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Home My WebLink About30141791 - Permit (3)Project Address: 945 N Fair Way Assessor'sParcel: 1O5-212-Os Lot: 40 Unit: Block: NA Bldg: Tract 2980 Address Range: 945-947 Historic: No Suite Range: Zoning: R2 City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, cAg27o2 Plumbing Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853 Permit #: 3O141791 Pin #:9995q{ Owner: Address Phone: Tenant Name: Contraclor Addressr Juan Armenta 945 Fair Way Santa Ana, CA 927031807 (71415s2-5207 Owner-Builder 01 1 16002 01 1 16002 01 1 16002 ol 116002 5160i 5160C 5'160' 5777C Amount 46.25 22.95 57.20 3.91 Fee $46.25 $22.9s $57.20 $3.91 Fee Type Sewer Alter/Repair General Plan Update lssuance Microfilm Records Qty 1.00 1.00 1.00 1.00 State Lic #: Lac Type: Bus. Lic #: Workers' Compensation lnsurance: Carrier: Policy #: Expires: Ju0fi Armentn 6ener(l Plon Update Fee rll I I6011?- IiI6t:-1tut1- Plu b ine 01116[02- 51602[trrl- n icnof i Lr l. Oscufients('l I 160u2- 3777[r-]00- Viso tC+: *******rx*r*5949Single Family Dwelling Miscellaneous Sewer Drain Repair Occupancy: Constr Type: Code: Aulh+:r-tBuilding Use: Job Type: Nature of Work Planning Conditions: Planning Approval By: Plan Checked By: Permit lssued By: Subject to Field: Building Permit #: ..v Date Date Dale Misc. Receipt: Misc. Receipt: Misc. Receipt: Total Zuniga, Alli Every pemit issuad shal becono invalid unless the wo on the sile authotized by such pemit is commenced within360 days aftet its issuance, or if lhe wod< authorized on the site by such permit is suspended or ebandoned fot a period 01360 days aftet the tine the wo* is commonced. lnspector MID#: 2020-156981 R-3 VB cPc 2019 01t09t2020 Account# 01 116002 51600 01 1't6002 51602 01116002 57770 Fee Total Paid to Date: Balance Due $'r 30.3'r $0.00 $130.31 $22.95 $103.45 $3.91 Phone: Botchi:53804 - !/?/21r2(r I0r HGARCIToffi(e! CIYH Trone+: 13 1 ofAcct+: frelil 3{1141791 Itcpt+:02861326 - L/9 /2t)2tt gr39 An Tr0nsoct ion Totol tlstl.'JI Notes: Repair existing sewer in private property. Auth on lile. PLUMBING.INSPECTOR RECORD APPROVALS DATE ID/SIG.COMMENTS OTVNER DU'LDI'N D!:I,CARATION I h.rch! rfirn u dd l)chrlry of Frjury rhd I am dcnlpr fnnn rhc Contrctni l-i.c s Lnq {or rhc folkrrinS rc!{)n rsc..7orl 5 Bu\nL'sr xl llrtc\snnr Co c) Any(iryoi(i)unryshi.hrcqtrnN.t nr n,.on(rcr. rkcr. irnlnrc. dcnmli(h,t Rt,Jn dn], itu.rlrc. nriort' ir\ is\urncc. aho rcqune\ ihc rppli.rd lar nr[ nriinirl' ri[ r silncd {dc rnr rhI ltor \hc n liccn\cd furu r) rh. porisi.trr ol rlr Gtrtr..rois l-iccnsd ljs (chur.r r), Co mcftin! Birh Scdion rdx) ol Divnion .l ni rhc Burim$ rnd Itolislion\ Codc)orrh{ hc orshc is crnrpr rhclcnom! 'hchr\i\lnrrhcrlicscdqcnDrnnr. Anyliolirionots(ri.n?0.115hyrny r!fli.inr f(tr dp.nnir subj..r( rhc rlrfli.dnr b acnilpcfulryofnor 'ftftrhrtr fiLc hundrcddulldrs (55tX)) -l- \ oencr of I hc pn,p.n y. {n nry cnrdoyccs wil h $ir$ rs rhcn q,b lannp.n\r nu. } lll do rl{ suk ud rhc iuh is n.l lnrctu.d oroil.rc tu !'lc(S& 7(!J. Bu\nr$md Prolt\\i{,ni Cod. lhc(ln rnktrrl-i.c \.ljqdocsn.rrml,n,0no$ncrof rh. pFpcny {tu, 6Iil& or ing,mrB rlxmn. md uho d{f,r sch so* hi.tr.llo. hc^cll or rhron3h ik or h.r oso.nDlorcc\. prniJcd rh{t su.h inpnr.rtrrs.e n idcn !{ or.ff(cd fir rnL ll hort!.r. rh. t^riklin! or nntn$mir is {'h s iriin .N )c!r ol .ompLrior, llE ()wts BuilL(r *ill hM rh. hi!dcn ol tovirp rln hc or slr di mr tnrildor im|novc rhc nm|cn, trhcl)urFis.f *0sowncrofthc |Iorny. anrcxclusivcly conra*in8 qirh li.rtrsd .onr!*$ Io otrsdd rhc tmjsr (scc 7044. Burircs Pn,fs\i,n Codci l he Co.lrdcttr s Liccn\c Lrw doc\ nor slnly r. an os.cr ofpopcn! {ho huildr or ifrprovcs d$co6. rnd who ootmcts for such pmi(ls with . Contelo(n [rciFd puBu to rhâ‚¬ Conrr.crols LtcrE Lrw). -l er.x.mfl lndcr 56r B. & P.C. tor rhh rcaso!. e4-fAlllBtrlBltaulult a! lEcldaArlQ! I trcEby aruo u.d.r F..Iy of Frjury oc of (E lolLwirg dc.linrhrci _l havc .rt eill nDinr0in n C.niforc oI C.nent ro Sclf,l isurc 16r wort.ts comr.hdio.. as pmvidcn 6r by Setion 3rGl of ihc ljhor Crn(. for lh. FrfornMc oI lhc *olt lor which rhc l,ermil h issucd. _l h.rc lnd will moinrain wor*ctr' .oq,.n$rion in$mftc. I rcauiEd by Sc.liotr 3?00 of lhc bbor Codâ‚¬. for lhc Frfornlmc of rhc *ol fot wfiich lhii Fmil is isnicd. My *ortqi .omn nelion insur.Nc erkr 8nd policy nlmbcr @: Poli., Ntrtr$cr: [ll)ic( l.cniry rhlr rnc l).rfortune otrhc work lin Bhich rhh lr.mir t hsu.rr.l rhrller crphy lny p.i$n a" nny mMncr s s 'o bccom sbiNt ro rhc wolkcs' conp.nsarion $ws ol Crlifomi!, ond .8N lhal if I should bcsm subicl to lhc *o*ss cotrrrxn$rbn provh 'ns of Seli.n l?00 of th. t{ktr Codc. l shrll, font*il h omrly wirh tno$ rmvhio.r WARNINC: railur. t, s.xE workcB' .ompcnslrion ('!m8c is unlnstul. rd shtrll *ubjccr !n .,ntlLr't to aininal Fnihics and civil fincs up ro om hu r.d lhouq.d dolhre ($100,000), in 0ddirhn ro $. cost of coryEnslion. damScs $ providcd ibr lhc L.bor C!dc, irlcEn lnd rnormy s o o )-a ^ DICIJ.BAIION I h.nhy trfllrnr u d$ |x ahy.l lcrjury rhd I rnr li.ci*lundcr |flrtnnr olClrpi$ 9 (connNmir8 sirh Sc.rion ?U[) olDivisior:] o, rhc Busincs and Prnn$tnrs Conc. nnd nryliccn\. n in tulllnrcc dcic.r SJISIBIJCIIONIIiNUINCJqEN.CI I hcrcht .{ h m u ,ld ,.Mlty u I lErjury rh.r rhcr. is , on{n.li'tr hndiu r8cn., for r hc l)criormrncc .f rhc sork tur which rhir pcnnir is hrucd (Sm :1097. Ci! C ) APIIICANLDECIAIAII(}N I h.t+y afiinn hdcr pcnalt, .l rrjuy oic oalhc aollo*itrE dala,alknrs Dcnnlnion Pcrmirs^slEnos Nolificarion Fcdcrrl R.BUhln'ns ('I nb iO, Pdn6) -Rcquircd Lcrts of Norifrdbn l.c ilirhd rhc icdcr rclrhriinr\ tog:trding r\hcn.\ r.nr'!rl rrc nor rPpli.ftt t, rhillmUrrr **rirhd I havc rcdd rhir applirarhn md Ndc rhd rhc aborc infomurn,n k cotrd l,Bre ro coq'ly wirn allCnyand Colnty and Slare La{t rlnrins ro buikling coi\mdn$. ud hcrhy auh,ia rct$.nru'ivcs olrhis Cny,nd Counlylo cnlcr ur.n lla/e//t ?DA UNDER GROUND Waste & Vent 7-lt2d ra<2, Water-Under floor Gas-Underf loor Building Sewer Area/Storm Drain lnterceptor/ Clarif ier TOP OUT Waste & Vent Water Piping Gas Piping Tub/Shower Test Rough Water Heater POOL/SPA P-trap/Drain Line Main Drain/Pool Pipinq Fill Line/Back Flow Pool Heater/Gas Line Miscellaneous Gas Service Lawn Sprinkler Sanrtary Sewer/Cap Back Flow Device Rough Plumbing Final Gas Test Meter Release FINAL z-//-4 fs-r >t-t t,tds J.^) Notes Remarks, Etc *,"tell o1,1 ZP lrlrJ.i\ A,ldrcs .'htrc'rnriLn'c'l pn.n(dy 1,tr i"\nc..ri,,!llll@!s. n*r*,*n**,o***/{/ +ftJ'4,611f *^u**.*,,n*('/ t J4 rA4g1ft!1t-A Roof Drain Water Service 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-'t3 CBC 2016 NOTICE TO PROPERTY OWNER Dear Property Owner: An applicat '1r'',d ing t has been submitted in your name listing yourself as the builder of the property improvements specifled at 64 We are providing you with an Owner-Builder Acknowledoment and lnformation Veriflcation 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 offlcial 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 veify this information. J. f\ 1 . I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builded' 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. JA-, 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. aAS I understand as an "Owner-Builder" I am the responsible pa(y 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 flled in his or her name instead of my own. IAt-a I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. 'tn :J. I+_5. I understand if I employ or otheMise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employe/' under state and federal law. J:A-O I understand if I am considered an "employer" under state and Federal law, I must register with the state and federal government, 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 flnancial risk. .-r- J,{l Z. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential structures 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. -JS-g 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 owner(s) that result from any latent construction defects in the workman- ship or materials. f.lAr. f understand I may obtain more information regarding my doligations as an "employel'from the lnternal Revenue Ser- vice, the United States Small Eusiness Administration, the California Depa ment of Benefit Payments, and the California Divi- sion of lndustrial Accidents. lalso understand I may contact the California Contractors' State License Board (CSLB) at'1-800- 321-CSLB (2752) or www.cslb.ca.oov for more information about licensed contractors. .'1-^J' l+ 10. I am aware of and consent to an Owner-Builder building permlt applied for in my name, and understand that I am the party dress s ly ro daland financiall y responsible for FA-t n- ul struction activit v at th e following.ad- lTI f f . I agree that, as the party legally and financially responslble for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner-Builders as well as employers. 1{ L':'r.1 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. Signature of Property Owner Date: , O Print name of Own ^l â‚¬ AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Prope(y 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 file the documents necessary to obtain an Owner-Builder Permit for my project. Project Location or Address 4 â‚¬N 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 Ownels Signature Date Print Name of Owner Note: A copy of the owne,'s driver's license, form notarization, or other verification acceptable to the agency is re- quired to be presented when the permit is issued to verffy the propetty owner's signature. 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 civil court. lt is also amportant 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. ,Vofe.' A copv of the propertv owner's driver's license. form notariza- tion. or other verification acceptable to the aaencv is required to be presented when the permit is issued to verifv the proDeftv owner's sionature. f "q /to ScopeofConstructionProject(orDeSCriptionofWork):