HomeMy WebLinkAbout10164881 - Permitcity of Santa Ana 20 civic center Plaza (M-19), santa Ana, cA 92702
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738
,-.--\ puilding Permit #:1016488{s
lnspector's Section: (7 I 4) 647 -5853
Project Address: 2000 N Fairview St
Assessor's Parcel: 101-652-13 Lot:
Unit:Bldg: Address Range:Suite Range:
Zoning: AlBlock: NA Tract:Historic: No
Building Use:
Job Type.
Nature of Work:
Existing Bldg. & Use:
Proposed Use:
Other
Miscellaneous
Preliminary Review
Church/Admin Bldg
Occupancy:
Constr Type:
Code:
Flood Zone:
# of Stories:
A-3
V B, SPK
cBc 2007
x-0602320144H
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area
Total:
Patio:
T.l.Area:
Yards Req'd
Valuation:
0
Bot,:lr*:gilj,j rtl5i lL/r-t? ID: uD(irf
0l {' ice: |:TYH I riins* r 1?7 I i;l
AccL*: Rr:l*: ltJl6tijil
FcptlrLftfSTri,ilt ' 5/Ll/?ltlt9 ?:12 f'fi'fronEuct ion ToLul $?1j. ,t-tt-t
Description of Work: Preliminary review for addn to existing church
Planning Conditions:
Wintersburg Prebstrian Church Of
2000 N Fairview Street
Santa Ana, CA 92706
(7141740-9400 ext.103
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
Engineer:
Address
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #:
r'/cirll . rr1
Ch,:clr
$92 i. . UU
ij,tr.,i.t:tt.i
[,] intersburs Frebstr inn (:hut'chOwner:
Address:
Phone:
Tenant:
54r-r1
I 1?n
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
PWA lnsp. Req'd:
Planning lnsp. Req'd:
Landscaping lnsp. Req'd
Date:
Date: 05/11/2009
Date: 05/11/2009
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
53433
077-07-s401 Hourly P/C
CI;ti''- '4'1^VI
Fee Total:
Paid to Date:
Balance Due:
$924.00
-l)qL4
$924.00
$77.00
..$e<+.oo
Chung, Ed
Morales, Ja
No
,"r,j t1.\
N
N
o
o
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No
Every permitissued shall become invalid unless the work on the site authoized by such permit is commenced
within 180 days after its lssuance, or if the wofu authoized on the site by such permit is suspended or abandoned
for a peiod of 180 days after the time the work is commenced.
Account #: 01 1-01-591 t lnspector Ir/tD#: 2008-83699
1L4
w
BUILDING. INSPECTOR RECORD
DATE ID/S!G.COMMENTSSITE.WORK
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
SubfloorA/enUlnsul.
Roof Sheathing
Shear Wall
Framing
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
f -94. 11 JJ.Sz bGr\FINAL
Notes, Remarks, Etc.
of
I lucby rff[m uoda pcillty of psjury rtut I u oxmpt form thc Cotra8dotr' Li6ro lrw fot thc followitrg roon (rrc.703 I . 5 Buinor
and prof*rioo Codc): Ary City or Couty which rc{uirs s pdmit to oEtruct' tlt6, improw, dcmolilh or rrleir rny !trug1ug prior to ii
itrut8!,rlsotcquirBthorppliontfornchpqmittofilcrtiSncdrtetmnt thathaorlhciliccNcd pulwttothoptovitiouofthc
Coilncror's LircruGd Lrw (Chrpt6 q Commcncint with Scction 7000 of DivirioD 3 of thr Buitr{ &d ProforbB Cod.) ot thlt hc or
shc is qcmpt thscfrom rnd thc brrir for tho rll6?cd qcmption .Any viohtion of Soction 7031.5 by any rppliont fot r Pmit subjcrt! the
tppliant to r civil pculry of not mrc tlln fivo hundrod dolhn (t500).
_I, I oms of thc proporty, or my cmploys with ugd r! thcir rclo comlcutio4 will do thc mtk md thc rtruawc i! not intmdcd
i?idtrcd for slc ( Si.zO44, AuilK ma Profqrions Codcr Thc Contr.Gtor'3 Licffi l:w do6 not rpply to m oma of tho proporty
who buildt or improva thao4 rnd who doo ruch work hiruGlf or hanolf or through hir or ls om ?mploy6, providcd lhrt ruch
improvcm@B r; rct intcndad or ofrdcd for slo. Iq howcv6, rhc building or improvcmcot ir sold whhin onc y{ of @mpletion, tlE
Ow.Buildq will hevc thc burdm of proviry that hc or rhc not build or improvc for thc purporc of rlc).
_I, u oma of thc propsty, tm qcluivGly ootrecing with lieucd @otfrctott to oilttuct thc projca ( Scc. 7044. Buinqr rnd
ffi'fcion Codq Tho Conmaor'r Liroc Lw dc mt rpply to u ow of propaty who builds or improva thcon , ud who
ontrras for ruch protcE with r Contr&tot(3) licmtcd puBuntto thc Cotttnclor't Lic@a ttw.).
-I
u cxempt unds Scciion & P.C for thi rcen
Date:
WORKERS COMPENSATION DECLARATION
I hocby rffum unda pcrhy of p<jury ono of tho follo*ing d*lentiou:
_thrvoudwillmrintrhrCcrtifiqEofcotrctrttosclf-IEutcforwr\ttr' @mpcMtiortu providcdforbyScaiotr3T0oofthc
ilbor Codc, for thc pqforronrc of thc work for which tho pcnit ir irsud
I h.v? ud will roitrtrin workan' @mpffition iNunDca, u 4quircd by Scction 3700 of thc lrbor Codc, for thc paformne of tho
-rcrk for which this pemit it i$ucd. My workd' omPcffitioE'irourane mkr rnd Policy numbs sro:
Clhis rclion mt bc @mglct d if thc Orc hundrcd or lcs)
t sdiry thrt in thc psrfomn* of thc wotk for which thir pa'mit ir imod, Ir}dl oot mphy roylmoa in anyMq rc r to
bcomc rubjcr to tho wrko ' ompcnltlon Lu of Crlifornie, rod rgre that if I rhouH bcom tubjst to thc wotk6'
ompcnruion proviriou of Scction 3700 of thc Lbor Codc,I rhdl, forthwith omply with thoro provilions..
WABIYING: Priluo to rcor6 mr&o' compsustion @w.gc ir unhwful, ud shlll tubj@t u Gmploys to Gimiill ponltis rnd civil
fina up o orc hm{rcd thoud dousr (81 00,000),in rdditiotr to thr olt of compcrutioq drmgcl u providcd fot tlE S*tion 3076 of
thc Lbor Codq intqBt ud rttomcy't fs,
I,TCENSED CONTRACTORS DECLAnATTON
I hssby rffirm undq pculty of pejury t}at I m lieucd undc provitbn of ChrptGr 9 (ommctroitrg with Sstion 7000) of Divirion 3 of
thc Buriru rod Profcriou Codc, rnd my liccuc ir iu full fore rnd offccl
chs: Licoroe Numba
ihacby"ftirmundup.Dltyofp6juryt,ht*,ffirronmofthcworkforwhichthi!pqmitit
i$uci (Se. 3097,
Lcnds'r Ntmc:
Civ. C.).
knda'r Addrru:
AITIJCANIILDECIiASAIION
Dcmlition PamiB-Arbstor Notiliotion Fod.nl RcgulstioB (Titlo 40, Prn 6)
_ Rcquircd lrttr of Notifiotion
to thir projoct
with ell City ad Couty
rbovc mcntioned
Applient or a
Pcrmitt€ Bma v
for
rcgrrding aro
rrd to 6ts upon tho
!