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Home My WebLink About20170981 - Permit (2)City of Santa Ana 20 civic center Plaza (M-19), Santa Ana, cA92702 Electrical Permit #: 2O17O9A1 Pin #: 4o452Permit Counteri (714) 647-5800 lnspection Requests: (7'14) 667-2738 lnspector Section: (714) 647-5853 Project Address: 622 E Adams St Assessor's Parcel: 016-136-20 Lot: 7 Unit: B Block: F Bldg: Address Range: TTact: EMMETT'S ADD HistoTic: No Suite Range: Zoning: R2 Owner: Address Phone: Tenant Name: Contractor Address: Salvador Lucas 522 E Adams St, B Santa Ana, CA 92707 (714) 631-6011 Owner-Builder Amount 22.95 57.20 Fee $5s.37 $22.95 $57 .20 $3.s1 Fee Type Serv Meter General Plan Update lssuance Microfilm Records Phone State Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance Carrier: Policy #: Expires: uff Tr( P'(lLch,i i::i4 ) irer CIYH Tn(lns+ jt+t129!2289 - 3/9 Inssct ion fotol Solvodor LucoBuilding Use: Job Type: Nalure of Work Planning Conditions Planning Approval By Plan Checked By Permit lssued By Subject to Field: Building Permit # R-3, U VB cEc 2019 Service m'dtdr lor unft B. Handout given Date Date Date Electr icol r-'ll1I6002- 5ldUlt-[]0- ll icnof iIn & Docu,trent B11l61102- i7?7lrr.1u0* (:flsh Ch0nseMisc. Receipl; Misc. Receipl: Misc. Receipt: Total Amsden, Julie Every permit issued shall become invalid unless lhe work on the site aulhoized by such permit is commenced within360 days aftet its issuance, or if the wotk aulhoi2ed on lhe sile by such pormit is suspended ot abandoned lor a petiod of360 days aftet the lime the wo* is commenced 03/09/2020 Account# lnspector MID#: 2020-158341 01 1 16002 51600 01 1 't6002 51603 01116002 57770 Fee Total: Paid to Date: Balance Oue: $139.43 $0.00 $139.43 01 I 16002 51603 01116002 5't600 01 1 16002 51603 01116002 57770 Qty 1.00 1.00 1.00 1.00 i( 2t-t 1;,r 11; l;rr? ['ll $ l3? . lrii Single Family Dwelling Alteration Service meter Occupancy: Constr Type: Code:Notes: $22.95 $112.57 $3.91 ELECTRICAL.INSPECTOR RECORD APPROVALS DATE ID/SIG.COMMENTS OWNT'TllUII,DE& DTTI,CARATION I hcrcby afrnr u cr p.Dalr, o, Frjury dd I ..x.nDr fbm rh. CodncloR' LilrM tiu lor E follo*in! EMn (S.c.70115 Busincss ,nd Pmlas$nrn Codcl: Any Ciry.r CDudy phf,h rcqurc. a pcrmir ro onifl.t. rlrcr, impmvc, d.mlish or ep.tr sy ntucruc. pri} ro irs n$aN.. itqr Equn.s rh. alllican lor sucl p.n to liL r rirEd sr:r.nEn! rh.t lE or sh. is li.ctr*d pusa! ro $c prcvisionx otthc ContKroas l,iccn*d lf,! (Ch.Ac.9. Conrrcrci.8 wirh Scdnn 7l)00 of Divkion I ofth. Bosin.s dd Profesions CL'de) orrlEr lr or dr ir.x.n'fi rturctoDrnd E hars forrlE allc8ed ckmprioo Ar, violarion ofSâ‚¬rior 70ll.5 by My opplico lo. o p.nnir suhj(rs rh. applicdrrorcivilp.Mhyornormrclh,nnv.hundrcndola^($500). l. $ oler.lrh. Omrcny. o ny.'n0loy.cs wirh wi8cs rs rhcn 5l. cono.ndion. silldo rhc *o* a'd.h. stlww is mt inr. d or uflcral Ir sL (S* 7Ur4, Businrss ,nd Prolssions Cod., Tlr Conrerols Gcds. L., do.s nor .pPly ro u own.t ot rhe IIDp.ny vho honds or i,{mE: rLtu4 rrd wls d(s sh $olk lins.lf or lErslf or rh'otrgh hk u h.r o*n.nploFs, provihd lhal sucn nn[,nrmds e ml imcndcd .r .llq.rl Io, salc lr. ho*cE, tlE t{ildin3 or nryr.wft'n ir sld *inin of y.4 ofconpbnr E OwEr Blill.r wil havc rtE h{nLn or proviry rlq lE o. sh. di'l d bui! or inpmvc dE pDpoq ror d. prFe o, 5-4, n. o**. "r,r," p,.p.ry. *h cxctusnrly codr&in8 ,irh li..tr*d .otueroB ro cusrrucl rrE Foi{ (s&. rx4, BusNs arn iioi:ssin Code Th. Contccbi'i Lftns. tlw ddr nor {ply ro otr over of pop.ny *lto buildr or ir,pov.s rh.m.. and vho conuds ,o, $ch l)rt,J..ts *irh r conrftro(s) Iiccncd p!r@ h iE Conu..rq r Lt4* kw) &u,aurpr uraq sctp u1)tsKEBltl!)lr$ll ra! I)Ee! 8t[IL9! I lErcby alltD u.d.r pcranr oI pslur) otu or rtt lblt,wiiS dccld.rirB -I h:v. $d eill ndn(.in r c.nrn(aE uf coNc to S.llltrsuE lor *ol}c Lu{Gnsarion, a ptiviJ.d lor by S.cion l70O oi ttr Ijru Codc, tor thc Frlonr$c ot thc eort fd $hi.h rh. pd.rit ! isrmd. _l hay. and *iU nuinrdn *ork.6 cor{E,sarion iNuhr.., as Equt.! by Sarion 3700 of th. bbor Cod., for rh. FrfonE f,. ol $. sork for vhth rhis tt mir i! i's{d. My ,ort.B mhp.Mion iNuIec cMii ui Frliy nunhc, m: PolicyNumh.r: ErpiEs: S_! e'1it rt r i, d. Ixrf"*.id or rlr work rur vhich ns p.rBir N ssu.d, I rhlll nor cnrloy any p.don s ry m-rcr s as ro hccom subj.ct ro ihc w.lk.N .onlp.ns.ri.tr laws of Cihfomi!. and ryrc. rhd iI I Jhuld b.com sbjcd ro rtE soi{ss.onU.n\atio.p'oli\iuBolS.diunll00otth.tiborCDd.,Istull,fodhwilhcotrp!*nhihosprovGions.. WAI{NING, F ilurc to â‚¬cur. *or[.n comp..ssrion c.v.tu3. ii unl.erul. ond $all subicr an chplorâ‚¬r to diniMl p.niki.s nd civrl liEi uI' b on. hundEd rlousa.d dolhn ($loo.Uro). in addiriotr b rlE uod of conD.'MtioD. dffi3.r a povid.d fD. rb. S.clion 1076 of thc t:tni Codc, inrci. .nd dNncyt L.s. 3 oi? a 1ro/or / uuS ucENsEp-cqNr&cro8 DEqdAAIIAN I hceby 0Jfrrh urd.r p.Mrry o, p.rjury rhd I .nr ric.nsJ uBl.r provlion o, Ch4rd 9 l.omENi,8 wnh Sation ?00o) of Divisio! 3 oa rh. Busiess dnd Ptuf.siotu Cod., rnd m, lic.n.. I in lull lorcc.nd cll(t Li.cD\eClJS l,iccDrc NurnDr: g)ISII.I]qINJENDIIGIGEBSI I hcEby .mrm und.r FDlty ol pcriury rhd lh* ir r c.nsncrion hndin8 .8.rcy lor tnc Ffme. or lh. vtrl for rrri.h thk pâ‚¬onit i3 issu.d (S.c. 3097. Civ, C.). AITUCAITLDECIdBA!!9! I hsd'y afmr und., Foaly oI tf,rEr, o,! of thc fo&,ri.3 del{ariont Dcmlition P.rtuit-A$.stos Ndficdon F.dchl Rcguldioni CInh 40. Pd6) -R.quiEd L,ucr ol N ituati,o _l ccni& rh'l th. lcd...l r.Suldio6 rc8ndir8 arb.ilns Emvd G mr aprliablc to 1& Proj.d. ttl cality th{ I lur Ead lnis +plksrion .nl {!rc rlr.r rlr !h,vc inlornurion n comd I !c@ ro 6nply qirh rI Cay ana CouDry ordilEsd .nd Star L{rs Ehrins ro buildinr codrcrio dn h.rcbyruthori2! rcr.crMlivcs o,lhir Ch, ind cody to..is upontr !hor. ftnli.,ktt p6Fn, ror in.Fcrior purFM. Appln nlorAEflrSipn.r g4z' ,5a /va/ar l,-,n( **,5/7/so.t, Site-Work Underoround Pole Bases Lioht Standards Spas, Pool, Fountains Siqns (monument) Lile Safety /Low Voltaqe Fire Alarm / Dampers Communications Cable Buildinq Under Slab / Floor tt.Z Bonding / Grounding / UFER tT P/Tt r) cn/ Er D / Transformers t Torqueing Sub-Panels Air Conditioners Roof Top Equipmenl Factory Wired Unit Walls (Conduit) Walls (Rouqh) Ceilinqs (Hard & Soff it Bouqh Ceilinqs (T-Bar Rouoh)\I [\,4eter Release 1 4 Vt)X\dL -+T d t I I Rouoh I Service l\/eter tv /l )a-t- W67 FINAL ql'rz "4 >&lAJ,^t+8,Nptes,,Remarks, Etc. q 6v J {L DCu I lr Rev. 08 07-2015 c 1.7- > Dff-n Planning & Building Agency Building Safety Division 20 Civic Center Plaza P.O. Box 1988 (M-19) Santa Ana, CA 92702 (714) 647-5800 www.santa-ana.org aPP-13 CBC 2016 NOTICE TO PROPERW OWNER An applicati specified at on for a buildin g per it has been submitted i your name listin g yours lf as o 1 the builder of the property improvements 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. We will not issue a building permit until you have read, initialed your understanding of 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. 5 L L l understand a frequent practice of unlicensed persons isto 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. -6J-Z 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. S L l. I understand as an "Owner-Buildef' I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. 5 L 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. 5 , S, t understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least flve hundred dollars ($500), including labor and materials, I may be considered an "employe/' under state and federal law. )L 6. Iunderstand if Iam considered an "employer" understateand Federal law, Imust register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and conkibute to unemployment com- pensation of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. 5 t l. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family resldential structures cannot legally build them with the intent to offer them for sale, unless all 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. J L 8. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any finan- cial or personal injuries sustained by any subsequent owne(s) that result from any latent constructron defects in the workman- ship or materials. Dear Property Owner: ) L 9. I understand I may obtain more information regarding my obligations as an "employei'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. lalso understand lmaycontactthe California Contractors' State License Board (CSLB) at1-800- 321 -CSLB (2752) or www.cslb.ca.oov for more information about licensed contractors. LIl, L 10. I am aware of and consent to an Owner-Builder buildinq permit applied for in my name, and understand that I am the party legally and financially responsible for proposed conskuction- activity at the following ad- d ress: 5 L ll .l 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. J L p. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have 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 resull of a complaint. Your only remedy against unlicensed Contractors may be in civil court. 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 agency responsible for issuing the permit, /Vote.' A copv of the Dropertv owner's driver's license. form notariza- tion. or other verification acceptable to the aoencv is required to be Dresented when the permit is issued to verifv the property owne r's siqnatu re. Signature of Property Owner ,frroa-'o^t 7/9/Ao2o Print name of Owner 5a l,.,oJo. lar,a <) AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and flle the documents necessary to obtain an Owner-Builder Permit for my project. Scope of Construction Project (or Description of Work) Project Location or Address Name of Authorized Agent Address of Authorized Agent Phone Number of Authorized Agent I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Property Owneds Signature Date Print Name of Owner: Note: A copy of the owner's driver's license, form notarization, or other verffication acceptable to the agency is re- quired to be presented when the permit is issued to verry the property owner's signature.