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Home My WebLink About101102213 - Permit (2)Proiect Address: 1136 S Flower St Assessor's Parcell 013-06341 Lot: NA Bldg: Address Range Suite Range: Zoning: RlBlock: NA Tract: NA Hisloric: No City of Santa Ana 20 Civic Center Plaza (M-'19), Santa Ana, cA 92702 Building Permat Counter: (714) 647-5800 lnspection Requests: (714\ 667-2738 lnspector Section: (714) 647-5853 Permit #: 1lJ11o2213 Pin #: 24386.,,f1 Building Use: Single Family Dwelling Occupancy: R-3 1st FL Area: Patio: Job Type: Alteration Constr Typer V B 2nd FL Area: T.l.Area: Nature of Work: Remodel & C/O Windows Code: CBC 2016 Other Areas: yards Req,d: Existing Bldg. & Use: Sfd w/det garage Flood Zone: X-0602320257J Garage Area: Valuation: S15,000.00 Proposed Use: # of Stories: , ,o,r,, Description of Work: Remodel kitchen & bathroom with new counters/cabinets. Drywall where necessary. Change out (12) windows with same size/style Owner: Address Contractor Addressl Address Cypress Flower LLC/David Kalili '15722 Hale Avenue lrvine, CA 92606 (949) 678-1 135 Owner-Builder Phone: State Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance: Carrier: Policy #: Expires: Phone Tenant Phone: License # Phone: License # Planning Approval By Plan Checked By: Permit lssued By: NPDES lnsp. Req PWA lnsp. Req'd: Planning lnsp. Req'd: Landscaping lnsp. Req'd E ez el ki, Teri $166.53 $3.91 $1 .00 $22.95 $57.20 Permit Fee Microfilm Records Bldg. Stds. Revolving General Plan Update lssuance]r :o No No No Fire lnsp. Req'd: No Police lnsp. Req'd: No Flood Zone Cert. Req'd: No 01116002 51600 011 16002 51601 01116002 51612 01116002 57770 Account#Total Every pemit issued shall become invalid unless the wo* on the site authoized by such permit is commenced within360days altet its issuance,or if the wo* authorized on the site by such pemit is suspended or abandoned for a period of 360 days after lhe time the wotk is cofimenced. lnspector IvllD#: 2019-155803 Fee Total; Paid to Date: Balance Oue: $2s1.59 $0.00 $251.59 Unit: Planning Conditions:No change in floor plan. All matorials to match existing. Engineer: Architect / Desiqner: Address: tâ‚¬neTs I l' ar11l6u0,'r- Buildrne fr11160r.t:- Bldg 5td: r-tl l16U[?- tl icrof i isr nl I16 t-r?" Lon Updote 51 6 U r:t0 r:ln - 516[r1iru0- FevoIv ins 51612r-t(rt'.. & Docufienl 5777ur:(:ri- Dale:1111212019 Date: Oate: 111'1212019 Subject to Field: Misc. Receipt: Misc. Receipt: Misc. Receipt: 0 7 776002 07776002 0 7 7 76002 0 7 7 76002 0 7 776002 57607 57770 57572 57 600 57607 $22.95 $223.73 $1.00 $3.91 COMMENTSSITE.WORK DATE ID/SIG. Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Subf loor/VenUlnsulation Roof Sheathinq Shear Wall Framinq Pt-,faetr-llnsulation/Enerqy /4/J4? , tDrywall, tt,'tl"lt ) Ext./lnt. Lath I eL!?pLr Brown Coal Ivlasonry Pool Fence T-Bar Deputy Final Report Engineer Final Report Flood Zone Certif FINAL 3/4 /24 .*+?/.) Certif icate of Occupa nc'y1 Notes, Remarks, Etc BUILDING. INSPECTOR RECORD OWN!iR BUII,Df, R DEI-CARATION I hBeb, oil-rm under pâ‚¬nahy oa tejury thal I an cxdnpl ftom rh. Conlrtcros' Li.m. kN lor the folloNin! r@$n (sd 70r I 5 Busins afri P(l6ri.n Codc) Any Cily o, Counly Nhrch rcquiG a ptf,nn lo coaslnrd, all(. nnpr.!c, ddnolish "r EIEn AnJ nrrurc. pno! ro irs isuucc. atro r.qut6 ihc +pli.d fff strch psnit Io file a sisncd rarmar th.t hc or shâ‚¬ is lics.d pGuMr kJ dr provisions oa lhe ConrAcloas l,iccnsql l-nv (charr.r 9. (omrncncins s'ilh Sdion 7000 of oivision I ol thc Busincss aid Plolcssions Codc) orrhal hc or snc is.rc.rpl lhdciom md lhe b.sis lor lnc allqen ermplion. ny viol.rion ors..lion T0ll 5 bt..'t opplicant for a p.nni subjâ‚¬crsrhc applicrnl lo acivilpcnsllyofnor nor.rhd n!. hundr.d dolla6 (5500) l.s o$nerollhcprolEny,or ry.ndort6 wilh war6 as lhcn sob compcnedion. s ill do th. Nott ud lhc $ndE i, nor inrEdql or orr.n lor ele {s(.7044, Businss and Proi6sioE ( od. llE aontr.cto.s Licose lnv .i'G .or apply to an owns ol rhc prupely who builds or i'nl'ovs lhdon, ed $ho dr6 nrch so'l nnnsclt or h@lf or fimu3n his or hd own chploy.6. povid.drldsuch im!rcvorols @rcr inrdxlql orofid.d forsk I[ h\r66- rhe h,ildi.S or i'nlro\.mm i! $ld$irhin on. ]a orcodpldion. rne o$ 6d auildG rvill halr thc bud6 or povinE rhd h. or she did nor hrild or imForc 6. ,opdy for thc purFs. ol I. ns o\ n.r .l'lhe propâ‚¬1y. ar Bclusivcly conrradins \ irh li..nsd cofltr.clos lo con(rucl rh. pmid (s( 70,1t. u6'nd and lhfssin ( od. rh.Contackx's l.ic.nsâ‚¬ l,a\c do6 nol appl) ro a.orvnd olpopdywho buildso' i'npror.s rhcron. I hove ud \ ill tuiarain a cedifi.ai. oacoNd ro Sclf'l6xrc to' so.k6 .omr)mrion. 6 ,,or idcd lor by Sdio. I700 olrhe rllr)r ('ode. tor rhe pslomBnccoflhc *!tI for $hich lhc Fmir is Gsucd lharâ‚¬andNrll'naimai.{.rhnt.onrN'solioninsrance.d'equtqlb!sdbnlT00ofth.liborCodâ‚¬,aorrhctâ‚¬foiinanceol lhe \ror* ntr*lichthis pd n is istrâ‚¬d. MyNorlm c.,.Fnraton iNure.c.,nid ddp.licynumb.r e Ireniryrhat in rlrndldnl.n.eofthe*ork for shichrhisp.flnir is irsu.{. lsh.llnoi a.pkrt anypssor inaf,rmannq s a ro b.$me srbjd ro rhr wor*6c.ompGrion la*soacaliaomia. a.d as'.r rhar ill should lE.n'c $rbjdl ro lh. $orks'comrcnstiont(lisiotuoaseclionlT00ollhetlxrtCode.lshrll,ndhwnhco,npl!vithlioseprovisions. WARNINC: F^ilurc ti sre $orke6' compcr n,hicd xn .l plutd t) dnniflal |amll6 and h .n. htrnd'ed rhoNan.l d llrrs l$xlr. dr rxlcs rs plori(lc(t la' l1r sdrnr' l016 ofrlte tabor (irde i.rE6r an a r) r.( I \k \ I l(,\ I lprcby.mnn utud pmahy of p.rjury lfrar I an licoed odo provisbn ol(-hipl6 9lcomnrcn.ing rvirh Sdion 7h$).rr)ivhion l oI rhc &sin6s Md Phadiiod Cod.. md mv licosâ‚¬ is in lulllorcedd cfldr CONSTRUCTION LANDTNC ACENCY I hd.by 0mrm undâ‚¬r Fnalry olpsju.y thd rh@ G a codtudion Lndinr asâ‚¬ncy forrlE pdfomr&cc olrhe$rk for rhich rhi! Frmn is issu.n (sd 10e7, Civ. C.). AEIIICAILUECIrItrdIO! lhoett afln undd rtrihy olptrjury onc olth. follo\ins declMali.ns Ddnolirrcn I'ermils-AsbsnxNoria.arbn l;â‚¬ddrl Rcctrlanons(lilled0, I'an6) Reqtrtrtd I clrs.rN.tfi.irifn ns eAddin! dlsros enrolnl ale n.l applic.blcrorh6 ptol.Ll rhcaur\cinronnarnris.ordr l.Brerocomdysnhallciryand('ounry n.a hs.hyaurhorta reprGonariv6 ollnis Cny dd Cormr ro.nl6 up.tr drc rl T 0/rD PaUlui tL lt ,-: :i$##:"NY':::. k*''im t 7 \ lzf,grl3^rll l hc'ch) rm"a un'jfl rd,i),,1 p6J,n oF olr\. |.-IlR rF,hldd.^ i Handicap Req. ?3 C (D =(D (o o)E3 E OJE(D gooâ‚¬ o:r(D E o- o, =OJ !4. (D joo E ojf,q t/tz/gAI o o!o oo- o- o rDol'r { I IHlll il;gvl bSsX [-l_ll-E ax A0IL u Vr (I N uJ I Z a +l q )av Z l..l -I tlr I ra L L'l ft l* LLLtl a I rlx B/ lr ri I I Y G ) o I t 1 G rl APP-13 CBC 201 6 Dear Property Owner An application for u ild in g per it ha ens itted in your name listing yourself as the builder of the property improvements specified at 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. l/ t. 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 flnancial 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- qrty' t-rh' / 2. 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. I \/ S f understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect Kylelf from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. iV-O I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers L6n permits and contracts. alue of I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employe/' under state and federal law. V ll 6. I understand if I am considered an "employer" under state and Federal law, I must register with the state and federal govBrnment, 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 sublect me to serious financial risk. d\r II |/L/L 7. I understand under California Contractors' State License Law, an Owner-Builder who builds singleJamily 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. 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. Planning & Building Agency Building Safety Division 20 Civic Center Plaza P.O. Box 1988 (M-19) Santa Ana, CA 92702 (714) 647-s800 www.santa-ana.org NOTICE TO PROPERW OWNER WeareproVidingyouwithantomakeyouawareofyour responsibilities and possible risk you may incur by having this permit issued in your names as the Owner-Builder. \x-9. 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. lalso understand lmaycontactthe California Cgntractors' State License Board (CSLB) at1-800- 321-CSLB (2752) or www.cslb.ca.oov for more information about licensed contractors. 10. I 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: ( )/( t t . I agree that, as the party legally and flnancially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner-Builders as well as employers. 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 result 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 lnjured 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 coov of the prooertv owner's driver's license. form notariza- tion. or other verification acceotable to the adencv is reouired to be presented when the permit is issued to verifv the Dropertv owne r's sionatu re. Date lr \r^ h \n/,,t Esutt tPrint name of Owner 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 file the documents necessary to obtain an Owner-Builder Permit for my proJect. Project Location or Address 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 Owner's Signature Date Print Name of Owner: Signature of Property Owner AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF ScopeofConstructionProject(orDeScriptionofWork): Name of Authorized Agent: 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 issued to verify the property owner's signature.