HomeMy WebLinkAbout101105902 - 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: (7'14)647-5853
Permit #: {O11O59O2
Pin #: 45{63
Project Address: 2210 3/4 N Grand Ave-
-Assessor's ParceI 396-191-01 Lot: POR G.L. RUSSEBIoCK: A
Unit: WCC01 Bldg: Address Range:
Tract A.B. CHAPMAN Historic: No
Suite Range:
Zoning: C5
Building Use:
Job Type:
Nature of Work:
Existing Bldg. & Use:
Proposed Use:
Other
Alteration
Cell Site
Occupancy:
Constr Type:
Code:
Flood Zone'.
# of Stories:
N/A
N'A
cBc 2019
x-0602320163J
1st FL Area
2nd FL Area
Other Areas:
Garage Area
Total
Patio:
T.l.Area:
Yards Req'd
Valuation: $+5,000.00
0
Description of Work Cell site modification, replace 3 exisitng antenna with 3 new antenna
Planning Conditions:
Owner:
Address:
SCE
1 Innovation Way
Pomona, CA 91768
P h O N C' P ERiJHPOATI C E L L E D
Tenant
DATE:-|ru
Engineer:
Address.
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #.
Contractor: Mastec Network Solutions, I
Address: 1825 PONCE DE LEON BLVI
Miami, FL 33134
Phone: (909) 597-6006
State Lic #: 984138
Lic Type: B, C-7 , A, C-l0
Bus. Lic #: 363514
Workers' Compensation lnsurance:
CaTTieT: ACE AMERICAN INSURANCE COM
Policy #: WLRC67464102
Expires: 0911512021
0f f i ce: (:TYH Tr
Ac,:t i :
Rcpt i :11331 1685
Trnnsact i on Totn I
lnstec Hetworlr Solut iCIns
Generql Plnn Updote Fet
Lrl I 160112- 516rr[r[r(r[l-
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Planning Approval By:
Plan Checked By:
Permit lssued By: \NPDES lnsp. Req'd:
$
Orozco, lvan
Ahangian, Kathy
Hernan dez, Kathy
Date: 0211712021
Date: 0412612021
Date. 06/03/2021
Subject to Field:
Misc. Receipt:
Misc. Receipt.
Misc. Receipt:
07776002 s7607
07776002 53600
07776002 57770
08907007 24000
07776002 57672
07776002 57600
07775002 57607
Permit Fee
Plan Check Fee
Microfilm Records
SMIP - Category 2
Bldg. Stds. Revolving
Genera! Plan Update
lssuanceAccount#
75237
Total
Fee Totat
Paid to Date:
Balance Due:
$6e0.s6
$478 68
$60.75
$12 60
$2.00
$23 7e
$s9 30
$1,327.69
$478.68
$849.00
No
PWA Insp. Req'd: No Fire lnsp. Req'd: No
Planning lnsp. Req'd: No Police lnsp. Req'd: No
Landscaping lnsp. Req'd: No Flood Zone Cert. Req'd: No
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 permitis suspended 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 57770
08901001 24000
$23.79
$749 86
$2.00
$60.75
$12.60
!nspector MID#: 2021-164083
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lt
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BUILDING- INSPECTOR RECORD
SITE-WORK DATE !D/SIG.COMMENTS OWNER BUILDER DELCANATION
I hcrcby affirm undcr pnalty of pcrjury lhat I m cxcmpi fom lhc Conhacto6' Licens ljw for thc following rcasn (Scc.7031.5
Busincss ard Profcssion Code): Any City or County which rcquircs a Jsmit lo onslrucl. alter. improvc, demlish or Epsir oy
structuc. prior to its issurec, alrc rcquircs thc applicant for such Frmit to file a signed statemnt lhsl hc or shc is liensd pursuant
ro lhe prcvisions of thc Contractor's Liccned lrw (Chrptcr 9. Comrcncing with Sstion 7000 of Division 3 of the Busiress and
PrcfcssionsCodc)orthathcorshcisexemptthcrcfromandthcba$isforthcalhgedcxcmption. AnyviolationofsetbnT03l.5byany
applicantforapcmitsubjcctsthc rpplicanltoacivilpenallyofnottrcrcthelivehundrcddollus($500).
_1, as owncr of lhc propcrty. or nty cmployccs with wagcs as thcir solc conlpcnsation. will do tlrc work and thc structurc is not
intendcd or oll'crcd lbr salc (Scc.7044. Busincss and Profcssions Ctdc: Thc Contractor's Licensc Law does not apply to an owner of
thc pro;rcrty who builds or irnprovcs thcrcu, and who drrcs such work hirnsclf or herself or through his or hcr own cnrployccs.
providcd that such irnprovcnrcnts are not intcndcd or ofli:rcd for sulc. lf. howcvcr. thc building or irnprovcrncnt is sold within one ycar
of complction, thc Owncr Buildcr will have the burdcn of proving that hc or shc did not build or inprovc thc propcrty for thc purposc of
salc).
_1. as owncr of the propcrty. am cxclusivcly contracting with liccnscd conlraclors to construct thc projcct (Scc. 7W, Busincss
and ftrofcssion Code: Thc Contractor's License Law docs nol apply to an owner of propcrty who builds or improvcs thereon.
and wh<l contracts for such projccts with a Contractor(s) liccnscd pursuant to the Contractor's Liccnsc [:w).
-l
am cxcmpt undcr Scction-, B. & P.C. for this rcason.
Date: Owner:_
WORKURS' CON I PI,NSA'tI()N
DIICI IITATION
I hcrcby affirrn undcr pcnalty of pcrjury onc of thc following declarations:
-l
havc and will maintain a Ccrtificate of Conscnt to Selt'-lnsurc firr workcrs' compensation. as providcd for by Scction 3700 of thc
Labor Codc. frrr thc pcrformancc of thc work tbr which thc pcrrnit is issucd.
-l
have and will nraintain workers' compcnsatiorr insurancc. as rcquircd by Scction 3700 of thc Lrbor Codc. for thc pcrformance of
thc work lbr which this pcrrnit is issucd. My workcrs' compcnsation insurance carrier and plicy nunrbcr are:
Policy 6'7 (
_l ccrtify that in thc lrcrformance of thc work for which this pcrmit is issued. I shall not cmploy any pcrson in any manncr
so as lo bcconrc subjcct to the workers' compensation laws of California. and agree that if I should bccoutc subject to thc
workers' compensation provisions of Section 3700 of thc l.ahlr Codc. I shall.those provisions.
WARNING: Failure to sccurc workers' compcnsation is unlawt'ul.all and
civil lincs up to onc hundrcd thousand dollars in adtlition to the
Scction 3076 of thc Latnr Codc. interest and attorney's
I
I hcreby alfirm undcr Jrcnalty of perjury that I arn liccnscd provision of Chaptcr 9 (commcncing with Scctiott 7m0) of Division 3
of the Busincss and Profcssions Code, and my licensc is in full force and effcct.
Liccnsc
Date:I I elo (
"/ '[
>l
I hcrcby afllrm undcr pcnalty of pcrjury that thcrc is a construction
issucd (Scc. 3097, Civ. C.).
lrndcr's Namc:
agcncy for the pcrfbrmancc ol'thc work ltrr which this pcrmit ls
[.cndcr's Addrcss:
APPLICANT DECLARATION
I hcrcby all-rnn undcr pcnalty of perjury onc of thc following dcclarations:
Dcmolition Pcrmits-Asbcstos Notification Federal Rcgulations (Titlc 40. Part6)
_Rcquircd lrtter of Notification
ruccrtity that lhc lbdcralrcgulations rcgarding asbcstos rcnroval arc not applicable to this projccl.
corrcct. I agrcc to cornply with all City and County
abovc nrcntioncd propcrty for
Applicnnt or Agent
I)ernrilce nilnre
thal thc
lo entcr upon thc
Set Backs
Forms/Stee!/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/Venill nsu lation
Roof Sheathinq
Shear Wall
Framinq
!nsulation lEnerqy
Drywall
Ext./lnt. Lath
Brown Coat
N/asonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
FINAL
Certificate of Occupancy
Notes, Remarks, Etc.
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