HomeMy WebLinkAbout101100470 - Permit (2)city ()f Santa Ana 20 civic center Plaza (M-19), Santa Ana, CA 92702
Permit Counter: (714) 647-5800 lnspection Requests. (714) 667-2738 lnspector Section: (714) 647-5853
Building Permit #:1O11OO47O
Pin #: 41351K/
Project Address: 2071 S Evergreen St
Assessor's Parcel 014-122-4'l Lot: 18
Unit:Bldg: Address Range:Suite Range:
Zoning: RlBlock: G Tract: 696 Historic No
Building Use.
Job Type:
Nature of Work:
Existing Bldg. & Use:
Proposed Use:
Single Family Dwelling
Patio Cover
Front Porch
Sfd w/no garage
Residential
Occupancy.
Constr Type
Code:
Flood Zone:
# of Stories:
R-3
VB
cBc 2016
x-0602320276J
1
1st FL Area: 0
2nd FL Area: 0
Other Areas: 0
Garage Area:
Total: 0
Patio:
T lArea:
Yards Req'd:
Valuation:
211
0@0
$4,200.00
Description of Work: New front porch.
Planning Conditions:
Owner:
Address:
Phone:
Tenant
Vicente Marquez
2071 S Evergreen St
Santa Ana, CA 9270730'17
(714t 486-1276
Contractor
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation Insurance
Carrier:
Policy #:
Expires:
Engineer:
Address:
Phone:
License #:
Architect /
Desiqner:
Address:
Phone:
License #:
Hebert Balanta, Designer
Hebert Balanta
12212Sapphire Street
Garden Grove, CA 92845
(714) 588-3408
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req
PWA lnsp. Req'd:
Guevara, Jerry
Scott Fazekas & Assoc
Date: 06/18/20'19 Misc. Receipt:
Date: 09/10/2019 Misc. ReceiPt:
Date: 09/2412019 Misc. Receipt:
Sub.lect to Field:
No
No Account#
01 1 16002 51601
01 1 16002 51612
01 1 16002 53600
01116002 57770
08901001 24000
en, Julie
Planning lnsp. Req'd:
Landscaping lnsp. Req'd:Flood Zone Cert. Req'd: No 01116002 51600
Every permit issued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 days after its issuance,or if the work authorized
on the site by such permit ls suspended or abandoned for a period of360 days after
the time the work is commenced.
Fire lnsp. Req'd:
Police lnsp. Req'd:
72742
Total
01.116002
07776002
07776002
08901007
07776002
07776002
07776002
57607
53600
57770
24000
57572
57500
57607
$150.00
$86.51
$35.1 9
$0 55
$1.00
$22.95
$57.20
Permit Fee
Plan Check Fee
Microfilm Records
SMIP - Category 1
Bldg. Stds. Revolving
General Plan Update
lssuance
No
No
No
Fee Total:
Paid to Date:
Balance Due:
$353.40
$82.29
$271.11
lnspector MID#: 2019-151690
$22.95
$207.20
$1.00
$4.22
$35.1 I
$0.55
BUILDING. INSPECTOR RECORD
SITE.WORK DATE !D/SIG.COMMENTS owNER ItUtl,t)ER t)Ul,( ARA',flON
Ihcrebyaflirrnunclerpenaltyofpe{urythatIenerernptfronrtheContractom l,icensel,awfirrthefolhwingreason(Sec.70,11.5
[]usin6s and Profssion Code): Any City or County which requi|s a lurnit lo construcl. alltr, ilnprove, denolish or repair any
structure.priortoits issumce.alsorequirestheapplicantforsuchpenuitk)fileasignedstatenlenl thatheorsheislicorsed pursuanl
to lhc prcvisions ofthe Contractor's Licensed Larv (Chapter 9. Cornnrencing silh Scclion 7000 ofDivisioil 3 oftlre Business and
I'rcfessions Code) or that he or she i-s exempt lhq-elio,n and the basis lir the allcged exenrplion. Any violalion ofScction 701 1.5 by any
applicant frrr a pennit subjects the applicant to a civ il penalty o f not nu e than livc hu ndred dollars ( $500 ).
()f,/{lt r*
"rthe
pmpeny. or rny ernployees rvilh rvaga as their $le compeilsation. rvilldo the sork rurd rhe slftrctue is not
inlqrded orofTetedforsle(Sc-T044.BusinesandProfesionsCode:l'heConlractor'sl,icensel.awdosnolapplyloanorvnqof
lhe p(rpq1y rvho builcLs or improva lhqmn. md rvho doe such \\u{ hiiltsclIor lterselfor through his or her own ernpkrycs.
proridedlhalsuch inrprovqnentsilenoliiltrdedoroffsedfor$le.lf.ho\r'evs.thebuildingorirnprovernenlissoldrvilhinoneyw
ol coillplction. lhe L)\vner Buildq rvill have lhe burclm ofproving lhal he or shc did nol build or iruprovc the pftrpety for lhe purposeof
sle).
l. as o\\'nq ollhe propety. am exclusilely conlracling \r'ilh licolsed conlracloc lo conslnld lhe prciB*t (Sw. 7&14. tlusinss
and [tofesbn Code: The Conlractor's License Law dos nol apfly lo an o\ter ofpropcfl)r Nho huilds or improres lhereon.
and who contracls for such prcj(ls \\'ilh a Conhaclo(s) licenscd pursuant lo the (i]nlrachr's l-icflse l-aw).
I anr exenrln Strlion . ll .t I'y' lor thrs rcas*'Yr*,llWWffi
!2E(-!"!B ffQl
onc ofthc folkrr int rlcclarations'
(r",",
I hqeby amrm unde pmalty ofpojury
I have ard * ill maintain a Certificate of Conml lo Self-lnsurc for workqs' compfisation. m prorided for by Setion .1700 of the
t,atnr Codc. for the pqfonnmce ofthe $ork for rvhich the pennit is issued.
lhateandsillmaintainw'orkes compnsationinsurance.as requiredbySecti<rn1700ofthel-atxn(bde.forthepofonnanceof
thc rvork for rvhich this pmnit is issued. My *orkcs' compssalion insurance carier ad Jxrlicy rtrmbtr ile:
('arier:
rll-1,.,", :,.
[i\pires:
perlirnnance ofthe rvork for *hich this pctnrit is issuetl. I shall not mrplrrv anv pcrson in nnl nranncr
so askrlxconresubiecttothe$orko's'conryensnlionla\\so[(ali[omia.an(lrtrcrlhatiflshoul(llrconlcsuhicclk)thc
cilil l'ines up lo one hundred lhousan<l dollars ($100.(XD). iil addition lo lhc oI coDpcnsali()n. clanrages as proridccl frrr lhe
Sccltrn .1076 ofthe Labor Code. interest aild alknrv s fees.
t)t,t( t.ARA iloN
I hcrcby alfirm undcr poalty of perjury thal I arn licenscd undcr provist)n of( haplq () (cornnrencing rvilh Section
of lhc Business and Professions Code. mcl rny liccnsc is in full firrce and elTect.
l-iccnsc
l)&le:
l-iccnsc Nurrtlrr :
( onlrtclor'
CONS RU("I'ION LINDING ACEN('I'
I hereby aflirm unrlo penahy ofperjuq,lhat thqc is a conslnrclion lcnding agenc! for lhc pfrfonnance ofthe lrrrk for rrhich this psrrit is
issued (Se'. 1097. Civ. C.).
l-ends s Narne:
--I-encler's Addrss:
APPT,ICANI' DE('LARA-I'ION
I hadry allinn under pmalt;" of pejury one of the followiilS d(laralions:
Denrolilion Pqrnits-AsbBtos Notification Fedqal Regulalions (-l itle.l0. Pan6)
Req!ired Lelttr of Notificalion
I cdif),lhat the fedsal regulations regudirg astElos rernoval are not applicable k) this proi.{
ild slate lhal lhe alxr|e infornralion is con'('t. I agre to cornply \r ith all City af,d ('ounty
ofthis ( ity anrl (irrrnt\ lo ealq' upoil the
alnve nrentioned propeny for
Applictrtrt or Agetr(
l'(rnrilcc ndillc (prinl):
construction.hercby authorize
-24-t7
Set Backs
Forms/Steel/Holdowns IU ttQ ? Ap,t|6L *<
Erection Pads
UFER Ground
SLAB Floor
Su bf looriVenUl ns u lation
Roof Sheathinq
Shear Wall
Framinq
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
l I ,l
FINAL 4 I r.{Va 7>tN vl/V 57
Certificate of Occupancy rl
Notes, Remarks, Etc.
"yl-4-$-
Planning & Building Agency r<^-
Building Safety Division
20 Civic Center Plaza
P.O. Box 1988 (M-19)
Santa Ana, GA 92702
(714) 647-5800
www.santa-ana.org
APP-I3 CBC 2016
NOTICE TO PROPERTY OWNER
Dear Property Owner:
An applicati
specified at
in ,AS6
We are providing you with an Owner-Builder Acknowledqment and lnformation Verification Form to make you aware of your
responsibilities and possible risk you may incur by having this permit issued in your names as the Owner-Builder.
Wewill notissueabuilding permituntilyou haveread, initialed yourunderstandingof each provision, signed, and returned this
form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner,
obtain the prior approval of the permitting authority.
OWNER'S ACKNOWLEGMENT AND VERIFICATION OF INFORMATON
DIRECTIONS; Read and initial each statement below to signify you understand or verify this information.
'r',/)| I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" build-
ing permit that erroneously implies that the property owner is providing his or her own labor and material personally. l, as an
Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and
his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I
am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my prop-
erty.
I-M, I understand building permits are not required to be signed by property owners unless they are responsible for the
construction and are not hiring a licensed Contractor to assume this responsibility.
Jfu I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect
myselT from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my
own.
!fl I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers
on permits and contracts.
!!ffi I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total
value bf my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an
"employer" under state and federal law.
\ru I understand if I am considered an "employer" under state and Federal law, I must register with the state and federal
gov'erhment, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment com-
pensation of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk.
),M, I understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential
structrires cannot legally build them with the intent to offer them for sale, unless a// work is performed by licensed subcontrac-
tors and the number of structures does not exceed four within any calendar years, or all of the work is performed under contract
with a licensed general building Contractor.
V.ttlr. I understand as an Owner-Builder if I sellthe property for which this permit is issued, I may be held liable for any finan-
cial oi personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the workman-
ship or materials.
on for a buildi been the property improvements
:;=->t' ff1, I understand I may obtain more information regarding my obligations as an "employe/'from the lnternal Revenue Ser-
vice, the United States Small Business Administration.the California Department of Benefit Payments, and the California Divi-
sion of lndustrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-
321-CSLB (2752) or www.cslb.ca.qov for more information about licensed contractors.
V [Vl lO.l am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the
party legally and financially responsible for proposed construction activity at the following ad-
dress: .
/ N,1. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
applicable laws and requirements that govern Owner-Builders as well as employers.
1I-MZ I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I
haVd provided on this form.
Licensed contractors are regulated by laws designed to protect the public. lf you contract with someone who does not have a
license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of
a complaint. Your only remedy against unlicensed Contractors may be in civtlcourt. lt is also important for you to understand
that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held
liable for damages. lf you obtain a permit as Owner-Builder and wish to hire Contactors, you will be responsible for verifying
whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage.
Before a building permit can be issued, this form must be completed and signed by the property owner and returned
to the aqency responsible for issuing the permit. Note: A copv of the propeftv owner's driver's license, form notariza-
tion. or other verification acceptable to the aoencv is required to be oresented when the permit is issued to verifv the
propertv ow n e r's s ign atu re.
Signature of Property Owner Date -2ol
t'tTo 0 E
Print name of Owner
AUTHORIZATION OF AGENT TO ACT ON PROPERry OWNER'S BEHALF
Excluding the Notice to Property Owner, the execution of which I understand is my rsonal responsibility, I hereby authorize
the following person(s) to act as my agent(s) to apply for, sign, and file the ts necessary to obtain an Owner-Builder
Permit for my project.
Scope of Construction (or Description of
Project Location or
Name of Autho Agent:
Address of Age
P mber of Authorized Agent:
I declare under penalty of perjury that I am and I personally filled out the above
information and certify its accuracy
Property Owner's Signature:Date
Print Name of Owner:
Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is re-
quired to be presented when the permit is rssued to verify the property owner's signature.
property owner for the address listed