HomeMy WebLinkAbout101106075 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853
Permit #: {O1106075
Pin #: 75063
Proiect Address: 3621 S Harbor BIvd-a-
Assessor's Parcel: 414-261-07 Lot: POR 3 Block: NA
Unit: 1 30 Bldg:
Tract: WILLIAMS
Address Range: 3601-3631
Historic: No
Suite Range:
Zoning: SD58
Building Use:
Job Type:
Nature of Work:
Existing Bldg & Use:
Proposed Use:
Commercial
Alteration
Demising Wall
Commercial/Offices
B
V B, SPK
cBc 2019
x-0602320258J
1st FL Area
2nd FL Area:
Other Areas:
Garage Area:
Total:
Patio.
T.l.Area: 0
Yards Req'd:
Valuation: $56,000.00
Occupancy:
Constr Type
Code.
Flood Zone'.
# of Stories:
0
Description of Work: lnstall a demising wall to create suite 130
Planning Conditions: lnterior Tl only.
Owner:
Address:
Phone:
Tenant:
0
Anne Ahn
11777 San Vicente Blvd #650
Los Angeles, CA 90049
(657) 325-8400
Contractor: Esplanade Builders lnc
Address: 23820 Hawthorne Blvd #100
Torrance, CA 90505
Phone. (310) 783-7664
State Lic #. 831964
Lic Type: B, C-2, C-9, C-33, C-23, C-17
Bus. Lic #: 352893
Workers' Compensation I nsurance:
Carrier'. Zurich American lnsurance Compe
Policy #: WC38046700
Expires: 0110112022
Engineer:
Address:
Phone:
License #:
Architect /
Designer:
Address:
Phone.
License #:
I
,.
H Hendy Associates
Susan D. Dwyer
4770 Campus Drive, #100
Newport Beach, CA 92660
(e4e) 8s1-3080
c33724
t
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
Le, Tung
Chavez, Dave
Date: 0310912021
Date. 0411912021
Date: 05/1 212021
Subject to Field:V??
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
07775002
07776002
0 5376002
07776002
08907007
07776002
07776002
07776002
57607
53600
53637
57770
24000
57672
5760 0
5760 7
75309
Total
Permit Fee
Plan Check Fee
Accelerated (per h,
Microfilm Records
SMIP - Category 2
BIdg. Stds. Revolving
General Plan Update
I ssu ance
Fee Total:
Paid to Date:
Balance Due:
$34s 28
$478 68
$1 53 39
$4 05
$15.68
$3.00
$23 79
$5e 30
$1 ,083.1 7
$478 68
$604.49
Fire lnsp. Req'd.
Police lnsp. Req'd
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 afterifs issua nce,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.
Noyes Account#
01 1 16002 51600
01 1 16002 51601
01 1 16002 51612
01 1 16002 57770
05316002 s3637
08901001 24000
$23 7e
$404.s8
$3 00
$4 05
$1 53 39
$15.68
!nspector MrD#'. 2021-164757
BUILDING. INSPECTOR RECORD
S!TE.WORK DATE ID/SIG.COMMENTS OWNER BUTLDER DEI.CARATION
I h6cby affm unds pcnalty of pqjury thsr I m qmpt from thc Contrrctos' Liccc [:w for thc following r@n (Sc.7031,5
Buinas and Prcf*ion Codc): Any City or Co6ty which rcquirs a pomit to coretruct, 8ltq, improvc, dmtotish or rcpair my
struc1uc. prior to its isuuc, also rcquiG thc applicmt for such pcmit to filc a signcd stalmot thal hc or $c is lic@cd pEuarlt
to thc prcvisioru of thc Contretor's Liccnscd law (Ch8pt6 9, Comcncing with Setion 7000 of Division 3 of the Bwinm md
PrcfesiomCodc)orthatheorsheisampthqcfromildthcbasbforthcallcscdqmpion. AnyviolationofSetiotrT03l.5byey
spplicat for I psmit subjets thc spplicut to a civil pcnslty of not morc the five hundrcd dollm (1500).
--1.
c omq of thc prcpqty, or my @plo)6 with wsgc I thcir rclc ompquarion, will do dE wort ud thc anrtrc is mt
intordcd or offocd for slc (Sc.7M4, B6ine md Profasioro Codc: The Coilretor's Liccrc Law do6 not apply to o ow of
thc prcp<ty who builds or improvc th@n, and who do6 $ch m* himself or h€Nlf or thrcugh hb or ha om mploycc.
prcvidcd that such imFovmts rc not iiladcd or ofrred for sh. l[ howc. thc buiHing or imprcvmt is sH withia onc ]qr
of complaio!, th€ otf,ns Buil& will havc thc h[da of prcving tha hc or she did mt build or inporc thc propqly for thc purpos of
sle).
-1,
6 oms of thc Fopsiy, m cxclsively contracring with lics€d contractoE to coEtrucl tlE projGr (Sa. 7044, BBin6
ud Prohsion Codc: Thc Contmctor's Licmsc Law do6 not apply to a own6 of propqly who builds or improv6 th@n.
and who @ntracts for such projets with a Contreto(s) licfficd puBwt to thc Cootractor's Licmc [aw).
-l
m cxmp unds Setion-, B. & P.C. for this rcmn.
Drle _ O*nE'
EOBKESS:CAMfINSAIION
DECI.ASATJON
I hocby affrm unda pdalty of pqjury one of thc following delaratioG:
_l have ad will mintain a Cqtificatc of Comt to Sclf-lrourc for workG' compcrEation, c providcd for by Serion 3700 of thc
labor Code. for thc pqfolMce of thc work for which thc pqrnit is issucd.
-l
have and will maintain workers' compensation Section 3700 of the Labor Code, for the pcrformance of
the work for which this perfnit is issued.carrier and policy number are:
a Cu
(\,\)a \Policy
-l
certift that in the performance of the work for which this pcrmit is issued. I shall not cmploy any person in any manner
so as to become subject to the workers'compensation laws of California, and agree that if I should becomc aubject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall, forthwith comply with those provisions.
WARNING: Failure to secure workers' compensation is unlawful, and shall subject an to and r
thecivil frnes up to one hundred thousand dollars ($addition to the cost
Scction 3076 of the tabor Code. interest and attorney's
D",., '5-l J--;Ul)\w
I hcreby affirm under pcnalty of perjury that I arn licensed provision of Chapter 9 (cornmorcing with Section 7000) of Division 3
of the
License
Business and Professions Code, and rny license '
i\3 L -,INumber:
,",., . s _\)-JlCe\
W
I hmby allim undo pcrulty of psjury thst thsc is a coctruclion knding 8g@cy for thc pqfomcc of thc wort for which this pqmit b
issucd (Sc. 3097, Civ. C.).
Lender's Name:
Lender's Address:
APPLICANT DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
Demolition Permits-Asbcstos Notification Federal Regulations (Title 40, Part6)
_Required Letter of Notification
with all City and County
and County to eflt€r upon thc
Applicnnt or Agent
l'ermitee name
I )\
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bfloor/Venul nsu latio n
Roof Sheathing
Shear Wall ,)Qo )
Framing ;lt\Hav N&t,L)
Insulation/Energy l/vt t n
Drnrvall 'o//dal :q0
Ext./lnt. Lath I
Brown Coat
Nlasonry
Poo! Fence ,l lt /')G
T-Bar /b/,lrfhAr /lDtlt 7%rtr
Handicap Req //
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
-'/ /l0
F!NAL IHA/YN-
Certificate of Occu
Notes, Remarks, Etc.
rA
.-
in lbll
Q-l
regarding asbestos removalare not applicable to this project.
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