HomeMy WebLinkAbout101104931 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: {O11O493{
Pin #: 42771
Project Address: 2715 3/4 W First S!
Assessor's Parcel: 007-1 42-12 Lot: NA
Unit: WC C02 Bldg: Address Range:
Tract: NABlock. NA Historic: No
Suite Range.
Zoning: Ml
Building Use:
Job Type.
Nature of Work.
Existing Bldg. & Use:
Proposed Use.
Other
Miscellaneous
Antennas
Cell Site
N/A
N/A
cBc 2019
x-0602320257J
1st FL Area:
Znd FL Area
Other Areas:
Garage Area:
Total:
Patio:
T.l.Area:
Yards Req'd:
Valuation: $S0,000.00
Occupancy:
Constr Type:
Code:
Flood Zone'.
# of Stories:
Description of Work: Replace antennas, add antennas and RRU's.
Planning Conditions:
Owner:
Address:
Phone:
Tenant:
Royal Crown Realty lnc
2715 W 1st Street
Santa Ana, CA 92703
(949) 295-7318
Contractor: Process Cellular lnc dba Prt
Address. 3020 W Harvard St
Santa Ana, CA 92704
Phone. (7141 617 -9921
State Lic #: 951819
Lic Type: B, A, C-10, C-20
Bus Lic #: 334565
Workers' Compensation lnsurance:
Carrier: Cypress lnsurance Co.
Policy #: PRWC127440
Expires: 0911712021
Engineer
Address:
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #:
Ersa H Persellin
Ersa H Persellin
c88844
Leaf Communication Consulting lnc.
1000 Calle Cordillera
San Clemente, CA 92673
(s49) 388-0192
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd. No
PWA Insp. Req'd: No
Planning Insp. Req'd: No
Landscaping lnsp. Req'd: No
Enriquez, Gissel
Le, Tung
Chavez,Dave_A
Fire ,lrp. Req'd:
Police lnsp. Req'd:
Date: 1011312020
Date: 1111612020
Date. 08/1 112021
Subject to Field:
Misc. Receipt.
Misc. Receipt:
Misc. Receipt:
07776002
07776002
07776002
08907007
07776002
07776002
07776002
Permit Fee
Plan Check Fee
Microfilm Records
SMIP - Category 2
Bldg. Stds. Revolvrng
General Plan Update
lssuance
No
No Account#
74850
Total
57607
53600
57770
24000
57672
57600
57607
Fee Total:
Paid to Date:
Balance Due:
$690.56
$478.68
$40.50
$14.00
$2 00
$23.7e
$59.30
$1,308.83
$478 68
$830.15
Flood Zone Cert. Req'd: No 01 1 16002 51600
Every 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 daysafter
the time the work is commenced.
01 1 16002 51601
01 1 16002 51612
01 1 16002 57770
08901 001 24000
$23 79
$749 86
$2 00
$40.50
$14 00
lnspector MID#: 2020-1 61243
BU!LDING. INSPECTOR RECORD
SITE-WORK DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hcreby affirm undcr penalty of pcrjury that I am cxempt fmm thc Contractos' Liccnrc law for the following rcuwn (Scc.703l.5
Busincss md Prufcssion Codc): Any City or County which rcquircs r lErmit lo construcl. altcr. impmve. dcfl)lish or rcpair my
strucm, prior lo its issusre. drc rcquircs thc lpplkant for such Frmit to filc { sigrcd statcrent that he or slE is liccnsd pusant
lo thc prcvisions of the Contractor's Licen$d kw (Chapter 9. Comrcrcing with Sstion 7000 of Division 3 of thc Busircss ud
PrcfcssionsCodc)orlhathcorshciscxemptthcrcfromandthcbasisforthcallcgcdcxcmption. Anyviolationofsstion?03l,5byany
applicant for a pcrmit subjccts the applicant to I civil pcnalty of not mrc than fivc hundred dollus ($5fi)).
-1.
as owncr of thc property, or my cmployccs with wagcs as thcir sole compcnsalion. willdo ttrc work and thc stnrcturc is not
intcndcd or offercd for salc (Sc.c.7044. Busincss and Profcssions Ccxlc: The Conlractor's Licensc [.:rw docs not apply lo an owncr of
lhc propcrty who builds or inrproves thcrcon. and who docs such work himsclf or hcrrclf or through his or hcr own cmployccs.
provided that such irnproverncnts arc not intendcd orofTcrcd for salc. lf, howevcr. ttrc building or improvcnrcnt is sold within onc )rcar
of cornpletion, thc Owncr Builder will have the burdcn of proving that hc or shc did not build or inprovc thc propcrty for thc purgnsc of
sah).
-1.
as owrrcr of thc properly. anrcxclusivcly c<lntracting with liccnscd contractors lo construct thc projccl (Scc. 7W, Busincss
and Profcssion Codc: The Contractor's Liccnsc Law does not apply lo an owner of progrcrty who builds or improves thcrcon.
and who conlracts for such projccts with a Contractor(s) liccnscd pursuant to thc Contractor's Liccnsc hw).
_l amcxcnlpt undcr Scction_. B. & P.C. for this rcason.
Date:_Owner:-
WORKEIIS' COTVT PFNSATION
DECLARATION
I hcrcby al'l'inn undcr pcnalty of pcrjury onc of thc ftrllowing dcclarations:
-l
have and will maintain a Ccrtificate of Conscnt to Self-lnsurc for workers' comyrcnsation, as providcd for by Scction 3700 of the
[:bor Code, fbr thc Jrcrformancc of thc work for which thc pcrmit ls issucd.
-l
havc and will maintain workcrs' conrpcnsal ion insurancc. as rcquircd by Scct ion 3700 of thc Lahor Codc, for thc pcrfrrrmance of
thc work for which this pcrrnit is issucd. My workcrs' compensation insurance carricr and policy numbcr arc:
l^S, "a^Ce bwrPav.y
i PR,wc lzlLtc{o a oq lmlz.tt'olicy
_l ccrtify that in thc pcrforrnancc of thc work fbr which this pcrrnit is issued. I shall n<lt cmploy any pcrson in any manncr
so as to becomc subjcct to thc workcrs'compcnsation laws of California. and agrcc thal if I should bccomc subject to lhc
workers' compcnsation provisions of Scction 3700 of thc [:bor Code. I shall. forthwith comply with thosc provisions.
WARNING: Failurc to sccurc workers' compcnsalion coveragc is unlawful. and shall subject an cmploycr to criminal pcnaltics and
civil fincs up to one hundrcd thousand dollars ($100.000), in addition to thc cost of comlrcnsation. damages as provided for thc
Scction 3076 of lhc Labor Code. intercst and attorncy's fecs.
t lt L\4ta*is ?*,A^n
DECI {RATION t
I hcreby alllrnr undcr penalty of pcrjury that I anr liccnscd undcr provision of Chaptcr 9 (commencing with Section 7m0) of Division 3
of the Business and Profcssions Code, and my liccnsc is in t'ull forcc and effect.
a atslg^t1,
€s ectl lar lnc .
W
I hcrcby aflirm undcr Fnahyof pcrjury thar thm is a construction hnding agcncy for thc lrcrforrorcc of thc work for which this tsmit is
issucd (Scc. 3097. Civ. C.).
kndcr's Namc:
Lcndcr's Addrcss:
APPLICANT DECLARATION
I hcrcby affrnn undcr penalty of prjury one of the following declarations:
Dcrnolition Pcrmits-Asbcstos Notification Fcdcral Rcgulations (Titlc 40, Part6)
-Requircd
lrttcr of Notilication
-l
ccrtity thut thc fcdcral rcgulations regarding asbcstos rcnrovalarc not applicablc to this projcct.
/r"nrfythat t havc rcad this application and sratc that thc is corrcct. I agrcc to conrply with all City and County
ordirranccs and Statc Laws rclating to building authorizc rcprcscnlutives of this City and County to entcr upon thc
atxrvc mcntioncd propcrty for inspcction purposes.
Applicant or Agent
I)crrrrilce nanre k cx-iE a,t1
Dare: - OOlrrl I
at
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bf loor/VenVl nsu lation
Roof Sheathing
Shear Wall
Framinq
Insulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
N/asonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Enqineer Final Report
Flood Zone Certif.
,A
FINAL t0lt3lO,t WtW W
Certificate of Occupancy
Notes, Remarks, Etc.
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Expircs:
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