HomeMy WebLinkAbout101102297 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Building
PermitCounter: (714)647-5800 lnspection Requests: (7141667-2738 lnspector Section: (714)647-5853
Permit #: {01102297
Pin #: 173s({
Proiect Address: 1666 N Main St-a-
Assessor's Parcel: 005-153-19 Lot: NA
Unit:Bldg. Address Range:Suite Range:
Zoning. SP3Block: NA Tract: NA Historic: No
Building Use: ultl-Famlly (5 o. moro unit ) Occupancy: NrA 1st FL Area Patio:
Job Type Sions Constr Type NrA 2nd FL Area T.l.Area:
Nalure of Woak Sions Code: cBc 2015 OlherAreas yards Req,ct
Existing Bldg. & use: Fiood zone: x{602320163J carage Area vetuafion: g2,ooo.oo
Proposed lJse: # of Stories: Totat O
Ooacription of Work Installation of (2) non-illumineled w.ll sign., (1) lor "S.ntr An. Art3 Colleclive", & (l) ior "G.llory", bond pald on ir-73797
Planning Conditions:P,nt,-h*:5-115A
Owner.
Address:
Phone:
Tenant
Santa Ana Afts Collective, LP
1640 S Sepulveda Blvd, Suite 425
Los Angeles, CA 90025
(310) 575-3543
Contractor: LA Signs & Banners
Address. 11902 Woodruff Ave
Downey, CA 90241
Phone: (562) 803-1988
State Lic # 930147
Lic Type: C-61 , O42
Bus Lic #: 344889
Workers' Compensation lnsurance:
Carrier. Hartford lnsurance
Policy #: 72WBCEV6692
Expires. 0110512020
Engineer:
Address:
Phone:
License #:
Architect /
Designer.
Address:
Phone:
License #:
Pfrepgl
1 1 l60Lr2
u r 1d ins
I I 161102 3 I Or-r I UUt-r -
F:evolv ins
5161 20lru-
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp. Req'd:
Planning lnsp. Req'd.
Landscaping lnsp. Req'd
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No
Graham, Jeffery
Amsden, Julie
Hernan dez, Kathy
Date: 1112012019
Date: 1112112019
Date: 1112512019
Subject to Field:
Misc. Receipt:
Misc Receipt:
Misc Receipt
0L1-76002 51601 Permit Fee
07776002 53600 Plan Check Fee
07775002 57770' Microfilm Records
01,7L5002 57672 Bldg. Stds. Revolving
07775002 s7600 General Plan Update
07776002 57607 lssuance
Fee Total
Paid to Date:
Balance Due:
$166 53
$115 44
$23 46
$1 00
$22 95
$57 20
$386 58
$0 00
$386.58
No
No
No
No
Account#Total
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within360 days afterifs 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.
01 1 16002 51600
01 1 16002 51601
01116002 51612
01116002 53600
01116002 57770
$22 95
$223 73
$1 00
$1 15.44
$23 46
lnspector MID#: 2019-156012
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BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/S!G.COMMENTS OWNER BUILDER DELCARATION
I hscby aflim undo ymalty of perjury that I m crempt from thc Contraclos' Licffe lrrv for thc following r@n (Ss.7031.5
Bsin6s md Profxion Codc): Any City or County which rcquiro a pcnnit to costruct, altc. improve. dcmolish or repair any
structurc. prior to its isuancc. aho rcquirG the applicant for such pennit to filc a sigtrcd starmot that hc or shc b licfisd puEuilt
to thc prcvisioG of the Contraclor's Liccnscd Law (Chaptq 9. Commcncing with Sction 7000 of Division 3 of the BNins ild
Prcfc$ions Codc) or that hc or she is cxcmpt thqcfrom dd the basis for thc allcgcd exmplion. Any violation ofScrrion 703 I .5 by any
applicantforapcnnitsubjetsthe applicanttoacivilpenaltyofnotmorclhufivchundreddollas($500).
. __1. as owner of the properly. or rny ernployees with rvages as their solc compensation. will do the rvork and the struclure is not
intended or offered for sale (Sec.7044. Business and Professions Code: l'he Contractor's License Law does not apply to an owner of
the prnperty who builds or irnproves therqrn. and rvho does such u,ork hinrself or herself or through his or her own employees.
provided that such irnprovanents are not interded oroffered for sale. lf. hou'e','€r. the building or imptovetnent is sold within one year
of cornpletion. the Owner Buildcr u.ill have the burden of proving that he or she did not build or improve the propory for the purpose of
sale),
_1. as owner of the properly. am exclusively contracting rvith licensed contraclors to construct the project (Sec. 7044. Business
and ProfEssion Code: The Contractor's License Law does not apply to an os'ner of property rvho builds or improves thereon.
and who contracls for such projects rvith a Contracto(s) licensed pursuant to the Contraclor's License Lau').
_l am exempt under Section_
-,
B. & P.C. for this reason.
I )rl t':0wner'--
WORK ERS' COI\I PT]N SA'I'IO N
DECl,ARA'tION
I hereby afTinn under penalty of perjury one of the follorving declarations:
,-l have and rvill rnaintain a Certificate of Consent to Self-lnsure for rvorker':s' compensation. as provided for by Section .3700 of the
Labor Code. for the pei'formance of the rvork for rvhich the pennit is issued.
_l have and s'ill maintain rvorkers' cornpensation insurance. as required by Section -1700 of the l-abor Code. for the po'formance of
the work for which this permit is issued. My s'orkers' compensation insurance ciurier and policy number are:
_ I cerlify that in the pcrforlnance of the rvork for which this pennit is issued. I shall rrot ernploy any person in any manner
so as to become subject to the rvorkers'compensation larvs of California. and agree that if I should become subjecl to the
w,orkers' compensation provisions of Section 3700 of the l,abor Code. I shall. forthrvith comply rvith those provisions.
WARNING: Failure to secure rvorkers' cornpensation coverage is unlarvful. and shall subject an onployer to crirninal penalties and
civil fines up to one hundred thousand dollars (S100.000). in addition to the cost of compensation. darnages &s provided for the
Section -3076 of the Labor interest and attorney's fees.q
I hereby afllrrn under penalty of perjury that I arn licensed under provision of (-hapter 9 (commencing rvith Section 7000) of l)ivision -3
of the Business and Professions Code. and my license is in full force ard efTect.
License Class:-
l)ntc:
CONSTRUCTTON LENDING AGENCY
I hrcby affm undo pcnalty of pcrjury that th@ is a @nsruclion knding agocy for thc perfomce of thc work for vhich Ihis permil b
issucd 1Se. 3097, Civ. C.).
I.ender's Narne:
Lender's Address:
APPLICAN'I' DI:(:LARA'TION
I ho'crby alfirrn under pcnalty of pcrjury one of the following declarations:
I)erno lition Perrnits-Asbcrstos Not i fi cat ion Federal Regulat ions ('Iit le 40. Pan6 )
_Required Letter of Notification
_l cerrify that the federal regulations regarding asbestos removal are nol applicable to this project.
I c6tiry that I have red this application ild state that the above infonnation is const. I agrc lo comply with all City 8nd County
odinancB ild Statc krvs rclating to building corotruoion. md hseby authorizc rc!tr66tariv6 of this City nd County lo ql6 uponlh€
above mentioned property for inspection
,\11;llicalrt or Agcrtt
l)ermilee narne (print):-+t/1/-
Date:-!W4l)a?
Set Backs
Forms/Stee!/Holdowns
Erection Pads
UFER Ground
.SLAB Floor
Su bfloor/VenUl nsu Iation
Roof Sheathing
Shear Wall
Framinq
lnsu lation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif.
FINAL /zd7- /?F. c /5^'c da; e 17
Certificate of Occupancy
Notes, Remarks, Etc.