76
$3.00
$22.08
$55.04
71442
Total
Permit Fee
Plan Check Fee
Microfilm Records
BIdg Stds. Revolving
General Plan Update
lssuancePWA lnsp. Req'd: No
Planning lnsp. Req'd: No
Fire lnsp. Req'd:
Police lnsp. Req'd
No
No Account#
Landscaping lnsp. Req'd: No Flood Zone Cert. Req'd: No
Every pemit issued shall become invalid unless lhe wo* on the site authorized by
such pemil is commencod within 180 days aftet its issuance ot if the work authorizod
on the site by 6uch pemil is suspended or abandoned fot a peiod ot 180 days aftet
lhe time the wo* is commenced
$22.08
$455.04
$3.00
$3.76 $1,043.88
$560.00
$483-88
lnspector MID#: 2018-145673
01 116002 51600
01116002 51601
01116002 51612
01116002 57770
Permit #: lOl97505
Pin #: 98,46,4
Unit:
Tractr NA
Fee Tolal:
Paid to Date:
Balance Due:
BUILDING. INSPECTOR RECORD
SITE-WORK DATE OWNIiR I}I] I LDER DELCA'L{TION
I h6.by amm undcr p€nahy ol pdjury thd I d qcmpl freto rhc Cont,.lon' Licerp Law ior rh. folloqinS rwn (Ss.7011.5
Busir6s and Profdion Code)r Any Cny or Co!.ty *hicl r.qun6 a lsnil ro comrtucl. alls. inlProve donolish or apat &y
shduc. prior ro ns isue.c. also requir6 d. appli.er for soch Fflrn lo filc a sisncd statm$l lhal h. or 3hc is licm.d tBuei
ro rh. rrovirioE oilh. Conrado.s Licnsd lls {Chaprd 9, Conn.n.in! wth Sdion 7000 ol Dilision I ol rh. Bsi..s dd
Profsions Codc) or th.r h. or shc is cr€'npt rh6.Eom lnd rhc &6is lor th. all.red crdprioo Any violalio. ofs&1io.70ll s bya,
applica ro. a psrnn subj.ds rh. applicdr ro a cilil dahy ol nor 60r. $m 6r hun&cd dolltrs ($500).
l. s oNn6 oathc prop€.ly. or my €mplo)6 wilh was6 6 lheir $lc co pdaion. *ill do thc so,[ ad ln eddrc i! ml
inrqdcd or o,te.ed lor slc (Sc.704,1. BBinB ed Ptut6sions Codc Th. Conlriclol s Lico$ tjw dod not apply lo d os6 of
rtc pmF y trho boilde or imp.ov6 th6oq o.d who d(E sucn No.t,rirs.lto' h*lr or lhrou8h his o.h6os cmploye.
proriid rh.r soch imrnovmB @.or i,t6ld.d oroltod aor eL.Ii ho$o."s. tlE hrildins o, inlproYdd i! $ld sithin on. rd
ofcoq,Lrion. rh. OMo Buildd will harc ih. hndd of povng rhat hc or sh. did not tdild or imFov. thc p(opqty for thc purpos of
l. 6 otr n6 ollhc Drcpdr, m .xclusiv.ly contEcr ins vith licc6.d co.rracrou ro codru!-r rh. projd (s(. 704.4. B6ins
and ftoisbn Codq Th. Conlflcror's Li..6. Law do6 .or atply to e osn6 oaproFny trho builds or improv6 rhdon.
and vto conlra.ls for such Irojels wirh a Conr6clo(s) licd.d pu6@l ro lhc Co.lEclols LicN ks).
la cxenrpl undd Scrnnr ,li. & l'.C. tuthr r6on
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I hcreby aman undcr pcn0h! ofpsjuryoncoith. aolloslnE dela.alions:
I hav.adNillMi sinaCdificareo|Cons ro S€lal6u,e tor rvo'k.d cdnrpen$rion,6 Fovid.d for b, Sdion ]700 oflhc
I4oi Cod., tor rhc pefor:M.e of lhe qorh for whicn tht pmnil is issued
I havcand Nillmaintain *!lke.t conrpensation i 6 requned by s(rioi 1700 oi r h. Ijbor (nd., for the psfonnancc of
lhe wo aor which lhls pmril is isnred. My worked n inntrnNc rmir mJ l{,ln, ru. cr 4,.
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c.diiythar i.lhcpdfoi,nMc.ofth.Bork for s'hich lhis !trmit is issucd.l shall nol oaloy any pdson in dymmn6
e s lo beome subj€l lo lhc NrL6' comFsslion la$ olcalilomia, dd are Oal ia l 3horld bdo,n subjd Io thc
porlm compwlion poviei.N ols€clioa ll?00 oi th. ljbor Cod.. I shdl. fonh* nh conpl, {ith rhoF l,ovasions.
WARNING Failure ro su. work6' conp.rodion covda8. is unlaNtul. md shall subjd d 6plo,6 to dimin l pduhie md
civil nn6 up ro or. nudr.d t
Sdion 1076olth€ bbor Code
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00,Ju0r. rn add .on ro rhf.nn r (qnp.nqr'o.. danarB a pro\'ded ror rh.2 f2t'bul" mrv
IIOXSEDTOTINASOB
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I hd.b, allm undd p.nrh, olpdjury lhal I m licss.d und6 ,rovision olchlprg 9 (.od'n .cins with sario.7000) oIDivision l
oa rhc BGin6s md Profasio6 cod.. ed my licmc is in ltll lorce ond .ilect
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I h.cb, afiirm undd Fnahy oI psjury lhal rhqe is a mnsruclion k dins as6.y for inc pafomecc of th. *ork tor snich lhie ponit ;
issled (sd. 1097, Civ. c ).
AITLICANLDIC!6AAUA!
I nor4.Irm lndr paalty ofpgjuryonc oflhc fouowinr d(larationsl
D.,nolirion Pmts-Asb6tos Norincalion F.ddal R€gulations (Till. 40. Pan6)
Rqu;q] Laln ol Notifi.dion
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c6ti ry rnar thc icddal r.rulalioE csedins 6b6ros r@oval rc nor applicabl€ to rhG pmld.
<i(Inr,n, , **."0
'nis
0pplicarion md sar.rhar rhc.bvc inronnariotr iscor.cr.I arre ro conpry $irh .rr ciry and counry
ordilan.6 ed St.rc bwc elatin8 lo building coanruction. drd hseby aulhoriz. r.F.$rdiv6 oalhis Cn, ed Counlylo (ls upoo lh.
,\pplicatrt or Bort Sianrli o-({
Perfl itec nrnm (prinr): !<
t?tt
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subfloor/VenUl nsulation
Roof Sheathinq
Shear Wall
Framinq I 7 t{v.wil
lnsulation/Energy
Drywall I
Brown Coat
Masonry
Pool Fence
T-Bar t \,v-w
Handicap Req L
Deputy Final Report
Engineer Final Report
Flood Zone Certif
FINAL 5"1 "l )-"Fl-r(
Certificate of Occupancy " r17
Notes, Remarks, Etc.
ID/SIG.COMMENTS
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Policy Nudbd:LErpn6:
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