HomeMy WebLinkAbout10195741 - Permitcity of Santa Ana 20 civic center Plaza (M-19), santa Ana, cA 92702 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714],647-5853
Permit #: {O{9574{
Pin #: E7695
ryProject Address: 420 W Central Ave
Assessor's Parcel 410-022-26
Suite Range:
Zoning: Ml
>4
Block: NA Tract: NA Historic: No
Building Use: lndustrial Occupancy: M 1st FL Area: Patio:
Job Type: Tenant lmprovement Constr Type: lll B, SPK 2nd FL Area: T.l.Area:
Nature of work: lnterior door code: cBc 2016 other Areas: yards Req,d: 4@40
Existing Bldg. & Use: Industrial building Flood Zone: X-0602320277 J Garage Area: Valuation: $10,000.00
Proposed Use: Medical marajuana dispensary # of Stories: , ,o,",,
Oescription of Work: lnstall door in existing demising wall to a new access hallway and a new exterior doorway opening serving the hallway.
Planning Conditions:
Owner:
Address
Phone:
Tenant
Burtin Manufacturing
420 W Central Ave
Santa Ana, CA 92707
17,t41270-1390
Therapeutic Hemp lnc
Contractor: R J S J Corporation dba R J
Address: 6102 E Paseo Rio Verde
Anaheim, CA 92807
Phone: (714) 981-6589
State Lic #: 928192
Lic Type: B
Bus. Lic #: 369993
Workers' Compensation lnsurance:
Carrier: California lns Co
Policy #: 458534001
Expires: 0410112019
Shahrokh
Shahrokh
E Radvar, P E
E Radvar
Address
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
Fire lnsp. Req'd:
Police lnsp. Req'd
0 77 76002
01176002
0 77 76002
08 9 0 7007
07716002
0 77 7600 2
0711600 2
57607
53600
5?770
24000
57612
5 7600
57607
Permil Fee
Plan Check Fee
l\4icrofilm Records
SNiIP - Category 2
Bldg Stds Revolving
General Plan Update
lssuance
Mar, Escarlet
Kwak, Jason
Date: 03/05/2018 Misc. Receipt: 70725
Dale:0711112018 tv'!isc.Receipt:
Date:07/.11/2018 lvlisc.Receipt:
Subject to Field:
No
;;" Account# Total
$160.25
$222.16
$7 .52
$2.80
$1.00
$22.08
$55.04
Landscaping lnsp. Req'd: No Flood Zone Cert. Req'd: No
Every permit issuod shall become invalid unless the work on lhe site aulhorized by
such permil is commenced within 180 days after its issuance,or if the wo* authonzed
on the site by such permit is suspended ot abandoned fot a period of 180 days atler
the time the wo* is commenced.
01 1 16002
01 1 16002
01 't 16002
01 1 '16002
01 1 16002
08901001
$470.85
$213.86
$256.99
lnspector MtD# 2018-141782
5't600
51601
51612
53600
57770
24000
$22.08
$215.29
$1.00
$8.30
$7 .52
$2.80
Fee Total:
Paid to Date:
Balance Due
LoI NA
Unit:Bldg: Address Range:
Engineer;
6412 Tulagi Street
Cypress, CA 90630
(7141270-6780
66139
rt
rlFdnl
r rirtitl.
5tr1r,rur_
vo 1v ir
Amsden, Julie
BUILDING. INSPECTOR RECORD
SITE-WORK DATE COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loor/Vent/lnsulation
Rool Sheathinq
Shear Wall
Framing I ht/tl e,t9v* /a
lnsulation/Enerqy k lb'rlil F nrffiJ "t)
Drywall tl:lo.-lY ut+li\
Ext./lnt. Lath
Brown Coat
Ir/asonry
T-Bar
Handicap Req.I
Deputy Final Report
Engineer Final Report
Flood Zone Certif
YAsrllV ka--'ttlt0ltr I
Certificate ol Occupans\L-- '/' '' 't
Notes Remarks
r--'-- v7L-,.1
, Zc-o*.--z'f)-- -/to-/')t,
4-- -I_r7 r 7 vc- .7
7
OWNER BUILDER DELCARATIoN
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inrcnrrcrl orotfcrcd atr elc (Sc..TOl.4, Burin.ssund Prefcrsions Codc lhc()nrracktr\Li...\clrwdocsnor0ndyro!oo*ncror
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and Aofssi Codc: ThcConkldolsLilctrsc Law docs nol applyro M osncr .f fiopcny eho builds or imt]rclcs lll.rcon.
xnd sho conhc( for such l,nick wnh ! Cofimcto( s) lacnsd purulnr lorhcConklck s Liccnsc tjnl.
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workcH' cumpcnsrion fmvniotrs of Sccl ion 1700 of rhc lih, A)d.. I \h,ll. tonhwith conuly wirh rho{ Pbvisions
WARNINC hilure lo sue w.rke6 $nltc ern,n $\cm8. ( u.lawful. md sh3ll sul,iccr an.mpbltr ro diminrlpcnrnts rnl
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DEQASAI]AN
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C!]ISISIJIITQN.LINDINIAGTN1:I
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i*ucd (Sc..3097, Civ. C ).
AfILICANLIIEII.A.BAIIO!
I ltEby rnim undcr p.trlllyofpcrjuryonc oarhc rolbwins dc.lfsrions
D.nmliri.h Pcrmir+Ashstos Norificarion Federal Rcgllalnns (Tirlc 40, P.d6)
Rcqut.d t trcro, Notifrcation
_l ccnily rhlr rhe f.{crd rcguhrnJnr dgedinE ashcsros rcnbrald. nol appliublc b rhh Pmjccl
l.clili rr llNc rcMlhn amliqrn,n hai rhc rti,k i'rronmrn i\.otrc.r I ll3r$bconlPlysirhrll Ciryttrd C.unry
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