HomeMy WebLinkAbout101103752 - PermitProiect Address: 200 W Santa Ana BIvd-a-
Assessor's Parcel: 398-253-06 Lot: 1-10
Unit: 100 Bldg: Address Range:
Tract: TOWN OF SANTA ANABlock'. 20 Historic: No
Suite Range:
Zoning: SD84
i City 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 #: {O1103752
Pin #: 66469
Building Use: High-Rise Commercial
Job Type: Tenant lmprovement
Nature of Work: T! - Partion Walls
Existing Bldg. & Use: Commerical/Offices
Proposed Use:
Occupancy:
Constr Type:
Code.
Flood Zone'.
# of Stories:
B
I A, SPK
cBc 2019
x-0602320276J
1st FL Area
2nd FL Area
Other Areas:
Garage Area
Totat
Patio:
T !.Area: 1100
Yards Req'd
Valuation: $S0,000.00
0
Description of Work: Remove/add non-bearing walls/doors to create offices and conference room.
Planning Conditions: lnterior Tl only. No exterior alterations/modifications.
Owner:
Address:
Phone:
Tenant
Santa Ana CA Ii Sgf LLC
1 N Wacker Dr /i4;O25
Chicago, lL 60606
(800) 91^4887
HCA
Contractor: H LMillerlnc
Address: 2201 E Winston Road
Anaheim, CA 92806
Phone. (7141 998-8699
State Lic #: 385912
Lic Type: B, C-33, C-6, C-39
Bus. Lic #: 2631
Workers' Compensation I nsurance:
Carrier: Falls Lake Fire & Casualty Compal
Policy #: FLA008988
Expires: 0410112021
Engineer:
Address:
Phone:
License #:
Architect /
Desiqner:
Address:
Phone:
License #:
3JK Design
1907 N Woodside Street
Orange, CA 92865
(7141 709-7934
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
Arechiga, Liana
Ahangian, Kat ^\r/Zuniga, Allissa $
Date: 1010612020
Date. 09/1 512020
Date: 1010T12020
Subject to Field:
Permit Fee
Plan Check Fee
Accelerated (per hr
Microfilm Records
SMIP - Category 2
Bldg. Stds. Revolving
Genera! Plan Update
lssuance
Account#
74446
Total
07776002
07776002
05376002
07776002
08907007
07776002
07775002
07776002
57607
53500
53537
57770
24000
57672
s7500
51607
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
$297.00
$407 00
$1s3.39
$32.40
$14 00
$2.00
$23.79
$59 30
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within360 days after ifs issuance,or if the work authorized
on the site by such permit is suspe nded or abandoned for a period of 360 days after
the time the work is commenced.
lnspector MID#: 2020-1 59 112
Fire Insp. Req'd. No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No 01 1 16002 51600
01 1 16002 51601
01116002 51612
01 1 16002 s3600
01 1 16002 57770
05316002 53637
08901001 24000
$23.7e
$3s6.30
$2.00
$11 00
$32 40
$153.39
$ 14.00
Fee Total
Paid to Date:
Balance Due:
$e88.88
$3e6 00
$592.88
tI
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bf loor/Ve nt/l nsu lation
Roof Sheathing
Shear Wall
Framinq I I q
I ?/0 DftTfl
lnsu lation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
[\Iasonry
Pool Fence
T-Bar
Handicap Req.
Deputv Final Report
Enqineer Final Report
Flood Zone Certif .
I ,l
FINAL (0l (/Dftqq
Certificate of Occupancv tt
Notes, Remarks, Etc.
TION
I hcrcby atfirm undcr Fnalty ot Frjury that I am cxcmpt from lhc Conlrack)s' Liccns Law lirr thc following rcavlr (Scc.70.ll.5
EusiDcss arxl Protbssi()n Culc): Any City or County which rcquics a trmit to conslruct. altcr. improve. dclq lish or n1Q any
structurc, prior k) its issu{ncc, also rcquircs thc applicanl lirr $uch Frmit lo lilc a signed slatemnt that hc or shc is licenrcd pursuatrt
k) thc pruvisions of lhc Cotrtraclor's Liccnscd llw (Chaplcr 9, Commncing wilh SNlion 7fi)0 of Division .l of thc Busircss and
Prutbssions Codc) or that hc or shc is cxempt thcrcltom and lhc hrsls lirr the alleged ercmfli(rn. Any violation of Sectitm 70-l 1.5 hy any
applicant l()r a lrcmit subjccts thc applicanl kr a civil pcnally of not m)rc thar five hundrcd dollars ($500).
_1. as owner of thc propcrty, or my cmployccs with wagcs as thcir sole compensation, will do thc work and thc slructurc is ltttt
intcnlcd or oU'ercd ftlr salc (Sec.7(X4, Busincss and Pnrfbssions Culc: Thc Contractor's Licensc Law dtrcs not apply to an owner of
the pnrpcrty who huilds or inrprovcs thcreolr, antl wlxr drrcs such work hinrsclf or hcrscll'or thrrugh his or hcr owlt cmployccs.
provirlcrl that such improvcrncnls arc mrt intcrulcrl or ollbrctl lilr sah. Il, howcvcr, thc buiLling or improvcrncnt is sokl withrn onc ycar
ol'complction, tlrc Owncr Buildcr will havc thc burdcn o[ proving that hc rlr shc did rxrt build or impnrve thc pnrperry lbr thc purprsc ol'
salc).
_1. as owncr ol'thc pnrpcrty, am cxclusivcly corrtracting with liccnscd contractors lo conslruct thc prcjcct (Scc. 1OM, Busincss
and Pnrtbssiln Codc: Thc Contractor's Liccnse Law docs not apply lo an owncr of pro;rcrty who builds or improvcs thcreon,
und wlxl contracts lbr such projccts with a Contractor(s) liccnscd pursuant to thc Contractor's Liccnse Law).
-IamcxcmptundcrSectiolt-,B.&P.C.forthisreastrn.
lV( )RKT:RS' COI\ I PENSATION
I)ECI,ARATION
I hcrchy al'l'irm urtrlcr Jrcnalty ol'Jrcrjury onc of thc tirlkrwing declarations:
_l havc and will maintain a Ccrtilicatc ol'Conscnt to Scll'-lnsurc tor workcrs' comJrcnsation, as pnlvidcd titr by Scction .37fi) of thc
Latxlr Culc. tirr thc pcrlirrmancc of thc wrlrk for which thc pcrmit ls issucd.
_l have antl will maintain workcrs'comJrcnsation insurancc, as retluirctl hyScrtion 3700of thc LaborCodc, lilrthc Jrcrlirrmanccof
thc wrlrk is compcnsation irrsurattcc carricr and Jxrlicy nunrhcr arc:this pcrmit
IV e c
I'olicy
{ ccrtity that in thc Jrcrlilrmance ol'thc wrlrk tirr which this Jrcrmit is issucd, I shall mlt cmpkry any lrcrson in any manncr
s6 iNto bccomc sub.jcct to lhe wrlrkcrs' cornJrcnsation laws of Calitilrnia, and agrcc that if I shoultl becomc sub.icct ttl thc
workcrs' comJrcnsation pnlvisions of Scction 3700 of thc Lrtxlr Crxle. I shall. lorthwith comply with thosc provisions.
WARNIN(i: I:ailurc li) sccurc wrlrkcrs'
civil lincs up to onc huntlrcd tltousanrl
is unlawlirl, and shall suhjcct an cmploycr to crimittal Jrcnaltics and
damagcs as providcd for thctrt thc cost (rf
Scction 3076 C<xlc, intcrcst and
I hcrcby al'lirm undcr pcnalty of ;rcrjury that I anr undcr provision ol'Chaptcr 9 (comnrcncing with Scction 7firu) ol'Division .l
of thc tsusincss and Prol'cssions Codc, arxl my liccnsc is in full tilrcc arxl cthct.
1
[-iccnsc Z
I hercby allirm undcr Jrcnalty of prjury that thcrc
issucd (Scc. 3097, Civ. C.).
lrndcr's Namc:
agcncy firr thc Jrcrlbrnrancc of thc work tbr which this Jrcrmit is
lrnrler's Address:
APPLICANT DECLARATION
I hcrcby allinn under 1**nalty of Jrcrjury onc of thc ltrllowing declarations:
Demolition Pcrmits-Asbcstos Notification Fcdcral Rcgulations ('l'itlc 40, Part6)
-Rcquircd
l,cttcr of Notilication
_l ccrtily that the' lbdcralrcgulatiuns rcgiuding ashcstos rcnxrvalarc not applicablc lo this projcct.
-l
ccrtfrhat I havc rcad this application arxl statc that thc ahrvc intirrmation
rlrdinanccs and Statc Laws rclating to arkl
atxrvc mcntioncd pnrpcrty tirr
Applicant or Agcnt
Pcrnritce nanre
with all City and County
altd to cnlcr ugln lhc
Parr nP.-n7-2n1q