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104105553 - Permit
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104105553 - Permit
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Last modified
9/8/2021 5:05:54 PM
Creation date
9/8/2021 5:05:53 PM
Metadata
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Permit
Permit Number
104105553
Full Address
501 S Santa Fe St
Permit ID
271178
Master ID Number
2020-163379
Project Name
N/V
Street Number
000501
Street Direction
S
Street Name
Santa Fe
Street Suffix
St
Building Use Code
Manufacturing
Job Types
Alteration
Permit Type
Building
Applied Date
12/23/2020
Issued Date
12/23/2020
Finalized Date
3/15/2021
Flood Zone
X-0602320276J
Description of Work
Removal of all unpermitted non-bearing partition walls and restore back to original permitted use. Owner-Builder form on file. *BUILDING SHALL NOT BE OCCUPIED UNTIL A PERMIT FOR A TENANT IMPROVEMENT HAS BEEN ISSUED AND FINALIZED*
Nature of Work
N/V - Remove partitions
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9. I understand I may obtain more information regarding my obligations as an "employer" from the lnternal Revenue Ser- <br />vice. the United States Small Business Administration, the Californih Department of Beneflt Payments, and the California Divi- <br />sion of lndustrial Accidents. lalso understand I may contact the California Contractors' State License Board (CSLB) at 1-800- <br />B (2752) or www.cslb.ca.qov for more information about licensed contractors <br />_10. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the <br />legally a fin a ial pon le forpa rty <br />d ress C) <br />nd onstruction activit y at the llowing ad-c <br />g1 I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all <br />/6pplicable laws and requirements that govern Owner-Bualders as well as employers. <br />'12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I <br />ave provided on this form <br />Licensed contractors are regulated by laws designed to protect the public. lf you contract with someone who does not have a <br />license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of <br />a complaint. Your only remedy against unlicensed Contractors may be an civil court. lt as also important for you to understand <br />that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held <br />liable for damages. lf you obtain a permit as Owner-Builder and wish to hire Contactors, you will be responsible for verifying <br />whether or not those Contractors are properly Iicensed and the status of their workers' compensation lnsurance coverage. <br />Before a building permit can be issued, this form must be completed and signed by the property owner and returned <br />to the agency responsible for issuing the pe rmit. ,Vote. A coBy of tlD prgpeftv owner's driver's license, form notariza- <br />tion. or other verification acceDtable to the aoencv is reduired to be presented when the permit is issued to verifv the <br />prope rtv owne r's s i q n atu re, <br />,>Gc/roSignature of Property Owner Date <br />Print name of Owner \Ljer crzur y'( 6," <br />AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF <br />Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize <br />the following person(s) to act as my agent(s) to apply for, sign. and file the documents necessary to obtain an Owner-Builder <br />Permit for my project. <br />Scope of Construction Pro.lect (or Description of Work) <br />Project Location or Address <br />Name of Authorized Agent <br />Address of Authorized 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 Owner's Signature <br />Print Name of Owner <br />Note: A copy of the owner's drivert /lcense, form notarization, or other verification acceptable to the agency is re- <br />quired to be presented when the permit is issued fo verify the property owner's signature. <br />nrro _
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