HomeMy WebLinkAbout103108117 - PermitCify 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 #: 1O3108117
Pin #: 71476
,/n .n7v
Proiect Address: 1607 E McFadden Avea
Assessor's Parcel: 402-322-17 Lot: NA Block: NA
Unit: A Bldg
Tract NA
Address Range: 1501-1609
Historic. No
Suite Range:
Zoning: Ml
Building Use:
Job Type
Nature of Work:
Existing Bldg. & Use:
Proposed Use:
Industrial
Alteration
Roof support
lndustrial
Occupancy:
Constr Type:
Code:
Flood Zone'.
# of Stories:
B
III B
cBc 2019
x-0602320276J
1st FL Area
2nd FL Area
Other Areas:
Garage Area:
Totat
Patio:
T.l.Area:
Yards Req'd
Valuation: $+50.00
De6crlptlon of Work RopaiE tor prope. rool suppo and penotretions. NO PLANNING REQ'O PER ROBERT CISNEROS - |I{TERIOR WORK.
Plenning Conditiona:
Owner:
Address:
Phone:
Tenant
Reza Semsarieh
1607 E McFadden Ave, A
Santa Ana, CA 92705
(7141 352-6990
Daily Hug Coffee Roasters
Contractor: Owner-Builder
Address:
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Engineer:
Address:
Phone:
License #.
Architect /
Designer:
Address:
Phone:
License #:
TrsnEoct i on Tots1
Re=o Semsnr i eh
Genernl Plnn Update Fee
01 I 16rilJ2- 516r-101100-
Buildins
Ltl 1 160[t2- 516r-rlrJ00-
Blds Stds Revolv i ns
Lt1 I 16LtLt2- Et6l2rtt-ttt-
11I 5(:
u1 I 16llu2- 536ll0rJ0t-t-
11 icrof ilm & Docutrtents
01 1160tJ2- 177 TLtLrLtu-
t777 .66
i2 (l
?1
UL
Planning Approval By.
Plan Checked By.
Permit lssued By:
NPDES lnsp. Req'd.
PWA lnsp. Req'd:
Planning Insp. Req'd
Date:
Date:
Date: O9l3Ol2O21
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Robert Cisneros
o t t t G o 02 tldd t.Pdfrti1 p56ii : :.
07776002 53600 Subject to Field
07776002 57770 Microfilm Records
07776002 s7672 Bldg. Stds. Revolving
07776002 57600 General Plan Update
07776002 57607 lssuance
Fee Total
Paid to Date:
Balance Due:
': $t7264
$1 72 65
$4 0s
$1 00
$23.79
$5e 30
Amsden, Julie
Landscaping lnsp. Req'd
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 permit is suspe nded or abandoned for a period of 360 days after
the time the work is commenced.
No
No
No
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No
Account#Total
01 1 16002 51600
01 1 16002 51601
01 1 16002 51612
01 1 16002 s3600
01 1 16002 57770
$23 79
$231.94
$1 00
$1 72 65
$4 0s
$433 43
$0 00
$433.43
lnspector MID#: 2021-169 176
?t(t
BUILDING. !NSPECTOR RECORD
SITE.WORK DATE !D/SIG.COMMENTS I h6cby affirm unds poarty orpcrjrr *" ,"Ni"*i'Hl'fl'"1*ff11}* t* for the following ,*n (s4.7031.5
BBin6s md Prcfeion Codc): Any City or Cowrty which requirc a pamit to oNtruct, altq. imprcvg danolish or rtaair uy
st$ctuq prior to its issumcc, alrc rcquira thc applicut for such pgrtrit to 6le a signcd statmot that hc or slE is licascd pEust
to the povisioN of thc Contrutor's Licmscd Law (Chapts 9, Commcing with Setion 7000 of Division 3 of thc Busincs ud
Prcfsios Codc) or that hc or shc is cxempt thacfrom ud thc ba3is for the allcged cx@ption. Any violation of Sdioo 7031., by uy
ffiffi#;d,J;ffiffi;ffi ffi *-il**********",
thcprcpsty whobuildsorimprocthon,edwho&ssrchwrthimselforhcclforthrcughhisorhoomcmployec,
providcd that such improvqn@ts rc rct intqdcd or olfsod for slc. I( how6, th€ buiEiry or improvffit is rcH within one 1an
ofcompl€tiorf the Owtrq Builda will havc thc hrdor ofpoving ttra hc or strc did mt build or improvc thc prcpqty for thc Fuposc of
#**rr,*tHs,',Hr:ir;:'L:ffi**T:iffi ffi ;*ffi :r,*ffi i,rTtriff "ly;l"T**Elrand who contmcls for such poj61s with a Contracto(s) licos€d pswt to the Cootraclor's LiccN Law).
-l
am exempt undcr Scction-, B. & P.C. for this reason.
Drte:ol o,r/ o r
WORIGRS'COMPENS
DECLARATION
I hereby affrm under penalty of perjury one of the following declarations:
_l havc and will maintain a Certifrcate of Consent to Self-lnsure for workers' compcrsation, as provided for by Section 3700 of the
Labor Code for the pcrformance of the work for which the pcnnit is issucd.
_l have and will maintain workcrs' compensation insurance, as required by Section 3700 of the l-abor Code. for the performance of
thc work for which this permit is issued. My rvorkers' compensation insurance carrier and policy number are:
Policy Numbcr: Expires:
ffi ccniry that in thc pqfomncc ofthc work for which this pcrmit is isued, I slnll rct mploy uy p6sn in my mona
\f c to baomc subjet to thc rcrtc'ompccstiotr lam of Cdifomia, ed agc that if I slpuld beomc subjct to thc
worlc' compcrsation povisiom of S€lion 3?00 of thc Labor Codc. I slull. forlhwilh smply with thos prcvisiou.
WARNING: Failurc to suc rcrk6' ompquation covogc is unlawful, ud shall subjet il mployq to qiminal poultic ad
civil fma up to onc hu&od thoMd dollG ($100,000), in addition to the cosc of compcNtion. damagc I prcvidcd for thc
attorncy's fees.
DECI.ARATION
I hereby affrm undcr pcnalty of perjury that I am liccnscd under provision of Chapter 9 (commencing with Scction 7000) of Division 3
of thc Business and Professions Code, and my license is in full force and effect.
License Numbcr:
W
I hcby a[Im undc p€ialty of pcrjury thd thcc b a construc{ion knding agmcy for thc pafmmcc of rhc rcrL for which thb Fmil b
isucd (Sc. 3097, Civ. C.).
lrnder's Name:
Lcnder's Address:
APPLICANT DECLARATION
I hodry afiirm under penalty of perjury one of the following declarations:
Demolition Permits-Asbcstos Notification Federal Regulations (Title 40, Part6)
-Required
Later o f Notification
with all City and County
and County to enter upon the
above mentioned property for
Applicant or Agent **?l golQ\
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bfloor/Ve nul ns u latio n
Roof Sheathinq
Shear Wall
Framinq
lnsulation/Energy
Drnruall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
FINAL /A-{r->l 3-c /S nA.tae: Z'1
Gertificate of Occupancy
Notes, Remarks, Etc.
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