HomeMy WebLinkAbout101104539 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: {O1104539
Pin #: 55482
Proiect Address: 3800 S Flower Sta
Assessor's Parcel: 410-291-02 Lot: NA
Unit:Bldg:Address Range: 3800-3928
Historic: No
Suite Ranger G, M, L
Zoning: R4Block: NA Tract: NA
Building Use: Multi-Family (5 or more units) Occupancy: R-2 1st FL Area:
Job Type: Alteration Constr Type: V A 2nd FL Area:
Nature of Work: Balcony Repair/sliding Glass psel Code: CBC 2019 Other Areas:
Existing Bldg. & Use: Apartments Flood Zone: X-0602320259J Garage Area:
Proposed Use: # of Stories: Total: O
Description of Work: Repair balcony and change out sliding glass door, per Master Plan plan check on 101102303.
Planning Conditions:
Patio:
T.l.Area:
Yards Req'd:
Valuation: $15,000.00
Owner:
Address:
Phone:
Tenant:
Prime & South Coast L P
50 California St 920
San Francisco, CA 9411 14606
(662) 643-7712
Contractor: GRS Construction lnc
Address: 421 S Brookhurst Street, #1i
Anaheim, CA 92804
Phone: (480) 808-0040
State Lic #: 1036367
Lic Type: B
Bus. Lic #: 375156
Workers' Compensation I nsurance:
Carrier. State Fund
Policy #: 9271129
Expires: 0310612021
Engineer:
Address:
Phone:
License #:
Architect /
Designer:
Address:
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 Insp. Req'd: No
Orozco, lvan
Verduzco, Vio,"N
Date: 0211912020
Date:
Date. 09/01 12020
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
07776002
07776002
0 777600 2
0 77760 02
0 77760 02
57607
57770
57672
57600
5760 7
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
$1,035.94
$4 05
$1 00
$23 7e
$59 30
Frre lnsp. 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 57770
Account#Total
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 days after its issua nce,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.
$23 79
$1 ,095.14
$1 00
$4 0s Fee Total:
Paid to Date:
Balance Due:
$1 ,123.98
$0 00
$1 ,123.99
lnspector rurD#. 2019-156049
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS OWNIiR BUILDER DEI,CARATION
I hcreby affirnr under penalty of perjury that I am exempt from the Cbntractors' l-icense l-aw for the following rcason (Sec.7031.5
Business and Prol'cssion Code): Any City or County which requires a permit to construct. alter, improve, dermlish or repair any
strucrure, prior to its issuancc. also rcquires the applicant for such pernit to fih a sigrred .slaternent that hc or she is licensed pursuanl
to thc provisions of thc Contraclor's l.icensed law (Chapter 9. Commencing with .Scction 7000 of Division 3 of the Business and
Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Sectbn 7031.5 by any .
applicant for a perrnit subjcct.s thc applicant to a civil penalty of not nnre than five hundrcd dollars ($5001.
_1. as owncr of thc property. or my cmployees with wages a.s their sole compcnsation, will do the work and the structure is mt
interxletl or offered for sale (Scc'.7(X4, Business and Profession.s Codc: The Contractor's Liccnsc Law tlocs not apply to an owner of
the property who builds or improves thereon and who does such work himself or herself or lhrough his or her own employees,
providcd that such improvenrcnts are not intended or ollered for sale. Il. however, thc building or irprovenrcnt is soH wilhin one ),ear
of conrpletion, thc Owncr Buikbr will have the burden of proving that hc or shc did not builJ or improvc ttrc propaty for the purposc of
sale).
_1. as owner of the property, am cxclusively contracting with licensed conlr&clors to conslruct the pmjcct (Sec. 7044, Busincss
and Prollssion Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon.
and who contracts for such projects with a Contractor{s) licensed pursuant to thc Contractor's License t aw).
-IamexemptunderSection-'B.&P.C.lbrthi.sreason.Dale:
WORKERS' COMPI:NSATION
DECLARATION
I hercby aflirm under pcnalty of perjury one of the following declarations:
_l have ard will maintain a Certifrcate of Consent to Self-lnsurc for workers' compcnsalion, as provided for by Section 3700 of the
Labor Code. for the pcrformance ofthe work lor which the pcrmit ls issued.
Kand will maintain workers' compensation insurance, as required by Section 3700 of the l-abor Code, for the perfonnancc of
thc work tbr whiclr this prmit is issuct.workers' compcnsation insurancc carricr arxl gtlicy numbcr are:
te
Policy ZI
not enrploy any lrcrson in any mannet
if I should become subjcct to the
comply with those provisions.
WARNING: Failurt: to sccurc workcrs'comlrcnsation coverage is unlawful, antl shall subjcct an cmployer to criminal pcnalties and
civil lines up to one hundrcd thousand dollars ($l00.Um), in addition to the cosl of cornlrcnsation, damages as provided for thc
Section 3076 of the l-abor Code, interest and attorney's
I hereby allirrn undcr pcnalty of perjury that I am licensed ol'Chaptcr 9 (cornrnencing with Section 7000) of f)ivision 3
of the Busincss and Professions Codc, anl my license is in full force arxl clfect.
License B Numbcr:36 3/
I hercby atlirm under pnalty of perjury tlut there is a construction lending agency frrr the performance of the work lbr which this permit ls
issuccl (.Scc. 3097, Civ. C.).
Lendcr's Nanrc:
knder's Address:
APPLICANT DECLARATION
I My affrm under penalty of pcrjury one of the following declarations:
Denrolition Permits-Asbestos Notification Federal Regulations (Titlc 40, Part6)
-Required
lrtter of Notification
_l certity that thc federal regulations rcgarding asbestos renmval are not applicable to this projcrt.
state that the above information is correct. I with all City and County
and County to enter upon thc
atxlvc mcntionctl propcrty lirr inspcction
Applicant or Agcnt \
Pemritee nanlr
orru, ?- / - Zb
Set Backs I Ir-,
Forms/Steel/Holdowns qlttlze Wru ,-T
Erection Pads U
UFER Ground
SLAB Floor
Su bf loor/Ve nVl nsu latio n
Roof Sheathinq
Shear Wall I
Framino hlz.t ltu)0tf7r2 2
lnsulation/Enerqv l- t /
Dqtwall
(ExJlllnt. Lath lol?.1 lu)An-Ht l-
Erown Coat
Jt/asonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Enqineer Fina! Report
Flood Zone Certif
I
FINAL tt I4/t o DA'+r
Certificate of Occupancy
Notes, Remarks, Etc.
Rev. 08-07-2015
7 orr* Q- /- L2
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