HomeMy WebLinkAbout101108287 - PermitProject Address: 1241 E Dyer Rd
Assessor's Parcel: 411-131-36 Lot: NA Block: NA
Unit: 200 Blds:
Tract: NA
Address Range: 1231-1241
Historic: No
Suite Range:
Zoning: SD63
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: {01108.287
Pin #: 6,4150
Building Uss Commoroial Occupency: B 1st FL Aaee Patio:
Job Type Rovl.ion CoNtr Type V B, SPK 2nd FL Area T.l.Area:
Natu.e ofwork OrT ln.p.ction Code: cBc mlg OtherAreas yards Req.d
Exbting Bldg. & Use: Commercl.lrofilces Flood Zone: X{602320r8J
Gerage Area V.lu.flon:
Propos€d Us€: # of Stories: ToEl O
O.sc.iption oi work Ovortlm. ln.p6cllon fd Frld.y, October 15. Rofsrence 101105453. Contact ls Dlogo Zop.d.,7l,t{097293, inspoctorwill be Oavld
Appel, 71+2403583.
Phnnlng Condltlon.:
Owner.
Address:
Phone:
Tenant
Greenlaw Partnens LLC
1241 E Dyer Rd #240
Santa Ana, CA 92705
(949) 331-1 316
Contractor: KPRS Construction Service:
Address: 2850 Saturn St
Brea, CA 92821
Phone: (7141 672-0800
State Lic #: 751130
Lic Type: B, A
Bus. Lic #: 188704
Workers' Compensation lnsurance:
Carrier: Everest Premier lnsurance
Policy #: CA10004028201
Expires'. 10/01 12021
Engineer:
Address:
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #:
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp. Req'd:
Planning lnsp. Req'd.
Landscaping lnsp. Req'd
Fire lnsp. Req'd: No
Police lnsp. Req'd. No
Flood Zone Cert. Req'd: No
Date:
Date:
Date: 1011412021
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
07776002 57770 Microfilm Records
07776002 57607 O/T lnspection
07776002 57600 General Plan Update
Fee Total
Paid to Date:
Balance Due:
$0.00
$690.56
$0.00
web_issue
No
No
No
No
Account#Total
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within360 days afterifs rssuance,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.
lnspector MID#: 2020-163257
$690 s6
$6e0.56
$0.00
tr-
BUILD!NG. INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDER DEICARATION
I hqchy aflm undo pcralty of pcrjury that I m cxmpt fiom thc Cootrrcton' Liccm t:w for thc followiog rcmn (Sc.7031.5
Buins ard Profsion Codc): Any city or Couty which rcquira a pcrnil to o[truct. alta, improvq domlish or rcpsir ey
struc{rc, Fbr to its ismcc, do rcquirc thc applicet for such pqmit to filc a signcd stal@6t th8I hc or slE b liccnscd pwatn
to th€ provisioB of thc Contrrctor's Licqsed lrw (Chapttr 9, Comocing with Sction 7000 of Division 3 of thc Buiae ud
Prcfsions Cod€) or that h€ or shc is qmpt thqcftom ud thc bosis for thc allcgcd q@flioo. Any violation of S6lbn 7031.5 by my
applicut for 8 pqmit subjcts thc applicut to a civil pmlty of oot mrc thq fivc hundrcd dollus (S500).
-1,
o omq of the Fopcrty. or my cmployG with w8g6 I thcir rcle compqstion, wil do tlE wt atd thc sfutrc b mt
intodcd or offqcd for slc (Se.7044, Buins ed ProfcssioB Codc: Thc Contraclor's Lic@ taw do6 not apply lo il oMq of
thcpropqry whohuildsorimproeth@Gddwhodoeschwrkhimwlforhdforthrcughhisorhaommpby€,
providcd thst such imFovqmB m mt intqrdcd or ollqcd for sh. lf, howq. thc tuildilu u inpromt is rcld whhin onc )qr
ofcooplrbn, thc Owna Buil& will havc thc hudsr ofproving tM hc or shc did mt build or improre thc popcty br thc prpos of
sl€).
_1, a omq of thc propqty. m qcluivcly contrrcliog wirh licoscd conltrior to @nstruct th€ projet (Sc. 7044, BNin6
ard Prpftsbn Code: Thc Contretor's Licw Law doq not Epply to e oms of propqly who builds or imprcvG lhq@n,
md who antrrcts for such trojcts with a Contracto(s) licflsd pmwt to thc Contraclor's LiccE Law).
I m cxcmDt utrd6 Setion-, B. & P.C. for this wn.
WORKERS' COMPENSATION
DECLARATION
I hereby alTinn under penalty of perjury one of the following declarations:
_l have and will maintain a Certificatc of Consent to Self-lnsure for workcrs' compensation, as provided for by Section 3700 of the
Labor Codc, for the pcrformance of thc work for which the pennit is issued.
_l have and will maintain workers' compensation insurance. as required by Section 3700 of thc Labor Code. for thc pcrformance of
the work for which this pcnnit is issued. My workers' compensation insurance carri€r and policy numh are:
Policy Number: Expires:
_t certify that in the pcrformance of the work for which this pennit is issued, I shall not employ any person in any manncr
so as to become subject to the workers' compersation laws of California, and agree that if I should bccome subject to the
workers' compensation provisions of Setion 3700 of the l-abor Code, I shall, forthwith comply with thosc provisions.
WARNING: Failure to sccure workers' compensation coverage is unlawful. and shall subject an employc to criminal pouhies and
civil fincs up to onc hundred thousand dollars ($100.000), in addition to the cost of compcnsation, damages .rs provided for the
Section 3076 of the Labor Code, interest and attorney's fees.
f lo to.
LICENSED CONTRACTOR
DECI.ARATION
I hereby aflirm under penalty of perjury that I arn licensed undcr provision of Chapter 9 (commencing with Section 7000) of Division 3
of the Business and Professiorrs Codc. and my license is in full force and effect.
Liccnse Class: Liccnsc Number:
CONSTRUCTION LENDINC AGENCY
t hacby alfm undo Fnalty of pdjury thrl thqc is I orlstruc{ion lcnding agocy for thc pofomucc of thc wk for which this pqmit b
isucd (Se. 3097, Civ. C.).t trdr's Nuc:
Lender's Address:
APPI ICANT DECLARATION
I horby affirm under penalty of perjury one of the following dcclarations:
Demolition Pcrmits-Asbestos Notification Federal Rcgulations (Title 40, Part6)
-Requ
ircd Later o f Notifi cation
-l
cstiry that thc fcdqat r€ulatioN rcgarding Bbetos rmoval uc not applicable to this prcj61.
_l cdiry that I havc md this appliotion ad stdc rhat thc abovc infonndion is cor€t. I 8gr to @mply with all City md Couty
ordireB md Statc taw rclatiry to tuildiry coErrudiorr ard holby authorir rcprstaivs of fiis City md Couty to dtq upoo thc
abovc mationcd prcpcrty for iroperion purposc.
Appllut or ABdt Sigmture: Dste:-
Permitee nnme (rlrint):
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bfloor/VenUl n s u latio n
Roof Sheathinq
Shear Wall
Framinq
!nsulation/Enerqy
Drywall
Ext./lnt. Lath
Brown Coat
Masonrv
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
tl .a\
FINAL /0lt>lA erruz;7
Certificate of Occupancy I
Notes, Remarks, Etc.
Date: Contrector:_