HomeMy WebLinkAbout101105487 - 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 #: {011o,5487
pin #: tsfilf
Proiect Address: 3900 S Bristol Sta
Assessor's Parcel. 412-131-22 Lot: NA Block: NA
Unit: B Bldg
Tract NA
Address Range: 3800-3950
Historic: No
Suite Range:
Zoning: CR
Building Use:
Job Type:
Nature of Work:
Existing Bldg & Use:
Proposed Use:
Commercial
Alteration
Storage Racks
Com mercial/Retail Sales
B, M, S-1
V B, SPK
cBc 2019
x-06023202s9J
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area:, -':
Patio:
T.l.Area:
Yards Req'd:
Valuation: $22,149.00
Occupancy:
Constr Type:
Code:
Flood Zone'.
# of Stories:
)
Description of Work: Storage racks, 6 racks, 8' tall.
Owner:
Address:
Phone:
Tenant:
ArneYoungman,SDC/Pacific/Youn Contractor: HobbyLobbyConstruction
One Corporate, Suite 200 Address: 7707 SW 44th Street
Newport Beach, CA 92660 Oklahoma City, OK 73179
(949) 760-8591 Phone: (405) 745-1557
Hobby Lobby state Lic #: 948265
Lic Type: B
Bus. Lic #: 3713'14
Workers' Compensation lnsurance:
Carrier: Ace American lns Co
Policy #: WLRC67814885
Expires: 1213112021
Engineer
Address:
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #
Eclipse Engineering
Nicholar Silver Burman
365 NE Quimby Ave
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Planning Approval By
Plan Checked By:
Permit lssued By:
NPDES lnsp.
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 01 1 16002 s1600
01 1 16002 51601
01 1 16002 51612
01116002 57770
08901001 24000
No
No
No
No
Guevara, Jerry
So, Anson
Amsden, Julie
Date: 0210212021
Date: O2lO1l2O21
Date: 0210812021
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. Revolving
General Plan Update
I ssuance
Fee Total:
Paid to Date:
Balance Due:
$345 28
$478.68
$s6 7V
$6.20 -
$1.00-
$23 7Y
$s9 30
$970 95
$478 68
$492.27
Account#
75122
Total
57607
s3600
57770
24000
57672
57600
57607
Every permit issued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 days afterifs issuance,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.
$23.79-
$404.58-
$1 .00-
$56.70-
$6.20 -
lnspector MID#' 2020-1 63375
Planning Condltlon6: Interior ti only .t .tr i.:ri. - ,
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BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hcrchy dflirm un'lcr lEmlly of Frjury lhat I am cxcmpl lt)m the ConlractoN' Liccnsc tlw lbr the tirllowing rcavrn (Scc.70Jl.5
Busincss anl Prolbssion CuIc): Any City or Coutrty vhich rcquircs a Jrrmit to corotruct. altei improvc. dcmolish or rcpair atry
struclurc, ltri(]r t(] its issuancc, also rcquircs thc opplicant for such JErmit to lilc a signed statcmnt that hc or shc is liccnsd pursuant
k, thc pmvisims of thc Gnilrackrr's Liccnsd llw (Ch0plcr 9, Commcncing with Setion 7(XX) of Division -l of lhc Busincss and
Prrlcs$()n$ Codc) or that hc or shc is cxempt thcrcfrom and thc basis tbr thc allcgcd cxcmplion. Any violalion of Setkrn 70J 1.5 by any
applicant li)r d trcmit subjccts thc applicant k, a civil pcmlty ofnot morc than fivc hundrcd dolles ($500).
_i, as owncr ol'lhc propcrly, or my cmployccs wilh wagcs as thcir sole compcnsation. will do the work and thc strur,*turc is nol
urtc'ndcd or ol'lcrcd lirr salc (Soc.7(X4, Busincss and Prot'cssions C<xic: The Grntractor's Liccnsc [^aw does not apply to an owncr of
lhc pnlJrcrty who huilds or improvcs thcrc.t)n, arxl wlxr drrcs such work himsclf or hcrsclf or through his or hcr own cmployccs,
provirlcd that such improvcnnnts are not intcrxlctl or ol'tercd tirr sah. If, txrwcver, thc huikling or improvcrncnt is sokl within onc ycar
of complction, thc Owner Buildcr will havc thc hurdcn ol'pnrving that hc or shc did not buikl or improve the propcrty lirr thc purytsc of
salc).
_1. asowncrol'thc proJrcrty, amcxclusivclycontracting with liccnscd contractorstoconstruct the project (Sec.7U4, Busincss
arxl Prulbsskln Codc: Thc Contractor's Liccnsc Law docs not apply to an owner of propcrty who builds or improves thcrcon,
and who contracts lilr such pnrjccts with a Contractor(s) licenscd pursuant to thc Contractor's Liccnsc taw).
_l anr cxcmpt undcr B. & P.C. tirr this rcason.
flo I a.A.--o-'
TASSEBSIOII8IN$AIION
DECI.AEAIION
I hcrcby afl-rm undcr Fnalty of tsjuryorc of thc following dsltrations:
-lhavcafilwil!
mintainrCcrtificatcofconsnttoSclf-lnsurcforworkss (rmFnsation,as FovidcdforbySetion3T00oflhc
t xrr Codc, for lhc lEfomrec of thc work for which thc lErmit is issuc{.
l]f,l have anrl will mintain workcrs' comlEnsati(rn insunrec, as rcquircd by Setion 3700 of the kbor Ctxle, for thc pcrforrorec of
thc work for which this lEmit is issuca!. My workcs' comlrcnsation insurance cMier ani;relicy number rc:
frU
Policy LLC b D-3'7l
_l ccrlify that in thc [rcrlbrmancc of lhc work lbr which this J,crmit is issucd, I shall not cmploy any lrer$)n in any manncr
$ astobocomsubFcttothcworkers'comlEnsationlawsofcalilbmia,andrgrcthstiflshouldbccomsubjctttothc
workss'q)mpcnsationpmvisionsofscction.l?00ofthclatrrCrxlc,lslEll,tirnhwithcomplywithtksprovisions.
WARNING: Frailurc to scurc workcrs'compcnsation covcruSc is unlawful, and shall subjct m cmploycr to qiminal JEmllics and .
civil linc$ up k) onc huulrcd thousatrd d()llars ($100,0()()), in addition to thc cost of comlEnsation, daMgcs as providcd lbr thc
Scctkn 3076 of thc htx)r Codc, intcrcst {nd sttonEy's fccs.
n"r.,4.- 8-21 Appscanr: HOYlbi LObol
,
DECLARATION
I hcrcby allirm undcr pcnalty of'Jrcr.iury that I anr liccnscd under pn)vision of Chaptcr 9 (commcncing with Scclion 7fiX)) of Division -]
ol' thc Busincss anrl Pnrl'cssions Codc, and my liccnsc is in lull lirrcc and cll'cct.
W
I hcrchy aflirm undcr lEnalty of lrcrjury that thcrc is a custructbn bnling agcncy for thc lErfomrec of the work for which this Ismit is
issucd (Se. 3097, Civ. C.).
lIndcr's Namc:
krttlcr's Addrcss:
APPLICANT DECLARATION
I hcrchy atlirm undcr pcnalty of pcrjury onc of thc folkrwing dcclarations:
Dcmolition Permits-Ashcstos Nolification Fcdcral Rcgulations (Titlc 40, Part6)
_Rcquircd lrttcr of Notificatirxr
_l ccrtily that thc l'cdcral rcgulations rcgarding asbcslos rcmovalarc not applicablc to this pnrjcct.
M..nity that I havc rcarl this applicatkrn arxl statc that thc ahrvc infrrrmation is corrcct. I agrcc lo comply with all City and County
turdinanccs and Statc [-aws rclating lo building construction. arxl hcrcby aut]xrrzc
atxlvc nrcntioncd propcrty lilr
Applicant or Agent
Pennitce nanre
purF)scs.
fr
of this City and County to enter u;nn thc
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/VenVl ns u lation
Roof Sheathinq
Shear Wall
Framing
!nsulati onlEnerqv
Drywall
Ext./lnt. Lath
Brown Coat
ltlasonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
t/
FINAL Lltlltr JL 6U
Certificate of Occupancy T
Notes, Remarks, Etc.
Elarr n9,-n7 -2n 1 6
/
q4B \b5Liccttsc cr"rr' b Liccnse Numbcr:
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