HomeMy WebLinkAbout101106287 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)-647-5853
Permit #: 1O110,6287
Pin #: 40677
Project Address: 2800 N Main St
Assessor's Parcel. 111-111-11 Lot: 1 Block: NA
Unit: 2365 Bldg: Address Range:
Tract: RESUB OF SHAFER Historic: No
Suite Range.
Zoning'. Cz
Building Use. Commercial
Job Type: Tenant lmprovement
Nature of Work Tl
Existing Bldg & Use: Commercial/Retail
Proposed Use: Storage
Occupancy.
Constr Type:
Code:
Flood Zone'.
# of Stories:
M, S-1
II A, SPK
cBc 2019
x-0602320163J
1st FL Area
2nd FL Area
Other Areas:
Garage Area:
Totat
Patio:
T.l Area:
Yards Req'd
Valuation:
286
$l t ,440.00
Description of Work: T!-Remove and install partition walls, t-bar ceiling and interior door
Planning Conditions: lnterior Tl only
Owner: Centennial Real Estate Company Contractor: Spike Construction Inc
Address: 8750 N Central Expressway #1740 Address: 7915 HarperAve
Dallas, TX 75231 Downey, CA 90241
Phone: (972) 888-8044 Phone: (5621454-7673
TENANT PERMIT CANCELLED StAtC LiC #: 435582
Lic Type: B\-_l|f, a:Urf\ CCrC_\C€us Lic#: 3zrz*s
DATE: B'i.."::T'"","T:?1'l':;ff,Yiil:"'( \--\\.\--,r2 | eolicv #: BNUwco154643
Expires: 0711312022
Engineer:
Address:
Phone.
License #:
Architect /
Designer:
Address:
Phone:
License #.
Jesus Hurtado, Architect
Jesus Hurtado
1310 S McDonnell Avenue
Los Angeles, CA 90022
(323) 48s4040
c29969
INIITAL:
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PYUA lnsp. Req'd:
Planning lnsp. Req'd
t^Ff,imez,
Pedro
%"
No
Scott Fazekas & Assoc.
Amsden, Julie
Date: 0712812021
Date: OT l22l2l21
Date: 09/01 12021
Subject to Field:
No
Misc. Receipt:
Misc. Receipt.
Misc. Receipt:
75372
Total
07776002
07776002
077L6002
07776002
07776002
077L6002
57607
53500
57770
57672
s7500
57607
Permit Fee
Plan Check Fee
Microfilm Records
Bldg. Stds. Revolvrng
General Plan Update
lssuance
Fee Totat
Paid to Date:
Balance Due:
$172 64
$239 34
$4 05
$1 00
$23 79
$s9 30
$500 1 2
$172 64
$327.48
Fire lnsp. Req'd:
Police Insp. Req'd Account#No No
Landscaping lnsp. Req'd: No Flood Zone Cert. Req'd: No
Every permit issued 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
01 1 16002 51600
01 1 16002 51601
01 1 16002 51612
01 1 16002 53600
01 1 16002 57770
$23 79
$231 .94
$1 00
$66 70
$4 05
lnspector MID#: 2021-165213
OWNER BI'II,DER DEI,CARA'I'ION
I herctr1 affirm unda pcnalty of peiilry that I m erempt fiom thc Conlracto6' [-icensc l-aw for lhe followin8 rea$n (Sc ?0:11.5
Flusin6s and Profession Code): Any City or Couily which rcquirs a [rcnnit to conslNcl. alts. impreve, dotolish or repair any
slnrclue. prior to its isiuance. also reqni.6 the applicanl for such Fmnil to file n si8ncd slalment that hc or shc ie licosed pursuanl
lo the prcvisions oflhc Contractor's l,icenwd kiv (Chapts 9. Commencing wilh Scction 7000 ofDivision I ofthe Rusircss and
Professions Code) or lhat he or shc is exempt lhsefrem and the heris for the allegcd cxqnp(ion. Any violalion ofsdlion 701 I .5 hy any
applicant for a pmit strbjcts the applicant to a civil penalty of not more lhan five hundrcd dollars ($500).
l. as o*'ncr of the propelly. ot nry ernployees rvith u,ages as their sole compensation. willdo the u'ork and the stntclure is not
inlcntlcd or offered for sale (Sc.c.7044. Business and Professions ('ode: The Contractor's Licensc I.au, does nol apply to an os,ncr of
lhe propolv rvho lruilds or irnproves thermn. anct rvho cloes srrch w,ort hirnself'or herself or lhrough his or her ort,n employecs.
provitletl that such irnprovenrents are not intencle<l oroffere.cl for sale. I[. hos,ever. the huilding or improve,nent is sold rvithin one ycar
o[cornpletion. thc Orvncr Ruilder rvill havc the brrrtlen of proving that he or she did not huild or impror,e the property for the purJxrse of
sale).
l. as o\\'ner of the propoly. arrr exclusively conlracling s,ith licensed contractors lo conslnrct lhe projecl (Sec. 7044. Brrsrness
and Proficssion ('odc: f'he Contractor's l.icense l.arv does not apply to an owner of propmtv s,ho huilds or improves ths'eon.
and s'ho conllacls for such projects rvith a Contractor(s) licenscd pursuarrt lo thc Contraclor's l-icense l.arv).
_ I arn cxcnrpl urrclcr Section . l]. & l'.('. f<rr llrrs rcason.
J)nlt:
DECLARA'TION
I herehy affirnr uncler penalty of po'jury one oIthe follorving cleclaralions:
._--lhaveancls'ill ntaintainaCertificateofConsenttoSelf-lnsureforrvorkers'cornpensation.as providedforbySection.lT00ofthe
Lalxrr Code. for lhe perfonnance of the rvort for u,hich lhe po:nit is issuetl.
#n:ltl,ili:ir',til;.l"ll;::::L:::'rfiJ,Hil,.I'i'iHJJ;;:J:i:l1;.llri:'J[:ilJhrl'fiJ;ll[l:l'
(-arer: htcllll JWlr*l ]pr*,rs* Jolrr/
,",., ;,,f;'uiitr,'t3'ftiFitW - .Exp rc,, -' -04
for the performance of
)/ZL
_ - I cedify that in the ptrform.f,cc ofthe uork for which this permit is issrerl. I shall not enploy any pcmon in any mnnno
so as lo hecornc snliiet to the rvorlios' composation larvs of Califomi.. and agrc that if I should haorne subi(t to I hc
rvorkoC compensation provisions ofSstion -17fi) ofthc lalnr Codc. I shall. fo|lhwith comply with those provisions.
WARNING: Faihrrc lo sccure workss'conrpensntion covcmge is unlarvful. and shall subjet an qnlloyer to siminf,l lEnlli6 and
civil fines up to one h$ndred thousand dollars ($100.000). in addilion lo tlrc cost of compcnsation. damagcs as providcd for the
Scclion .1076 of thc l.ahor Coclc. intercst
OI
Ll(: I,INS lit) (.O N't'RACr'O R
Dt!,('LARA'l'l()N
I hereby afl'irm under penalty of per.iury that I arn liccnscrl under provision of Chaplo'9 (comrnencing s'ilh Section 7000) of Division .1
of the Busincss and Profcssions Code, and my liccnsc is in full forcc antl elfecl.
h Nunrtrcr:
L{\5,8L
l)n lc:
CONS RUC'I'ION LENDTNC ACENC}'
I hcrchy aflirm under lmalty of pcrjury thal th@ is I constnrction lending agflcy for tfte pofomance of the rvork for rvhich this gumit is
issued (Ss. 30q7. Civ. C.).
[,ender's Narne: _
l-ender's Acldress:
A PPLICANT DECLARATION
I hodry affrnn undt'r poralty of pcr.iury one of the follos,ing cleclarations:
Denrolitiorr Pcrrnits-Astrestos Notification Federal Regulations ('title 40. Parl(r)
-
Required Letterof Notification
_ _- I ccrlify lhat lhc fcrlcral regulations regarding asbestos renroval are n()t applicahle to this pro.iect.
cor ify I hat I havc read this npplicat ion ancl statc that the ahrve inflormation is corect. I agrcr to cornllly rvith all City and Coqtnly
ordinancs f,nd Slate l-aws rclatinE to bililding constnrcl ion. ild herchv authorize rqrscnlal iv6 of this ('ily and (:ounty to ml€ tpon lhc
alxrvc lrrcnlionctl propcrly lor
l,iccnsc (-lass:
,Allplicant or Agent
Pcrnrilcc nrlmc
-Dn,e:-o Yotf2 t
VA
SITE-WORK DATE ID/SIG COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bfloor/Ve nUl nsu lation
Roof Sheathing
Shear Wall
Framing
Insulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
lMasonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
F!NAL
Certificate of Occu pancy
Notes, Remarks, Etc.
BUILDING. INSPECTOR RECORD
()rlner:
11',0 ItK l,,lts' ('ol\t PI.,NSA l' l()N
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