HomeMy WebLinkAbout101106289 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: {01106289
Pin #: 70578
Project Address: 2800 N Main St Unit: 24gS Bldg: Address Range:
TTACT: RESUB OF SHAFERAssessor's Parcel:111-111-11 Historic: No
Suite Range:
Zoning: C2Lot: 1 Block. NA
Building Use: Commercial Occupancy: M, S-1 1st FL Area
Job Type: Alteration Constr Type: llA, SPK 2nd FL Area
Nature of Work: Tl Code: CBC 2019 Other Areas
Existing Bldg. & Use: Commercial/Retail Flood Zone: X-0602320163J Garage Area
Proposed Use. # of Stories:
Total
Description of Work: Remove all partition walls, t-bar ceiling, finishes on wall and floor and pre-fab walk-in cooler-
Patio:
T.l.Area: 400
Yards Req'd
Valuationt $t 6,000.00
Planning Conditions: lnterior TI only.
Owner:
Address:
Phone:
Tenant
Centennia! Real Estate Company
8750 N Central Expressway #1740
Dallas, TX 75231
(9721 888-8044 Phone:
PERirtlT CANCELL EBr,e Lic #:
Lic Type:
Spike Construction lnc
7915 Harper Ave
Downey, CA 90241
(s62) 454-7673
435582
B
378785
pensation lnsurance:
Berkley Nat'l lns
BNUWCo154643
07 t13t2022
Contractor:
Address:
Bus. Lic #:
Workers'Com
Carrier:
Policy #:
Expires.
Engineer:
Address:
Phone:
License #:
Architect /
Designer:
Address:
Phone.
License #:
\o:l e$s\socjrtr)
DATE:q \..--\- 2-\
Jesus Hurtado, Architect
Jesus Huftado
1310 S McDonnell Avenue
Los Angeles, CA 90022
(323) 48s4040
c29969
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp. Req'd:
Planning lnsp. Req'd:
Pedro
Scott Fazekas & Assoc
Julie
Date: 0712712021 Misc. Receipt: TS3TT
Date: 0712212021 Misc. ReceiPt:
Date: Og/01 t2OZ1 Misc. Receipt:
Subject to Field:
No
No Account# Total
07776002
07776002
07776002
07776002
07776002
07776002
Permit Fee
Plan Check Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
Fee Totat
Paid to Date:
Balance Due:
57607
53600
57770
57672
57600
57607
$172.64
$239.34
$4.05
$1 .00
$23 7e
$5e.30No
No
No
Fire lnsp. Req'd:
Police Insp. Req'd
Landscaping lnsp. Req'd:Flood Zone Cert. Req'd: No 01 116002 51600
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 days 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.
01 1 16002 51601
01 1 16002 51612
01 1 16002 53600
01116002 57770
$23.79
$231.94
$1 00
$66.70
$4.0s
$s00 1 2
$172 64
$327.48
lnspector MID#: 2021-165206
a
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG COMMENTS OWNER BUILDER DELCARATION
I hqcw affm unds pcoahy of pqjury that I m qmpt from thc Contrac{oF' LiccE Lrw for thc following tten (Ss.7031.5
Buinas md Prcf*ion Codc): Any City or County which rcquim a pamil to coNtruct, alto, improvc rkrnolish or rcpair iny
strucluq prior lo its isuucc. also rcquirG thc applicut for such pennit to filc a signcd statoot thal hc or shc b liccnscd ptmEtl(
to thc povisio$ of thc Clntractor's Liccnsd law (Chapts 9. Commcing with Setioo 7000 of Division 3 of thc B$ins {d
PrcfcsionsCodc)orthathcorsheiscxmptthqcfromodtheb8isforthealleg€dq@Fion. AnyviolalionofSdtionT03l.5byany
applicdt fo. a pcrmit subjcts thc applicant to a civil pcnalty of not more thil fivc hun&cd dollffi ($500).
_1. as owner of the property. or my cmployecs with wages as their sole compensation. will do the work and the structure is not
intended or offered for sale (Sec.7044. Business and hofcssions Code: The Contractor's Lice'nse law does not apply to an owncr of
the properry who builds or improves thereon, and who docs zuch work himself or hersclf or through his or her own employec.
providd that such improvancnts arc not intended or oflA'od for salc. If. however. the building or improvernent is sold within one )car
of complaion the Orvner Buildcr will have the burden of proving that he or she diJ not build or improve the propcrty for thc purposc of
sale).
_1. as owner of the property. am exclusively contracting with licensed contraclors to construct the project (Scc. 7044. Bwiness
and hofession Code: The Contractor's Licensc Law does not apply to an owner of property who builds or improves thereon.
and who contracts for such projects with a Contraclo(s) licaued pursuant to the Contractor's Licensc l-aw).
-l
am e.\empt under Scction---. B. & P.C. for this reason.
l)alc
WO RI(E R,S' COMPEN SATION
DECLARATION
I hereby affrrm under penalty of perjury one of the following declarations:
_l have and will maintain a Certificate of Consent to Self-lnsure for workers' compensation. as provided for by Scction -3700 of the
Labor Code.
/, nur. urroG work for
for the perfonnancc of the work for which the perrnit is issued.
Section 3700 of the Labor Code. for thc pcrfonnance of
,carrier and policy number are:
Policy t\L
-l
ccniry that in thc pcrfomancc of thc work for which this pcrmit is issucd, I shall not mploy any pcrson in oy mona
m utobeomesubjcttothercrk6'ompersationlawsofCalifomia,edagrcthatiflshouldbeomesubjattothc
rcrk6' comperution prcvisiou of Serion 3700 of the Labor Codc, I slu.ll. forthwith comply with thos prcvisiorc.
WARNINC: Failurc to suc mrkm' comperstion covmgc is unlawful, ad shall subjat m aploF to qiminal pquhiB ild
civil fincs up to onc hundrcd thousd doll6 ($100,000). in addition to the cost of compcrution. damg6 s providcd for the
Section 3076 of the labor Code. interest and attorney's fecs.
I 11
I hereby allirm under penalty of perjury that I am licensed 9 (commencing with Section 7000) of Division.l
of the Business and Professions Code. and my license is in full force and effect.
License
Date:
Number:E5
ctlloil 'Ll t1r----f
W
I hcrcby aflirm undo pcnalty of pqjury that thqc is a @Ntruction loding agocy for thc psfomucc of thc work for which lhis pqnil b
issucd (Se. 3097, Civ. C.).
Lender's Name:
Lender's Address:
AEUCANIDECI.ABAIION
I ho@afirm undo poalty of pcjury onc of thc followitrg delsntios:
Dcmolition PmitsAsbetos Notifrcstion Fcd@l Rcgulatios (Titlc 40, Pan6)
-Rcquircd
trtta of Notificarbtr
_l cqriry rhar thc fcddal rcaulatiom rcgrding cbcros moval e not applicablc to thie proj6{.
ftft "rttty t* t t nc rad this application 8d ststc thar rhc abovc informaion is conet. I agre to comply with all City ud Couty
ordiruc6 ed Statc law rclalg to building construction, atd h@by suthorire rcprenativc of rhis City ud Couty to mtq upotr thr
above mentioned property for inspection
Applicant or Agent
Permitee name
Set Backs
Forms/Stee!/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bfloor/Ve nUl n s u I atio n
Roof Sheathing
Shear Wall
Framing
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif.
F!NAL
Certificate of Occupancy
Notes, Remarks, Etc.
i'w
5
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