HomeMy WebLinkAbout101100824 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Building
PermitCounter: (714)647-5800 inspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: 1O11OO824
Pin #: 99804
Unit:Bldg: A.ddress Range:wProiect Address: 3540 W Warner Avea
Assessor's Parcel: 414-231-11 Lot: POR 7 Block: NA Tract: 1024 Historic. No
Suite Range.
Zoning: M1
Building Use:
Job Type:
Nature of Work:
Existing Bldg & Use:
Proposed Use:
Commercial
Miscellaneous
Walk-ln Freezer
Commercial/Retail
Occupancy:
Constr Type:
Code:
Flood Zone'
# of Stories:
B, S-1
ilt B
cBc 2016
x-0602320258J
1st FL Area
2nd FL Area
Other Areas:
Garage Area:
Totat
Patio:
T.l.Area:
Yards Req'd
Valuation: $1 80,000.00
0
Description of Work: lnstatt walk-in freezer (4839 sq feet)/roof mounted equipt
Planning Conditions:
Owner:
Address:
Phone:
Tenant
Minh's Market
3450 W Warner
Santa Ana, CA 92704
Contractor: A-Temp Refrigeration, lnc
Address: 9311 Fern St
South El Monte, CA 91733
Phone: (626) 350-8393
State Lic #: 648603
Lic Type: C-10, C-38
Bus. Lic #: 374804
Workers' Compensation lnsurance:
Carrier: CHUBB INDEMNITY INSURANCE C
Policy #. 2071772234
Expires' 1110112020
Engineer:
Address:
Phone:
License #
Architect /
Desiqner:
Address:
Phone:
License #:
Michael Chen
Michael Chen
642 E Dewey Av
San Gabriel, CA 91776
(626) 288-5568
Michael Chen
Michael Chen
642 E Dewey Av
San Gabriel, CA 91776
(626) 288-s568
a
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
Graham, Jeffery
Scott Fazekas
Zuniga, Allissa
Date: O1l0gl2020
Date: 0110712020
Date: 0110912020
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
No
No
No
No
Account#
73225
Total
0 77L6002
07776002
0777600 2
08907007
0 77750 0 2
0 77750 0 2
07776002
57607
s3600
57770
24000
57672
57500
57607
Permit Fee
Plan Check Fee
Microfilm Records
SMIP - Category 2
BIdg. Stds. Revolving
General Plan Update
I ssuance
Fee Totat
Paid to Date:
Balance Due:
$333 06
$461 .74
$23 46
$50 40
$8 00
$22 95
$57 20
$9s6 81
$461 74
$49s.07
Fire lnsp. Req'd: No
Police lnsp. Req'd. No
Flood Zone Cert. Req'd: No
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 days after ifs 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
01 1 16002 51600
01 1 1 6002 51 601
01116002 51612
01116002 57770
08901 00 1 24000
$22 95
$390 26
$8 00
$23 46
$s0 40
lnspector MID#' 2019-153063
BUILDING- INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hcrchy atlirm undcr Fnally of pcrjury that I m cxcmpl lrom thc G)ntractoN' Liccnsc [aw for thc tblloeing rcaon (Se.7)] 1.5
Business anrl Profcssion Cqlc): Any City or County uhich rcquircs a pmit lo conslrucl, altcr. improvc. demlish or rcpair any
structurc, prk)r to its issuancc, .lso rcquircs thc a{rplicmt for such lrrmit lo l'rlc a siSncd slalcmnl lhal lE or shc is lien$d Pmuanl
to the la)visions of thc Contractor's Liccnscd [:w (Chaptcr 9, CommcncinS wilh Sstion 7000 of Division 3 of the Busincss and
PrufessionsCqlc)orthathcotshciscxcmptth€rcfromandthcb.sisforthcallcgcdcxcmption. AnyviolationofsetitnT0ll.5byany
applicanl tbr a pcmil subjets thc applicant to a civil penally of nol morc than livc hundrcd dollars ($500).
_1, as owrcr olthc pNFrty, ot my cmpkryes with wages &s thcir solc comlrcnsati(rn, will do ttE wqk afil lhc strulrc is noI
intcDlql or ollbrcd f(rr slc (Se.?044, Busincss md Profcssions Colc: Thc Glntrackrr's Licus llw d(Es not apply to m oercr of
thcpn)Frty wlx)huilds()rimpmrcslhcBln.arlwhod@ssrehu)rkhimscllorhcrclforthn)ughhisorhcromcmployccs,
provided that such impR)vcmnts N not inlerxldl orofibrcal for sb. Il; tx)wcwf, thc huildin8 (tr imFowmnt is rcll wilhm orc )a[
of complcti)n, thc Owncr BuiLlcr will haw the burdcn of provin8 that hc or shc did mt builJ or impmrc thc pm[Hty for thc purFrc of
eb).
_1, al owncr()l thc lm)lrcny, am cxclusivcly contracting with liccnsd cohlrackrs lo construct thc In jccl (Sec. 7(X4, Businc*s
anrl PnrtbssirnCorlc:'fhcG)ntracbr'sLiccnscLawd@snolapllytoanowncrofp()lrcnywhohuildsorimpnvesthercon,
and who qlnlracts lor such prujsts with a ContEcto(s) li@nsed pursuanl k, lhc C(rilrucklr's l.iccnsc Law).
I am cxcmDt unrlcr Selion-, B, & P.C. Ibr this rcason.
IVORKERS' CONTPENSATION
DECLARATION
I hcrcby all'irm undcr Frcnalty of pcrjury onc o[ thc lbllowing dcclarations:
_l havc arxJ will maintain a Ccrtilicatc of Conscnt to Self-lnsure tbr workcrs' compcnsation. as provided tbr by Section 17ffi of the
Labor Crxle, tor thc Jrcrlbrmancc of the work tbr which the grcrmit ls issucrJ.
_l havc and will maintain workcrs' compcnsation insurance, as rcquircd by Scct ion -17fi) of lhc [:bor Ctldc, for the Jrcrftlrmancc tlf
the work tbr which this prmit is issued. My workcrs' compcnsation insurancc carricr arxl pllicy numbcr are:
c t7 -a /(- a: l- Acc
lhat in thc pcrlirrnrancc ol'thc work trlr which this pcrmit is issucd, I shall not c:nploy any pcrson in any manncr
subjcct to thc workcrs'comlrcnsation laws of Calilirrnia, and agrcc lhat if I shttuld hccttme subject to thcsoas
wrlrkers' contpcnsation provisions of Section J7fi) of the Lahrr Codc, I shall, lirrthwilh contply with thtlsc provisions. .
WARNING: Failurc to sccurc workcrs' conrpcnsation coveragc is unlawtirl, and shall suhjcct an cmpkrycr to criminal pcnalties alld
civil lincs up lo onc hundrcd thousand dollars ($100,Uru), in adtlition trl thc cttsl of damagcs as providcd for thc
Scction ,]076 of lhc Latxlr Crxlc, intcrcst and atlorney's
u (./r'(.
a
(comnrcncing with Section 7000) of Division JI hcrchy al'lirnt undcr Jrcnalty ol'Jrcrjury thal I am liccnsed undcr pnlvisitln ol'
ol' thc Business and Pnrtbssions Corlc. and my licensc is fur t'ull litrcc and cfl'cct.
Liccnsc c- 38
7-d,11
I hcrchy all'irnr undcr pclralty ol'pcrjury that thcrc is a
issued (Scc. l0t)7, Civ. C.).
lcntling aPcncy of thc work firr which this pcrrnit is
[rndcr's Nanrc:
APPLICANT DECLARATION
I trcrcby allirm undcr pcnalty ol'Jrcrjury onc of the lbllowing rlcclarations:
Dcmolition Permits-Asbcstos Notificalion Fedcral Regulations (f itle 40. Part6)
_Requ ircd [-ct tcr ot' Notilication
-I
thc l'cdcralregulati<lns rcgan-ling asbestos removal euc nol applicahlc ttl lhis pnrjcct.
ccrtily that I havc rcarl this application and state that thc atxlvc intirrntalion is correcl. I agrcc to comply with all City and Ctlunty
rcprcscntativcs of this City and County to entcr uJxrn thcorrlinances and Statc Laws rclaling to
atxlvc nrcntioncd pnrJrcrty lbr
Applicant or Agent
Penrritee n&une
construction, arxJ hereby authoriz"e
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor ildno ?--*st ^oly'
"2i
)
S u bf loor/VenVl nsu Iation I u r\J"t-
Roof Sheathinq
Shear Wall
Framinq
lnsu lation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
[Vasonry
Pool Fence
T-Bar
Handicap Req
Deputv Final Report
Enqineer Final Report
Flood Zone Certif
/t .F
FINAL 6ltblzo TI)(n @,I
TCertificate of Occupancy
Notes, Remarks, Etc.
,rr"
*,,: /'f - Aa