HomeMy WebLinkAbout10199620 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: {O199620
Pin #: 46359
Project Address: 1851 E First St
Assessor's Parcel: 400-071-02 Lot: POR 16
Unit:Btdg:
Tract: MAYBURY
Address Range:Suite Range:
Zoning: SD54Block: NA Historic: No
Building Use: High-Rise Commercial Occupancy: NrA 1st FL Area Patio:
Job Type: Signs Constr Type: NrA 2nd FL Area T.l.Area:
Nature of work: Monument sign code: cBc 2016 other Areas yards Req,d
Existing Bldg. & Use: Commercial btdg Flood Zone. X-O6O2320277J Garage Area Valuation:
Proposed Use: # of Stories: Total O
Description of Work New 4'2" x 10' monument sign for "Tower 1851 East First Street"; led-illuminated, bond posted on M-72503
Planning Conditions:
$15,000.00
i
Owner:
Address:
Phone:
Tenant
UBS/Xerox
1851 E First St
Santa Ana, CA 92705
(e4s) 3s0-5s31
Xerox Center
Contractor. Zee Sign Systems, lnc
Address. 8 Choate
lrvine, CA 92620
Phone: (949) 5524060
State Lic #: 450600
Lic Type: C45
Bus. Lic #: 346154
Workers' Compensation I nsurance:
Carrier: State Fund
Policy #: 0794117
Expires: 0110112020
Engineer: Sullaway Engineering
Address:PO Box 28789
San Diego, CA 92198
(858) 312-s150
48588
Architect /
Designer:
Address:
Phone:
License #:
Phone:
License #:
Planning Approval By.
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd: No
PWA lnsp. Req'd: No
Planning lnsp. Req'd: No
Landscaping lnsp. Req'd: No
Kelaher, Selena
Amsden, Julie
Hernan dez, Kathy
Date: 0312812019
Date: 0411712019
Date: 0412412019
Subject to Field:
Misc. Receipt:
Misc. Receipt.
Misc. Receipt:
07775002
07776002
07776002
07776002
07776002
57607
s3600
57672
57600
57607
Permit Fee
Plan Check Fee
BIdg. Stds. Revolving
General Plan Update
I ssuance
$160.2s
$1 1 1.08
$1 00
$22.08
$s5.04
Fire lnsp. Req'd:
Police lnsp. Req'd Account#
No
No Total
Ffood Zone Cert. Req'd: No 01 1 16002 51600
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within360 days afterifs rssuance,or if the work authorized
on the site by such permitis suspended or abandoned for a period of 360 days after
the time the work is commenced.
Temporary MID#: 201 9-150391
01 1 16002 51601
01116002 51612
01 1 16002 53600
$22.08
$zt 5 29
$1.00
$1 1 1.08 Fee Totat
Paid to Date:
Balance Due:
$349 45
$0 00
$349.45
I
BUILDING- INSPECTOR RECORD
Flev. 08-07-201
SITE-WORK DATE ID/S!G.COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bf loor/Ve nt/l nsu I atio n
Roof Sheathins
Shear Wall
Framinq
lnsu lation/Enerqy
Drvwall
Ext./lnt. Lath
Brown Coat
[\/asonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
I
Certificate of
FINAL
Notes, Remarks, Etc.
OWNER BUI LDE,R DEI,CA RA'I'ION
I hereby affirm untler penalty of perjury that I am exempt from the Contractors' License l-aw firr the following reason (.Sec.7031.5
Business and Profession Crxle): Any City or County which requires a prmit to construct, alter, improve. dermlish or repair any
structure. prirlr to its issuance, also requires the applicant for such Jrerrnit to file a signe<t staterEnt that he rlr she is licensed pursuant
to the pnlvisions of the Contractor's Licensed Law (Chapter 9, Commencing with ,Section 7fiD of Division -3 of the Business and
ProfessionsCrxle)orthatheorsheisexempttherefromandthehasisfortheallegedexemption. AnyviolatirtnofSectionT03l.5byany
applicant for a pernrit suhjects the applicant to a civil penalty of not rnrre than five hundred dollars ($5tXt1.
_1, as owner of the property, or my employees with wages as their srh compensat ion. will do the work and the structure is not
intended or offeretl frrr sale (Sec.7O44. Business and hofessions Code: The Ctrntractor's License Law does not apply to an owner of
the proJrerty whr tnrilds or impnrves thereon, and who tloes such wrrrk himself or herself or through his or her own empkryees.
provitled that such improvernents are not intended oroffered firr sah. If. hrwever. the huikling or inTrrovenrnt is sold within ('rne )Ear
of completion, the Owner Buikler will have the hurden of proving that he or she ditl not buikl or impmve the prof,erty for the pur;xrseof
sale).
_1. as owner of the property. am exclusively contracting with licensetl contract()rs t() construct the project (Sec. 7044. Business
antl ltofessirnCode:'fheContractor'sLicenseLawdoesnotapplytoanownerofpropertywhobuildsorimprovesthereon.
and who contracts for such pnrjects with a Contractor(s) licensed pursuant to lhe Contraclor's License Law).
-IamexemptunderSectirln-.B.&P'C.ftlrthisreason.
I)ute:( )u ltcr.
WORKERS' C(rMI'ENSA'|.ION
DECLAITA'I'ION
I herehy affirm under penalty of perjury one of the following declarations:
-lhaveandwill
maintainaCertifrcateofConsenttoSelf-lnsureftrrworkers'compensation.as pnlvidedforhySection.ST(X)ofthe
L^ahor Crxle, for the perfirrmance of the wrlrk frrr which the permit is issued.
_lhaveantlwill maintainworkers'compensationinsurance.as requiredhy.Section3T(X)ofthel,aborCode,fortheperformanceof
the work for which this permit is issued. My workers' compensation insurance carrier and grlicy number are:
Carrier:
Policy
_l certify that in the Jrerfrrrmance of the work for which this perrnit is issuetl. I shall not empkry any person in any manner
s() astobeconrsuhjectlolheworkers'compensationlawsofCalifrrrnia.anttagreethatif lshluldhecomesuhjecttothe
workers' compensation provisions of Section .17(X) of the Lrtxrr Crxle. I shall. forthwith comply with those pnrvisions.
WARNIN(): Failure to secure workers' compensntion coverage is unlau,ful. and shall suh.iect an employer ttl criminal Jrnalties antl
civil fines up to one hundred thousantl tkrllars ($l(n,(XX)). in addition to the cost of compensalion, damages as provided for the
.Section 3076 of the Lahrr Cotle. interest and attorney's fees.
l)ate : Applic:rnt:
LICENSED CONI'RAC'I'OR
DTCLARAI'ION
I hereby affirm under penalty of Jrcrjury that I am licensed under provision of Chapter 9 (comnrncing with Section 7Un) of Division 3
of the Business and hofesskrns Code. and my license is in full frrrce antl effect.
License Nunrber:
CONSI'RUC'I'ION LENDING AGENCY
I hercby aflirm under Jrnalty of perjury that there is a construction hnrling agency for the perfrrrmance of the work for which this Jrermit is
issued (Sec. 3()97, Civ. C.).
Lender's Name:
I )atr:: ('onlr:tctor:
Lender's Aeldress:
A PPLICAN'I' IIL,CLAR A'TTON
I her$y affnm under penalty of grcrjury one of the following declarations:
Derrxllition Permits-Asbestos Notification Federal Regulations (Title 4O. Part6)
-Required
Letter of Notification
_l certify that the federalregulations regarding tsbestos renrrvalare not applicahle lrt this project.
-l
certify that I have read this application and state that the atxrve information is conect. I agree to comply with all City and County
onlinances and State Laws relating to building construction, and herehy authrriz.e representatives of this City and County to enter uJxrn the
above mentioned property frrr insJrcction purynses.
Applicant or Agent Signaturt: Date:-
a