HomeMy WebLinkAbout101105684 - Permitf@ city of santa Ana 20 civic center Plaza (M-19), santa Ana, cA 92702 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: {O11O56E4
Pin #: 45388
Rtv
8J
Project Address: 2900 S Main St
Assessor's Parcel: 410-31 1 -06 Lot: NA
Unit:Bldg: Address Range:Suite Range:
Zoning: C5Block: NA Tract: NA Historic: No
Building Use: Commorcial occupancy: NrA lstFlArea: Patio:
Job Type: Signs Constr Type: NrA 2nd FL Area: T.l.Area:
Nature of Work: Slgns.illumin.ted Code: cBc 2019 Oher Areas: yards Req'd:
Existing BldO. & Lrse: Connercl.lrDrivs.{hru re.teurent Flood Zone: X{602320278J GaEge Area: V.tu.tion: ,ZT,OOO.OO
Prcposed Use: # of stories:
Totat:
D6crlptlon of Work: Signagafor "OslTaco', includea (3) channcl lottor wall signs,7'menu cabinat, driv.-thru order canopy, directional aign,lO
claarance baf. Bond lncludsd.
Planning Conditions:H(-t.
Jt tl'rt -t_LrJ I
Owner:
Address:
Phone:
Tenant:
Randall Cornelius
27290 Scott Rd
Menifee, CA 92584
(4121 600-1685
Del Taco
Contractor: Darneil Enterprises dba D &
Address: 1282 W Lambert Road, A
Brea, CA 92821
Phone: (7141 822-6457
State Lic #. 856006
Lic Type: C45
Bus. Lic #: 376177
Workers' Compensation I nsurance:
Carrier: State Comp lns Fund
Policy #: 1643978
Expires'. 10/01 12021
600 B Street, Suite 300
San Diego, CA 92101
(619) 354-1 152
c81435
Engineer:
Address:
Phone.
License #:
Architect /
Designer:
Address:
Phone:
License #:
I
(:
I 6 LtLt ? -. :-' 3 6 Lt Ll LlLlLl
11 icrof i Im & Do,-ument
Lf l 1 16ttt l2- 177 Tttt-tt-t0-
t 07776002 57607 Permit Fee
07776002 53600 Plan Check Fee
07776002 57770 Microfilm Records
08907007 24000 SMIP - Category 2
07776002 s7672 Bldg. Stds. Revolving
07776002 57600 General Plan Update
07776002 57607 lssuance
0s376002 53636 Bond
Fee Total:
Paid to Date:
Balance Due:
$172.64
$239.34
$81.00
$5 60
$1 .00
$23.79
$59.30
$200.00
Planning Approval By:
Plan Checked By.
Permit lssued By:
NPDES lnsp. Req'd: No
PWA lnsp. Req'd: No
Planning lnsp. Req'd: No
Landscaping lnsp. Req'd: No
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No
Pezeshkpour, Ali
Ahangian, Kathy
Chavez,Dave<rzC
Date: 1210212020
Date: 03l,04l,2021
Date: 03/1 012021
Subject to Field:
Misc. Receipt:
Misc. Receipt.
Misc. Receipt:
Account#Tota!
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 suspe nded or abandoned for a period of 360 days after
the time the work is commenced.
01 1 16002 51600
01116002 51601
01116002 51612
01 1 16002 53600
01 1 16002 57770
05316002 53636
08901 001 24000
$23.79
$231 .94
$1.00
$239.34
$81.00
$200.00
$s.60
$782.67
$0.00
$782.67
lnspector MID#'. 2020-1 61046
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG COMMENTS OWNER BUTLDER DELCARATION
I hcrcby arlirm utrdcr Fnaly of lErjury thal I am cxcmpt liom lhc Contrachrs' Liccns hw for thc li)llowing rca*rn (Ss.4ll.s
Busincsr ?nd Profcssion C(xlc): Any CiIy or County which requircs a Jrmit k, construct. alts, improvc. dcmrlish or rcpair any
struclurc, [rx)r to its issuancc, also rcquircs lhc applicant for such Frmit k] filc a signcd slatcmnt that hc or slE is liccn$d pursuant
k) lhc E()visi()ns of thc Contracl()r's Liccnrcd taw (Chaptcr 9. Commncing with Scction 7000 ot Division .l (!f thc Busincss and
Pnllcrsk)n$C(xlc)orthalhcorshciscxcmptthdchom.ndlhchasisforthcallcgcdcxcmplion, AnyviolationofSetionT0ll.5byany
applicaDt li)r a fErmit subjets thc al,plicanl to a civil pcmlty of not mrc than five hundrcd dollas ($500).
--1, as owncr of thc propcrty, or my cmployccs with wagcs as thcir solc compcnsation. will do thc work aftl lhc strur,*turc is not
intcrxlcd or oll'crcd lbr salc (Scc.7044. Business and Prot'cssions Ctxlc: Thc Glntractor's License law dtrcs not apply to an owncr of
thc pnrJrcrty wlxl builds or imprrtvcs thcrcon, anl who tltrs such work himsclf rtr hcrsclf or through his or hcr own cmpkryccs,
provitlcd that such impnrvcnrcnts arc not intcrxlcd or oft'crcd tirr sah. It. txlwevcr, thc building or improvcrncnt is sokl within onc ycar
ol'complction. tltc Owtter Buildcr will havc thc burden ol'pnlving that hc or shc did not builtl or improve thc proJrcrty lirr thc purJxlse ol'
salc).
_1. as owncr ol'lhc property, ant cxclusivcly contracting with liccnscd contractors lo construct tlrc projcct (Scc. 7044, Busincss
arx.l Pnrtbsskrn Codc: Thc Contraclor's l-icense Law docs not apply to an owncr of progrcrty who builds rlr improvcs thcrcon,
and who conlracts tor such projccts with a Contraclrlr(s) liccnscd pursuant to thc Contraclor's Liccnsc Law).
-IamexcmptundcrScction-.B,&P.C.tbrthisreastln.
WORKERS' COI\T PENSATION
DECLAITATION
I hcrchy al'llrm undcr pcnalty ol'prjury onc of thc tillkrwing dcclarations:
_l havc arxJ will maintain a Ccrtilicatc of Consent to Scll-lnsurc tbr workcrs' comJrcnsation, as pr<rvidctl lirr by Scction 3700 of thc
Latxlr Crxlc, tor thc Jrcrtirrmancc of thc work tbr which thc pcrmit Ls issued.
_.l havc and will maintain workcrs'comlrcnsation insurancc, as rcquired by Scctiun -]700 of thc Labor Codc, tirr thc lrcrlirrmancc o[
thc wrlrk tilr which this ;rcrmit is issucd. My workers' conllrcnsation insurance carricr and Jxllicy numbcr arc:
s
Policy -,0--l-zl
_l ccrlily that in the Jrcrlirrmancc o[the Work tbr which this Jrcrmit is issucd, I shall mrt cmphly any lrcrson in any manncr
so as lo hcconrc subject to thc workcrs' compcnsation laws of Calililrnia, and agrec that if I should bec<lmc subjcct to thc
wrlrkcrs' conrJrcnsation pnlvisions of Scction 3700 of thc Lahlr Crilc, I shall, lirrrhwith comply with thttsc pnrvisions.
WARNING: lrarlurc to sccure workcrs' conrJrcnsation covcragc antl shall subjcct an cnrploycr to criminal Jrcnaltics and
civil lirrcs up to onc hundrctl thousarrd dollars in lo thc cosl ol'cornlrcnsation, damagcs as providcd tirr thc
Scclion -1076 of'thc Labor Ctxlc. intcrest and attonrcy's
p"6, .3- lO-Z(
I hercby allirnr under Jrcnalty of pcrjury that I am liccnscd undcr provision of Chaptcr t) (commcncing with Scction 7UX)) of Division 3
ol' thc liusiness and Pnrl'cssions C<xlc, anrl my licensc is in lull lorcc and cfi'cct.
Liccnsc a 4s Esr.,(frla
,^*, o'1 "10 *Zl
w r
I hcrcby allirm undcr penalty of Frjury that therc is a coDstruction btrding agency for thc Jrcrfomrcc of thc work for wbsh this Ismit is
issucd (Scc. 3097, Civ. C.).
lrndcr's Namc:
hndcr's Addrcss:
APPLICANT DECLARATION
I hcrcby allirm undcr pcnalty of Jrcrjury onc of thc firllowing dcclaratkrns:
Dcmolition Pcrmits-Asbcstos Notillcation Fcdcral Regulations (Titlc 40, Part6)
_Rcquircd lrtter of Notilication
_l ccrtily that the l'cdcral regulations rcgarding asbcstos rcmoval arc not applicablc to this projcct.
mk.",aity that I havc rcarl this application uxl state that thc atxrve intbrmation is corrcct. I agrec to comply with all City anrt County
rlrriinanccs and Statc Laws rclating to arxl hcrchy authorizc rcprcscntativcs of this City and County to entcr u;xln thc
atxrvc mcntioncd proprty ti)r
Aliplicarrl or Agenl
I)crrttilcc ttanrc
ortu, --blFZl
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/VenVl nsu lation
Roof Sheathing
Shear Wal!
Framinq
lnsu lation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
Jt/asonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Fina! Report
Flood Zone Certif
tl
FINAL 'llt ftt \K yz
Certificate of Occupancy tt
Notes, Remarks, Etc.
)
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