HomeMy WebLinkAbout101106305 - PermitCity of Santa Ana 20CivicCenterPlaza(M-19), Santa Ana,CA927O2 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853
Permit #: {01106305
Pin #: 29017
Project Address: 2621 3/4 S Bristol St-
-Assessor's Parcel. 410401-13 Lot: NA Block: NA
Unit: MET02 Blds:
Tract: NA
Address Range:Suite Range:
Zoning: C2Historic: No
Building Use: Other Occupancy: N/A 1st FL Area
Job Type: Alteration Constr Type: NrA 2nd FL Area
Nature of Work: Cell site Code: CBC 2019 Other Areas
Existing Bldg. & Use: Gell site Flood Zone: X-0602320259J Garage Area
Proposed Use: # of Stories: Totat O
Description of Work: Modifications to existing - includes replacing antennas, adding equipment in existing cabinet.
Planning Conditions: Screening required
Patio:
T.l.Area:
Yards Req'd
Valuation: $S0,000.00
Engineer: Leaf Consulti
Owner:
Address:
Phone:
Tenant T-Mobile
RPS Group
5020 E Copa De Oro Dr
Anaheim, CA 92804
Contractor: Nuwave lnternational lndust
Address: 1875 Coronado Ave
Signal Hill, CA 90755
Phone: (562) 498-0800
State Lic #: 1000182
Lic Type: B, C-10, C-20
Bus. Lic #: 369314
Workers' Compensation lnsurance:
Carrier: State Compensation lnsurance Fur
Policy #: 9157867
Expires: 0110112022
Address:
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #:
1000 Calle Cordillera
San Clemente, CA 92673
(s4s) 388-01e2
c 88844
lu5
Planning Approval By:
Plan Checked By.
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp. Req'd:
Planning lnsp. Req'd:
Enriquez, Gissel
Ahangian, Kathy
, Julie
Date: 0512712021
Date: 0512612021
Date: 1010512021
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Fire lnsp. Req'd:
Police lnsp. Req'd
No
No Account#
75420
Total
07776002
07776002
07776002
08907007
07776002
07776002
07776002
57607
s3600
57770
24000
57672
57600
57607
Permit Fee
Plan Check Fee
Microfilm Records
SMIP - Category 2
Bldg. Stds. Revolving
General Plan Update
I ssuance
$345.28
$478.68
$44 55
$14 00
$2.00
$23.7e
$se 30No
NoLandscaping 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 within360 days afterits 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. :
01 1 16002 51600
01 1 16002 51601
01 1 16002 51612
01 1 16002 57770
08901 001 24000
$23.79
$404.s8
$2 00
$44.5s
$14.00
Fee Totat
Paid to Date:
Balance Due:
$967 60
$478.68
$488.92
lnspector MID#: 2021-165255
a
--'No
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS OWNER BUTLDER DETARATION
I hqehy affm undc pcnalty of pojury thrt I m cxcmpt ftom thc ContncloB' Licre lrw for thc following @n (Se.7031,5
Buins ad Profsion Code): Atry City or County which roquire a pcrnit to @mtrucl altq, improvg danolish or rcpair ay
sructurq Fior to its ismcq also rcquic thc +plicut for such pqnit to filc s signcd stalmat thd hc or drc b licqEcd pllMt '
to thc provisioE of thc Coilretor's Liccnscd hw (Chsptq 9, Comcrciog with Setion 7000 of Division 3 of thc Buirc ud
PrcfsioB Codc) or that hc or shc b qopt thq!&om md thc basb for thc allcgcd amptioo. Any viobtion of Sdbtr 7031.5 by oy
epplicut for a pcmit subjets thc applimt to a civil pcmlty of rot morc the frve hundrcd dotlas ($500).
-1,
c omc ofthc pmperly, or my cmplo)6 with w8g6I thcir slc @mpcNrion. will do th€ wort and thc stndE is not
intqrdcd or offcred for slc (Sc.7044. Buins md Prcfeiore Codc: Thc Contraclor's Licffi la doc not 4ply to u oms of
thc Fppcty who huilds or irprove ttE@n sd who do6 reh wrt himrlf or helf or thrcugh hB or h6 om mployce,
prcvidcd that such imFomr @ mt intqdrd orolH for slc. lf, lrcw, tlrc hilding or inprcvsmil is $H within onc )@
of ompktioD, thc Own6 BuiU6 wil harc th€ hrda of prcvig thd hc or shc did et hild or inrprcvc thc popqty for thc Frposc of
sdc).
-1,
I om6 of thc propsty, m crclwivcly cotracting with licqB.d coilmctoE to @Etnrct thc Fojet (Sc. 7044. Bain6
srd PD&sih Codc: Thc Coflrelor's Lic6c law do6 rct apply to s owtr6 of propdy who builds or imprcvB th6on,
md who @ntracls for such projEls with a Coilrrclo(s) licoscd puuant to thc Contraclor's Licw law).
-l
mcxcmpt undo Sction- B. & P.C. forthis Iwn.
EABtrEEISOMPINSAIIaN
I h@by sffm und6 pq,lty of pqjury onc oC,rc fotlo*inffi
/-l^trave at wltt mhtsin I Cdrific{tc of CoMt to SclflBurc for rcrlq' ompsrdion I prcvidcd for by s$liotr 37OO of the
' Y;::::[:,'ffi::::ff,:::il *T,Ir,*.",700 0f ,hc rabor codc. fo.hc pqfomcc of
thc rcrk for which this pmit is isrcd, My work6' ompcosatioo iromcc mia ard policy numba re:i +^+e o ,-d
Policy 0 t /tt lzzII
_l certi& that in thc performance of the work for which this permit is issued. I shall not employ any person in any manner
so as to home subject
workers' compensation
to the workeis'compemation laws of California, and agree that if I should become subject to the
provisions of Sertion 3700 of the l-abor Code. I shall. forthwith comply rvith thosc provisions.
WARNINC: Failure lo secure workers'
civil fines up to one hundred thousand
and
the
attorney's fc€.
I hoeby affrm und€r penalty of perjury that I am licenscd 9 (commencing with Section 7000) of Division 3
of the Business and Professions Code. and my liccnsc is in full force and effect.
o^*, I License Numbcr:///>
a L Vv v,/ ol
W
t hmby affim undc perulty of pcrjury that th@ is a corutruc,tion bndiry agocy for thc pqfor:mcc of thc rcrk for which this pqrnit is
isucd (Se. 3097, Civ. C.).
Lcnder's Name:
Lcnder's Address:
APPLICANT DECLARATION
I hatby affirm under penalty of perjury onc of the following declarations:
Demolition Permits-Asbestos Notification Federal Regulations (Title 40, Part6)
-Required
lrtter of Notification
.-,
certiry that the ftderal regulations regarding asbcstos removal are not applicablc to this project.
-l
cqtiry thal I havc rad this applietion ad statc that thc above infomation is cotrq1 | .gE to omply with all City ad Couty
-ordimcc ad Statc Laws rclatilg to building constructio[ dd hmby authorirc rcprMtaliv6 of this City ed County to ats upon thc
above mentioned property for
,Nolicent
or Agent
(ermitee
name
-0 5 L
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bfloor/Ve nUl ns u latio n
Roof Sheathinq
Shear Wall
Framinq
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence V
T-Bar \
Handicap Req.
Deputy Final Report
Enqineer Final Report
Flood Zone Certif.
Ir r
FINAL \9\Wt-t\vy\r4 7
Certificate of Occupancy
Notes, Remarks, Etc.
\
Drte:
_ Dete:_