HomeMy WebLinkAbout101103498 - PermitProiect Address: 3260 S Susan St-a-
Assessor's Parcel: 414-241-08 Lot: 5
Unit:BIdg
Tract: 10908
Address Range:Suite Range:
Zoning: MlBlock: NA Historic: No
city 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 #: {01'103498
Pin #: 70.281
Building Use: lndustrl.l Occupancy: F-l 1st FL Arca: Patio:
Job Type: Tsnant lmprovemonl Constr Type: v B 2nd FL Arca: T.l.Area: 5500
Nature ofwork TlrRoo{ Irtounted Equlp Code: CBC 20'19 OtherArcas: yards Req'd:
Existing Bldg. & use: Indu.trtal Flood zone x{602320258J carage Area: vatuafion: g35o,ooo.oo
Proposed Uss Commercial Cenn.bir enufaclur # of Stories: I aor", O
D€3crlptlon of Work Tl-Remove end lnstall pa.tition walb and t-b.r coiling, in3t ll e pr+fab frsezsr, a pre,f.b C1D2 l.b, . p.+fab po6t prcce3a lauroof
mountod equipt (undor l70 lb) . N.w Sprinkl.r ry.tem p€r OCFA.
Planning Conditions:
Owner.
Address:
Phone:
Tenant:
Tom Broderick
3260 S Susan St
Santa Ana, CA 92704
(7141 7e7-23e6
Cannavision
Contractor: IMC Professional Building C
Address: 12155 Magnolia Ave, Unit 10
Riverside, CA 92503
Phone: (9511 279-7705
State Lic #: 962294
Lic Type: B, C-61 , C-21
Bus. Lic #: 376552
Workers' Compensation I nsurance:
Carrier: Compwest lns Co
Policy #: WCF5503560
Expires: 0712712021
Engineer:
Address:
Phone:
License #:
Architect /
Designer:
Address:
Fox Engineering
James G. Fox
851 Panorama Road
Fullerton, CA 92831
(7141 423-5047
21543
Edward B Sapigao
Phone.
License #: C 21158
Planning Approval By.Pezeshkpour, Ali
Plan Checked By:
Permit lssued By:
Ahangian, Kathy
NPDES lnsp. Req'd
PWA lnsp. Req'd:
Amsden, Julie
No
Date: 03/1 512021 Misc. Receipt: 74338
Date:
Date: 03/1
Subject to
Yes
Yes
No
Account#Total
07776002 57607 Permit Fee
Fee
Records
2
Bldg. Stds. Revolving
07776002 57500 General Plan Update
07776002 57607 lssuance
No
Yes
No
Fee Total:
Paid to Date.
Balance Due:
$1,492.64
$2,663.02
$162.00
$98.0O-
$1+.OV
$23.79-
$5e.30
$4,5 12 .7 5
$2,1 20.87
$2,391 .gg
Planning lnsp. Req'd:
Landscaping lnsp. Req'd:
Fire Insp. Req'd:
Police lnsp. Req'd:
Flood Zone Cert. Req'd 01 1 1 6002 51 600
01 1 16002 51601
01 1 16002 51612
01 1 16002 57770
08901001-24000
$23.79/
$rfsre+
$1+.00/
$162.00/
$98 .00 -
2aqLl .cgEvery permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 days afterifs issua nce,or if the work authorized
on the site by such permitis suspended or abandoned for a period of 360 days after
the time the work is commenced
lnspector MID#: 2019-155300
ornme
a cwtlffi'IaI€It
a
BUILDING- INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDER DEI,CARATION
I hcrcby allirm undcr pcnalty of Jrrjury that I am cxcmpt ln)m lhc G)nlraclors' Liccnsc tlw for thc lbllowing rcasu\Se.7031.5
Busincss arkl Profcssi(rn C(xlc): Any City or County which rcquircs a lEmit k) construct, altcr, improvc. dcmlEh or rcpair any
slruclw, [trk r t, ils issuarLt, als(t rcquircs thc applicant lbr such ]Emil to tilc a si8ncd stalcmnt that hc or shc is liccnsd pur$tst
k) lhc prlvisions of thc C(rnlraclor's Liccnsd hw (Chaptcr 9, Commcreing with Sccti(rn 7000 of Division .] of thc Busincss and
P(rfcssionsC(rdc)orlhatlEorshciscxcmptlhcrcliom.trdthcbasislirrthcallcgcr.lexcmplion. Anyvi()laliqrofseti()n70.ll.5byany
applicant li)r a lrcmit subjccts thc applicnnt to a civil pcnally of nol morc thtn livc hundrcd dollars ($500),
_1, as owncr of'thc propcrty, or my cmployecs with wages as lheir sole compcnsation. will do the work afiJ the slructurc is nol
intcndcd or oll'crcd lirr salc (Scc.7(X4, Busincss and Profbssions Crilc: Thc Contractor's Liccnsc Law does not apply to an uwncr of
thc pnrJnrty who builds rlr impnrvcs thcrcon, artd who drrcs such work himsclf or hcrsclf rlr through his or hcr own cmphyccs,
providcd that such impr<lvcn**nts arc xrl inlcndctl or oll'crcd lirr salc. Il, howcvcr, thc building or imprcvcrncnt is sold within onc ycar
ol'comphtion, thc Owncr Buildcr will havc thc burrlcn ol'proving that hc or shc did rxrt build or impnrvc thc propcrty lirr thc purprsc ol'
salc),
-1,
as owner of the property, am cxclusivcly contracting with liccnscd contractors to constntct lhc projcct (Sec. 7M4, Busincss
and Prulbsskrn Codc: The Contraclor's Liccnsc Law docs nol apply to an owner of prcJrcrty who builds or improvcs lhcrcon,
and who contracts lilr such prtrjccts with a Contractor(s) liccnsctl pursuant to lhc Conlractor's Liccnsc Law).
-IamcxcmptundcrScctirln-'B.&P.C.tirrthisrcastrn.
fl.'Ia.
]UABtsEESSAIIEENSIIONpsc!,AMgoN
I hcreby allirm undcr Fmlty oflErjuryonc oflhc f(rllowing dcclarations:
idl havc arl will maintaio a Ccdil-rcalc of Consnt to Sclf-lnsurc li)r workcrs' comlrcusation, as prcvidcd for by Scction .!?fi) of thc* Labor Gxlc, for thc JErformrEc of thc work f(rr which thc Jrcrmil i{ issucd.
{$ havc an.t will maintain workcrs' compcmation insurancc, as rcquircd by Scction .17fi) of lhc L{bor Gilc, tor thc pcili}mancc of
thc work lilr which this 1rcmit is issucd. My xrrkcrs' com;rcnsation insurancc caricr anl Fllicy numbcr ec:
()\T\\
tr 2l t
tlrat in thc pcrtirrnrancc of thc work lirr which this pcrrnit is issucd, I shall rxrl cnrpkly any pcrs()n in any manncr
so as to bccomc subjcct to thc workcrs' compcnsation laws of California, and agrcc that if I slxluld bccome subject to thc
wrlrkcrs' compcnsation pnrvisions of Section 37fi) of thc Lahlr Crilc, I shall, tirrthwith comply with thosc pnrvisions.
WARNING: Failurc lo sccurc workcrs' com;rcnsation covcragc is unlawl'ul, and shall subjccl an cmploycr to criminal pcnaltics and
civil lirrcs up to onc hundrcd thousantl dollars ($lffi.fiXtt, in additi<ln to thc cost of compcnsalion, rlamagcs as providcd ftlr thc
Scction .1076 of thc l-ahlr Crxlc, intcrcst and attrlrncy's t'ccs.
'2
I hcrcby allirnt urrrler pcnalty ol'1-*rjury l
rtl' thc lJusirtcss and Prol'csskrns Codc, and my liccnsc is in f'ull tirrcc ard cflbct.
Liccnsc crurr, 9 Licensc Numbcr:4v7Zq,L1
I\.. t ^.I HL ?ro'{G5\<;nc\\ Bqt Ur}1
W
I hcrcby off[m undcr lEnalty of Fsjury that therc is a constructhn hndirg agcNy for the JErformree of thc work for which this Ismit is
issucd (Scc. 3097, Civ. C.).
[4Blcr's Namc:
Lctttlcr's Adtlrcss:
APPLICANT DECLARATION
I lrcrcby allirm undcr Jrcnalty of Jrcrjury onc of thc lirlkrwing tlcclarations:
Dcnxrlition Permits-Asbestos Notification Federal Rcgulations (Titlc 40, Part6)
_Rcqu rcd lrtter ol' Notilication
-l
ccrtify that the lcdcral rcgulations rcgddinS asbcstos rcmrval arc not applicablc ft) this p()jet.
r.-lJ
\zLI lcnily that I havc rcad this application aBl statc that thc alxlvc inli,rmtkrn is corcct. I agrc to comply with all Cily and County
ordhamcs nftl Statc hws rclaling to huilding construction, firl hcrcby authorize rcFcsntatives ofthi$ City anl County to cntcr uFrn tlr
atxrvc mcnlioncd propcrty tbr purF)scs.
Ua-tc-tu lz(Applicant or Agerrt I,a
Pcmilemmc(prino, t-rnct t-llcltvrct
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bf Ioor/Ve nVI nsu lation
Roof Sheathinq
Shear Wall
Framing
Insulatio nlEnerqy
Drywall
Ext./lnt. Lath
Brown Coat
Jt/asonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Engineer Final Report
Flood Zone Certif .
I a9r )
FINAL lpltfilz;r (T
Certificate of Occupancv rI t ()
Notes, Remarks, Etc.
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