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Home My WebLink About10197100 - Permit (2)Project Address:4 WEI rAv Assessor's Parcel 109-123-01 Lot.84 Bldg: Address Range Suite Range: Zoning: RlBlock: NA Tract: 1346 city of santa Ana 20 civic center Plaza (M-19), santa Ana, cAg27o2 Building PermitCounter: (714) 647-5800 lnspection Requests: (714\ 667-2738 lnspector Section: (714) 647-5853 Permit#: lO{97lOO Pin #:4{ { 2FJ Building Use: Job Typel Nature of Work: Existing Bldg. & Use Proposed Use: Occupancy: Constr Type Code: FIood Zone: # of Stories: R-3 VB cBc 2016 x-0602320257J 1 1st FL Area: 2nd FL Area: Other Areas: Garage Area Total: ncbP Patio: T.l.Area: Yards Req'd: Valuation: Single Family Dwelling Addition Addn & Convert Garage Sfd w/att garage Sfd Wdet garage & det ADU 223 0@0 $38,600.00#tY tr Description of Work: Add laundry room, bathroom, & closet. Convert attached garage (223 s0 to bedroom. SAUSD #3803 Planning Conditions: Owner: Address Phone: Tenant: Martin Gonzalez 2430 W Elder Avenue Santa Ana, CA 92704 (949) 544-9901 Contractor Address: Engineer Address: Donald J lnman & A3sociates Donald J lnman 5'131 Fox Hills Avenue Buena Park, CA 90621 (714) s21-0554 11888 C&CDrattingDesiqn Edgar Cortez 1651 Raymond Ave., 190-G Anaheim, CA 92801 (714) 813-6555 Phone: State Lic #: Lic Type: Bus. Lic #: Workers' Compensalion lnsurance: Carrier: Polacy #: Expires: Phone: License # Architect / Desiqner: Address: Phone: License # Planning Approval Plan Checked By: Permit lssued By: NPDES lnsp. Req' Byl PWA lnsp. Req'd: No Planning lnsp. Req'd: Yes van S azekas & Assoc. rodowski, Teri 07775002 07776002 08907007 07175002 0 77760 0 2 07776002 5760L 53600 24000 51672 5760 0 5760 7 o Dale: O7l2Ol201B Misc. Receipt Dale 1212812018 Misc. Receipt Date: O21OS/2019 Misc. Receipt Subject to Field: No No Account#Total $352 08 $440 10 $5 02 $2.00 $22.08 $s5.04Fire lnsp. Req'd: Police lnsp. Req'd Landscaping lnsp. Req'd; No Flood Zone Cert. Req'd: No Every permit issued shall become invalid unless lhe wotu on the site authonzed by such permit is commenced within 180 days after its issuance,ot if the wofu authoized on lhe slte by such pefinil is suspended or abandoned fot a peiod af180 days after the time the wotk is commenced lnspector lVlD#: 2017-135399 01 1 16002 01 1 16002 0'1 1 16002 0'1 't 1 6002 08901001 51600 51601 51612 53600 24000 $22.08 $4O7 .12 $2.00 $27.00 $5.02 $876.32 $413 iu i463.22 Fee Total: Paid to Date: Balance Due: U nit: Historic. No 1/t:;/ ltti7 I0; Lflrl5r\l 11 ol Owner-Builder r-1'l'i ,' li. U: Permit Fee, rl Plan Chedk',Fee SIIlP - Category 1 Bldg. Stds. Revolving General Plan Update lssuance 71267 COMMENTSSITE-WORK DATE ID/SIG. Set Backs dlxh,t 1t W\*radl 'D)Forms/Steel/Holdowns Erection Pads I UFER Ground SLAB Floor SubfloorA/enUl nsulation )h lt4 lq,ttxt Roof Sheathina itglLtrtrtl^ ,, -)Shear Wall ;tlvilll rP-a Framing 4ltlrot W +)rll^ qw \1__.,lnsulation/Energy e,47ilt4 ',t 4 7r)Drywall t/Ext./lnt. Lath d.zulla n Brown Coat $\ Masonry Pool Fence Handicap Req Deputy Final Report Engineer Final Report Flood Zone Certif lvY(K tlle;li\ululr4 'it /^ pq44.sltln fi 'rr,EuaHJ FINAL ,/"a-^>I Certificate of Occupancy Notes, Remarks, Etc OlVNIJR I}UII,DI'T DI:I,(' RA'I]ON I hercb amid undd p$alry oa rEiury rhal I a. c\eD to rhc ('ontaclor' l-ic.nse l as fin rh. rdl vins Busings a d ,lofsion Codc): Any Ciry oi Cotr rt shrh rcquts a p6mn ro consrtu.l, alld. inptpvc. denolGh .r srrudu,e. prior ro irs isudc.. also râ‚¬rtun6 lhc applic l lor sucn p.mir ro tild . siSncd {aldft tha lt ot ro rfie prcvisions ofrht Contrartor s Licensed Lr* (chsrler 9. Comm.ncins rvirh s.ction 70m of Division 3 o Prcf*ions Codc) o. rhar h. or 3hc t B.mpl thgcfroE od lhc bs6 fot lh. alL8.n smplion Any violdion oasllidn .pplicer aor a pdnir subjars rhc agplicanr ro , civil p@lry o f iot morc Ibtr nv. hun&cd dolles ($5001 l. 6 o$n6 ofrhc ptup.ny, or .ry oployG wilh wa-!6 6 thcn eb conpcNlion. sill & lh. so* and $c sME G nol iNdd.d or oilded aor slc (SE.?0,14. Busin6s od Prol6sions Codâ‚¬ Th. Conlr'clor s t-i.cB. tlw do6 nol apply to d oM.r oa lhc Fopdry rho bilds tu impmrs tlso6. rnd \vh. do6 sucfi Nlt hioself or h.*lf or lnNusn tis ot hq os'. mploy.6. plovided thar such ioprovoNnrs e. nor intdddl oi oild.d aor sl.. Ii hoNdq. lhc ttrildins or inpr.\mdr is $ld Nittin onâ‚¬ ,Er oacolnplâ‚¬lion. lhc Oqn6 BujB6 Nill ha* rhc hrdd orpmvi.! ihd lE ot sfiâ‚¬ did rcl build or improe. th. lmFy for lhc plrFE or -1. ar ownd olrhc rropsly. dn .xclusiv.ly controcl irs rvilh licâ‚¬ccd contadoN ro cotrnrud lhc prciel (Sd ?044. au5i.6 and Potusion Co&: rhc cotrrtdol s Lic.m. tjr doB .ot apply io an o\rn6 orprorfiy who bu ilds or imptovG rhden, and rvho conraft lor su.h pmjEls wnh a Co nclo(s) ltâ‚¬.s.d ttruuMl lo rlE aontracrors l.icd* La{). -l ancr rpt under Sation-. R & P c aor ibis râ‚¬aotr lloRxl,lLs' col\tPENsaTtoN DEC!.4!{IIA! I hcr.5t amnn unJd pd.hyofpquryoneoIlhe aolkNir! ddhralions: I ha\. dd $ ill mainlain a C.nificalâ‚¬ orcotudl ro self-lBurc aor rrcrk.rs cdfrr&s,(ion, 6 pmid.d foi by S6rion :1700 o lthc bLlr cod., for rh. pdlomancc ollnâ‚¬ *o,k lor whi.h rh. p.nnil is ia{ed. I haveand willdaimain workerr co'npâ‚¬malion insurflnce, d requircd[yS(rion ]?00 otlhâ‚¬ lnb1rr(odc aor lhc psfonldce or r hâ‚¬ sork lor lvhich rhb p.mn is issuâ‚¬d My *orkrt compa@l io. iBurmcâ‚¬ caEis ud Fli.y numbs tr : I'dicy Nurh.r:-FrPnes: I ccniay lnar in rhâ‚¬ psronnanc. ofrh. work ior \rhich rhis p.m't is itru.( I shall not dnploy any p.6on in tn, mannd e a r. b..on. subjd lo thc qorl6 enp.nsatiod latrs ol Califomi{ dd asr thll ia l sh.uld beom. subj..l lo thc $ork6 .ompeffariofl proisions ofS.dion 3700ollh. Lat r cod..I shnll. forlhwith .ompl, wnh lhos provisios. WARNINC: rzifurc lo ecu. \ork6 co,npos.tion covmsc is unlaNiul. dd sha]l subjd mtloycr ro cimiMl l)<oalti6 ed civit lina up to one hundEd rhousdd dolls ($100,0010). in addilion lo rh. con olconDmsalion. ddag6 6 p.ovided lor thc sorion 1076ofrfi.IiborCod.,inrd6rmd.norn y sfG ppliont_ ITCEISED.(]ANIIAqIAB IIECI,AAAIIO! I hmbv amm unda pc.alryoapdilrylhal I an [.dsl undd proision olChaPra 9 (commcins with Sdion 7000) olDivision ] of lhc au!i.6 6d PrcfsiomCodc. and nylicse isin tull forc. md ctfsl. q)NiIAUCIIQII.IIDIIIICENCI I hsâ‚¬by alimr undg !.nahy ofpâ‚¬rjury lhol lt6c is a conntuclion le in8 aSmcy lor lhâ‚¬ priomanc. of th. ro* lor *nich rni! pdmt is issu.d {Se 1097. Civ. C.). Affu(ANr.llcLAaauor I lElby afim undo pdairy of perjory o.. ol lhc follorviar decldaiio.s Demolirion P6ins asbGros Norificrlior râ‚¬d6alRcsuldiotu Gnl.40, Pd6) Rqlun.i L.lrd of Nolificalion -l c6r ily lhar the Ld6al r.tularios cgedinS sbeslos rmoval de nol eplictblc lo thu Drcj{l -r.cnilyrhat I har.rqdrhisrpplicationd slatr that lhc aU,\c inlomaion itcotrd I asre to.o,npl, Nilh aU Cily dd Cou.ry ordind.6 dd sratc Laws râ‚¬lalins lo buildins coNrtudio., tnd lHcbyotrlhodzc ler.*nrarivd oflhis Cily and Coumyto.md upon lhc au,ve froriondl pmpdly lor inspâ‚¬.lion pu,F66. ApDli.r r or,{genr Sig rltrre Pâ‚¬rmilft nin'e(pnn(): BUILDING. INSPECTOR RECORD T-Bar Lic.ns. Clds:-l-icdse Nu,nbd: - Dele ('onlr.clo.: L.n,l.r ! Add6:- 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 Dear Property Owner lication ra bu itdt4 pe rmit has be LUr en NOTICE TO PROPERTY OWNER rn yo ur name listi yo urself as the builder of the prope improvementsAn app n specified We are providing you with an OwnerBuilder 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 offlcial address indicated. An agentofthe owner cannot execute this notice unless you, the prope(y 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. " lt -YS ,understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builded' build- ing peimit 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- erty. ^A t Yi, \ ( iZ. t 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. ^lt /^ JII-S t 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. -[].l[o. ' understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. .ll (V( h s. f understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total valud of my construction is at least flve hundred dollars ($500), including labor and materials, I may be considered an "employel' under state and federal law. ^t I tllh_6 I understand if I am considered an "employer" under state and Federal law, I must register with the state and federal govdrnment, 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. ['\'lk I I understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential stiu"dtures 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. ffi8. 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- personal inluries sustained by any subsequent owner(s) that result from any latent construction defects in the workman- ship or materials d ilI, W\tDg I understand I may obtain more information regarding my obligations as an "employe/'from the lnternal Revenue Ser- 'vice,fhe United States Small Business Administration, the Califonlia Department of Benefit Payments, and the California Divi- sion of lndustrial Accidents. lalso understand I may contact the California Contractors' State License Board (CSLB) at1-800- 321-CSLB (2752) or www.cslb.ca.qov for more information about licensed contractors. 0. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the pa ally and financially responsible for proposed construction activity at the following ad- SS _11. 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. _12. 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 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 p ermit. /Vofe.' A copv of the propertv owner's driyer's /rcense, form notariza- tion. or other verification acqeptable to the agencv is required to be presented when the permit is issued to verifv the propertv owne r's si(l natu re. Signature of Property Owner Print name of Owner V )D"t", ll-ZG-l r'llvfl)<-' 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 file 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 Ownef s Signature Date Print Name of Owner Note: A copy ol the owner's driver's license, form notarization, or other ve fication acceptable to the agency is re- quired to be presented when the permit is issued to verify the property owner's signature.