HomeMy WebLinkAbout101106078 - Permitt city of santa Ana 20 civic center Plaza (M-19), santa Ai-,:, cA 92702
Permit Counter. (714) 647-5800 lnspection Requests: (714) 667-2738 tnspector Section. (711) 64
L Building
Luu,
Permit #: {01106078
Pin #: 96o^72
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Project Address: 3770 W McFadden Ave
Assessor's Parcel: 144-561 -09 Lot: NA Block: NA
Unit: E Bldg:
Tract: NA
Address Range: 3500-3790
Historic: No
Suite Range:
Zonrng: SP2
Building Use: Commercial
Job Type: Tenant lmprovement
Nature of Work: Tl
Existing Bldg & Use: Commerical/Massage
Proposed Use:
Occupancy:
Constr Type
Code:
Flood Zone'.
# of Stories:
B
VB
cBc 2019
x-0602320256J
1st FL Area:
2nd FL Area.
Other Areas:
Garage Area:
Total:
Patio:
T l Area: 1390
Yards Req'd:
Valuation: $25,000.00
0
Description of Work: Tl for new massage business including new partition walls.
a
Owner:
Address:
Phone:
Tenant:
Rio Vista West LLC
2443 E Coast Hwy
Corona Del Mar, CA 92625
(s4s) 667-7888
Royalty Massage
Contractor: New Bear Wind lnc
Address: 13304 Netzley Place
San Gabriel, CA 91776
Phone: (626) 383-2020
State Lic #: 1059216
Lic Type: B
Bus. Lic #: 378070
Workers' Compensation !nsurance:
Carrier: Exempt
Policy #:
Expires:
Engineer:
Address:
Phone:
License #:
Architect /
Desiqner:
Address:
Phone:
License #:
Central Pacitic lDesign/Build
VincentTran: : ;
,
9615 Skylark Blvd
Garden Grove, CA 928;41
(7141 71945s8
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd
PWA lnsp Req'd:
Orozco, lvan
BCS Consultants
Date: 0310912021 Misc. Receipt:
Date: 0412312021 Misc. ReceiPt:
Date: OSt26lZO21 Misc. Receipt:
Subject to Field.
No
No Account#
01 1 16002 51601
01116002 51612
01116002 57770
75311
Tota!
07776002
0 7776002
0 7776002
0 7776002
07776002
07776002
57607
s3600
57770
57672
57600
s7607
Permit Fee
Plan Check Fee
Microfilm Records
Bldg. Stds Revolving
General Plan Update
I ssuance
$37s 30
$514 30
$24 30
$1 00
$23 7e
$se 30
sden, Julie
Planning lnsp. Req'd:
Landscaping lnsp. Req'd:Flood Zone Cert. Req'd: No 01 1 16002 51600
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within360 &ys afterifs issuance,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.
lnspector MID#: 2021-164765
No
No
No
No
Fire lnsp. Req'd:
Police lnsp. Req'd:
$23 79
$434 60
$1.00
$24 30 Fee Total:
Paid to Date:
Balance Due:
$997 ee
$st4 30
$483.69
!
Planning Condltlons: Inl.rior Tl only.
BUILDING. INSPECTOR RECORD
SITE.WORK DATE^a ID/SIG.COMMET.ITS OW]!ER BUILDER DEI.CARATION
I hrcby affm undo pctulty of pcrjury thar I m cxcmpt from the Contracto6' Licmc I.3w r?rr thc follorrig lwn (Se.703 1.5
IJuins and Profsion Code): Any City or County which require a pcmit to @Gtruct, altq, imprcvq dcmolish or npat uy
stuctrc. pdor to its issuilcc, also requiG thc applicet for such psmit to filc a signed slalm@t that hc or $c b licsE€d plNilt
to thc provisiom of thc Contrctor's Liccnsed Law (Chapts 9, Comcncing with Sstion 7000 of Division 3 of the Bwins md
Profesions Codc) or that hc or shc is cxmpt thqcfrom ad the b6sis for the allcged exmpion. Any violation of Setbn 7031.5 by uy
applicant for a pemit subjsts the applicant to a civil pemlty of not morc thu fivc hundred dollrs ($500).
_1. as owner of the property. or my employe$ with wages as their sole compcnsation. willdo the work and the structure is not
intendod or offerd for sale (Sa.7044, Business and hofessions Code: The Contraclor's License Law does not apply to an owner of
the property who builds or improves ther@n, and who does such work himself or herself or through his or her own cmployees,
provided that such improvonents are not intended or offered for salc. If, howeiver. thc building or improvement is sold within one )Ear
of complaion, the Orvner Builder will have the burden of proving tha he or she did not build or improve the property for the purpose of
sale).
__t, as owner of the prop€rty. am exclusively contracting with licensed contraclors to construct the project (Scc. 7044, Btsiness
and hofession Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon,
and who contracts for such projccts with a Contracto(s) licersed pursuant to the Contractor's License taw).
-l
am exempt under Section-. B. & P.C. for this reason.
I)q I o'
WORKERS' COMPENSATTON
DECLARATION
I hcreby allirm under pcnalty of perjury onc of the following declarations:
_l have and will maintain a Centificate of Consent to Self-tnsure for workers' compcnsation, as provided for by Section 3700 of the
I-abor Code, for the performance of the work for which the permit is issued.
_l have and will maintain workers' comp€nsation insurance. as requircd by Section 3700 of the l-abor Code. for the performance of
the work for which this permit is issued My workers' compcnsation insurance carrier and policy numbcr are:
And*.
Policy Number: Expires:
fil*tt that in the performance of the work for which this p,ermit is issued, I shall not ernploy any person in any manner
so as to become subjcct to the workers'comporsation laws of California, and agree that if I should become subje*t to the
workers' compensation provisions of Section 3700 of the l-abor Code, I shall, forthwith comply with those provisions.
WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an onployer to criminal penalties and
civil fines up to one hundred thousand dollars ($100.000). in addition to thc cost of compcnsation. damages as provided for the
,
Section 3076 of the Labor Code, interest and attorney's fees.
I hereby affrrm under 3
of the Business and Professions Code, and my license is in full force and effect.
License Nurnber:0
Dare: + llA/rr1 1-l w
W
I hmby affm unda pcnalty of pcrjury that th6c is I @nstruciion lmdiog agocy for fic pofommce of the mrk for which this p6nit b
issucd (Se. 3097, Civ. C.).
Lf,dd's Nmc:
Lendcr's Address:
APPLICANT NECLARATION
I hqrby affm undq Fnalty of perjury onc of thc following dclaratiom:
Dcmolition Pcmit$Asb6t$ Notification Fcdqat Rcgulations (Titlc 40, Part6)
-Rcquircd
trtto of Notifiqlion
-*r^rr, ,* ,tre fcdaal rcgulatiore regEding 6b6tos rmoval e nor applicablc to this prcjct.
l-?o,,,ry ,nn I have rad this application sd state that the abovc infonnalion is conct. I agre to @mply with all City and County
ordhilcG od Statc lrws rclairg to building coretrucrion, and hoeby authorirc rrF6@tativ6 of this City ad Couty to atq uIDa 0E
above mentioned property for inspection
6Applicant or Agent I
I'crnrilcc nanrc
Iten I 0
Set Backs D
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bfloor/Ve nUl n s u Iatio n
Roof Sheathins
Shear Wall
Framinq .-zq4 O CRJ )
lnsulation/Energy
Drywall /rr$J&7q-z {UC?-'7
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence (
T-Bar tLcri n
Handicap Req.
Deputy Final Report
Engineer Final Report
Flood Zone Certif
FINAL L (-i-'ru*v2r7Certificate of Occupancy
Notes, Remarks, Etc.
O