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10296887 - Permit (2)
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10296887 - Permit (2)
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Last modified
12/12/2022 4:17:21 PM
Creation date
12/12/2022 4:17:20 PM
Metadata
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Permit
Permit Number
10296887
Full Address
418 S Diamond St
Permit ID
243105
Master ID Number
2018-144345
Project Name
Chavez - SFR Window Changeout
Street Number
000418
Street Direction
S
Street Name
Diamond
Street Suffix
St
Building Use Code
Resid-1 unit
Job Types
Alteration
Permit Type
Building
Applied Date
6/27/2018
Issued Date
6/27/2018
Finalized Date
7/11/2018
Flood Zone
X-0602320257J
Description of Work
Legalize (8) window change outs. Owner-Builder form on file.
Nature of Work
Window c/o
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licensed subcontractors and the number of structures does not exceed four \ivithin ariy calendar years, or all of the work is <br />performed under contract with a licensed general building Contractor. <br />Od , understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any <br />financial or personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the <br />workmanship or materials. <br />Qdn t understand I may obtain more information regarding my obligations as an "employea'from the lnternal Revenue <br />Service, the United States Small Business Administration, the California Department of Benefit Payments, and the <br />California Division of lndustrial Accidents. I also understand I may contact the California Contractors' State Llcense Board <br />(CSLB) at 1 -800-321-CSLB (2752) or www.cslb.ca.oov for more information about licensed contractors. <br />f2drfO I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am <br />the party le ally and financially res onsible for proposed construction activity at the following <br />address <br />2-d I I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by <br />all applicable laws and requirements that govern Owner-Builders as well as employers. <br />eAhZ.l agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the <br />information I have provided on this form. <br />Licensed contractors are regulated by laws designed to protect the public. lf you contract with someone who does not <br />have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain <br />as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. lt is also important for <br />you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your <br />property, you may be held liable for damages. lf you obtain a permit as Owner-Builder and wish to hire Contactors, you will <br />be responsible for verjfying whether or not those Contractors are properly licensed and the status of their workers' <br />com pensation insurance coverage. <br />Before a building permit can be issued, this form must be completed and signed by the property owner and <br />returned to the agency responsible for issuing the permit. /Vote.'the owner's driver's license <br />form notarization, or other verification aceeBtable to the aqencv is required to be presented when the permit is <br />nature, <br />Signature of Prope(y Owner Date 27 /2 <br />Print name of Owner <br />Name of Authorized Agent <br />Address of Authorrzed Agent:_ <br />Phone Number of Authorized Agent: <br />I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above <br />information and certify its accuracy. <br />Property Owneis Signature Date <br />Print Name of Owner: <br />Note: A copy of lhe owner's driver's license, form notarization, or other verification acceptable to the agency is required to <br />be presented when the permit is issued to verify the prope,ty owner's signature. <br />ir -r. ii,);,-i!i.r-A^,,, ir 4::..-: ri. :'i:..., 1. 1i,ir--1, ! : -- t,,r :.l ra <br />SANTA ANA CITY COUNCIL <br />mouiido@sa.la-ana o.o <br />Mayor P.o Tem. ward 2 <br />fr manr.ez@sania-ana.ora <br />v cenle sarmienro <br />vsarmienlo@sanla-a.a oro isolono@sanla ana oro <br />P DavLd Benavrdes <br />dbenavides@santa-ana oro N eoas@sa.ta-ana oro sl nalero@sanla a.a oro <br />AUTHORIZATION OF AGENT TO ACT ON PROPERW OWNER'S BEHALF <br />Excluding the Notice to Property Owner, the execution of which I understand is my personal respons,bility, I hereby authorize the <br />following person(s) to act as my agent(s) to apply for, sign, and Ule the documents necessary to obtain an Owner-Builder Permit for my <br />Scope of Construction Project (or Descriphon of Work):_ <br />Project Location or Address: _
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