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City of Santa Ana <br />. I <br />20 Civic Center Plaza (M-19), Santa Ana, CA 92702 · Building Permit#: 10489282 <br />Permit Counter: (714) 647-5800 Inspection Requests: (714) 667-2738 Inspector Section: (7 14) 6 47-5853 Pin#: 81716 <br />Project Address: 121 E Washington Ave Unit: Bldg: Address Range: Su ite Ra ng e: <br />As-;;essor's Parcel: 398-132-06 Lot: POR 10 Block: G Tract: GOODWIN ADD Histori c: No Zoning : SP3 <br />Building Use: Commercial Occupancy: B 1st FL Area: Patio: <br />Jo b Type: Tenant Improvement Constr Type: VB 2nd FL Area: Tl.A rea: 600 <br />Nature of Work: Tl/Demo/Restrooms Code: CBC 2013 Other A reas: Yards Req'd: <br />Existing Bldg. & Use: Commercial Flood Zone: X-0602320163J <br />Garage Area: <br />Proposed Use: Dental Office # of Stories: 2 <br />Total: 0 <br />Valuation: $30,000.00 <br />Description of Work: Remove illegal demising wall that created Unit B. New partitions to create (2) new accessible restrooms, waiting area, & hallway on <br />1st Floor. New partitions to create storage, billing, & chart rooms on 2nd Floor. e.atch~:36247 _ 1l/l'.:i/:20.l 6 ID: F'LOPEZ::, <br />Planning Conditions: <br />Owner: <br />Address: <br />Phone : <br />Rosalva Garcia <br />121 E Washington Ave <br />Santa Ana , CA 927013779 <br />(714) 392-1276 <br />Contractor: <br />Address: <br />Phone: <br />Sky Blue Construction <br />24000 ALICIA PKWY #17367 <br />Mission Viejo, CA 92691 <br />(949) 422-3419 <br />Ofi ice~ CTYH Tran st: i6 2 of 5 <br />ikd.:: Ref~: .l u429282 <br />Engineer: Jeffrey JtjnsJ_J ~ ~fji}~i~' -: 1l / i ':,/2016 .-q: ~•i-. erl <br />Jeffrey Cra i§1!n)ffss'di1' iot.a.l !bU6/.IJ . .1 <br />Address: 946 Call 8i:~gt a9ns:~r Construct.ion <br />San Clemente, CA 92673 <br />Phone: (949) 412 4aS5th ,1 Plan UP date :=ee <br />Li cense #: <br />~ <br />Tenant: Dr Rosalva Garcia, DDS State Lie#: <br />Lie Type: <br />987832 <br />B <br />01116002-51600000- <br />Buildins ·Vi17.:l2 <br />Planning Approval By: <br />Plan Checked By: <br />Permit Issued By: <br />NPDE S lnsp. Req'd : No <br />PWA ln sp. Req 'd: No <br />Planning lnsp. Req'd: No <br />Lan dscaping lnsp. Req'd : No <br />Bus. Lie#: 350542 <br />Workers' Compensation Insurance: <br />Carrier: BENCHMARK INSURANCE COMPJ <br />Policy #: CST5007918 <br />Expires: <br />Escamilla, Manny <br />So.Anson ~ / <br />Zuniga, Allissa I \V <br />03/16/2017 <br />Date: 11/09/2016 <br />Date: 10/27/2016 <br />Date: 11/15/2016 <br />Subject to Field: <br />Misc. Receipt: <br />Mi sc. Receipt: <br />Mi sc. Receipt: <br />Fire lnsp. Req'd: No <br />Police ln sp. Req'd: No Account# <br />Flood Zo ne Cert. Req'd: No <br />Every permit issued shall become invalid unless the work on the site authorized by <br />such permit is commenced within 180 days after its issuance,or i f the work authorized <br />on the site by such permit is suspended o r abandoned for a period of180 days after <br />the time the work is commenced. <br />01116002 51600 <br />01116002 51601 <br />01116002 5161 2 <br />01116002 53600 <br />01116002 57770 <br />Inspector MID#: 2016-128828 <br />Architect/ Salemi &1:P.i'eiz:ti@stgrfs\.60i000- <br />8ids 3tds Revolving $2. 00 DesiQner: <br />Address: <br />Phone: <br />Li cense #: <br />68028 <br />Total <br />$20.56 <br />$517.12 <br />$2.00 <br />$204.00 <br />$52.50 <br />73 Garrisob~~cS8~2-. 51.· 61201.10- <br />r· I t,l -n l .d..i r ~ Lad era R~~Ch,, c.~.:1..:~-::1:4 . . . ,- <br />(949) 320'~'13 3's:i UU..:-':.1 ~".l.!Utt1.1,_t- <br />fT 1 ,_rot d m e. Do,:un'1er. ts <br />·$204. 00 <br />01116002-57770000 - <br />:p,._ "'-07 ~ _ ._( <br />01116002:'s,p00:1H Permft-Feei 38 <br />01116002 53600 Plan Check Fee <br />riuthi': U$'Mi M 25 <br />01116002 57770 Microfilm Records <br />01116002 5 1601 Investiga tion <br />01116002 51601 Pena lty <br />01116002 51612 Bldg . Stds. Rev olvi ng <br />01116002 51600 Genera l Plan Upd ate <br />01116002 51601 Iss ua nce <br />Fee Total: <br />Pa id to Date: <br />Balance Due: <br />$396.00 <br />$52.50 <br />$90 .14 <br />$226.47 <br />$2.00 <br />$20.56 <br />$5 1.26 <br />$988.18 <br />$192.00 <br />$796.18