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Home My WebLink About20170746 - Permit (3)City of Santa Ana 20 civic center Plaza (lvl-',lg), santa Ana, cAg27o2 Electrical Permat Counter: (714) 647-5800 lnspection Requests; (714) 667-2738 lnspector Section: (714) 647-5853 Permit #: 2lJ17lJ74Ii Pin #: {466\( Project Address: 200 W First St unlt: 105 Block: 2 Bldg: Address Range: 2OO.22O t Tract: PALMER'S ADD Historic: No Suite Range: Zoning: SD40Assessor'sParcel: 398-277-09 Lot: 1-12 Owner: Address Micha Mottale 7604 Via Capri La Jolla, CA 92037 (619) 2184812 Another Level Smoke Shop 01116002 51603 011 16002 51603 01116002 51600 01116002 51603 01116002 57770 Fee Type Serv Meter [Iin Fee Adj General Plan Update lssuance lvlicrofilm Records Amount 16.98 22.95 57 .20 3.91 Qty 1.00 1.00 1.00 1.00 1.00 Fee $55.37 $ 16.98 $22.95 $57.20 $3.91 Phone: Tenant Name: Contractor Address: Owner-Builder Bnlchi I 14?66 - llf't' i .Er irl Yil Rcpti i r-l2gB96Ui Irgl'i5flil H irho t'lol tiâ‚¬!ner't 1 F'1(rn tlpd(tt( r:r1 1 I 6tr!:{2- 51 6r:rurJr:rtr- El ECIr' i cn1 [1 1 1 6t-[-t2- 5 1 dr:r3r:ru.r- nr l1 Ui c t)ocuf,ieut.- 7 7 Lr r:[:rL'l - Building Use: Job Type. Nature of Work Commercial Alteration Service meter Occupancy: Constr Type Code: B VB cEc 2019 Notes: l--ltlili Letter of authonrile. Planning Conditions \ l\,'lisc. Receipt: Ivlisc. Receipt: Misc. Receipt: Total Plan Checked By Permit lssued By Subject to Field: Building Permit # sden, Julie o21o6t2020 Account# $156.41 $0.00 $156.41 Every pemit issued shall become invalid unless the wo* on the site authorized by such pemit is commenced within360 days after its tssuance- or i the worh authonzeal on the ste by such peinil ts suspended ot abandoned fot a penod c1360 days dftet the time lho woth ts commenced lnspector MID#: 2020-'157600 01 116002 51600 0'1116002 51603 01116002 57770 $22 95 $129.55 $3.91 Fee Total: Paid to Date: Balance Oue Phone: State Lic #i Lic Type: Bus. Lic #: Workers' Compensalion lnsurance: Carrier: Policy #: Expires: i l g /'lt-t?t,l I r(lr r,+: tr ,l ,/ 6 ,";,] Ll:l l-l n1 Lu: ilr Planning Approval By:Date. Datel Date: ELECTRICAL.INSPECTOR RECORD APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCANATION I h6.by arm und6 p.nalty of pdjury rhar I d q.,npr fton rh. Conn do. Licru tiw for th. lollowins @n (Se.?o:l l.t A6in6s ud Prolission Cod.): A.y Cily or Counly shicn r.quir6 a p6tri to condruci alrd. inpro!., danolilh or t.pâ‚¬r y itudun, piorio ils Lssudc., als rcqut* lh. @plic&l for s!.h p.mi( to iile a sistrcl s$rmd thal hc or shc n ticosd psuul. lo $. Fovtsio6 ol th. contnclor's Licosd Lsw (ClBpld 9, Codtftins wih Sdlion 7000 ofDivision I otlhc BuinN sd Pml6io.s Cod.) or rlut h. or shâ‚¬ b .rmpl thgcfron ed rh. bsb for lh. alLg.d â‚¬xmFioi. Any violaion olselio. 7031.5 by my applrant for ap.mn $bj6r!ln rppli.a.l lo acivil p.naltyol.ol mor.lh fivc hundrcd dol6 (St00). Vflir. ". o*o or,r," p,'p".y, or my cmplolc with *aB6 6 rh.ir $l..on,FNrion. will d! rh. wo* ed tE (f,rdE b mr i @d.d or ono.d for s.l. (sa.704!, Alsin6 ed Prcl6ioN Codc Thc Cont .ror's Lic.N tjw do6 nol aply lo u oMG ol rhâ‚¬ rilDdry who bnildi or imptuvs th66n. ed who do6 suh srt hinaclr or h@ll or throo8h his or hs own employ.6. polid.d rh.t such imp.lwrs a. @t irqxrdl or orald for saL If, tow.E. thc hiildins or ioprovc16l i! eld within on. ,@ of.omplaioq th. O*rd Buildd wi,l ha!. dr htrdc. oip.viig thd he or sh. did mi build or inFolc lnc !@paly for th. PtrpoE oa l. s om6 oartE Fopsty, m cxclusilcly contEti.s * ith licorsl cotu.croB b conshcl lhâ‚¬ Foi6t (Sd. 704{, B6in6 d ftDfsebn Cod.: Tn. Cont,acrofs Li.cose t,av do6 nor appl, io e ownd olproFrly who builds or dprovc rhdon. tud sho .onthcrs aor such pmjccls wirh a C.ntEclo(, licncd pu6@r ro lhe Co.rador's LiccM t2s). I @.xmDi ,nd6 S(rior ,,," 1k)?o UOBrIBIU-COMT&NSAIION E&CI.ASAIION I h6cby amrn u.d{ F.aIy drFjlry on 6l$. aol,o*i68 dels.tioN: I have ,nd will mintain a Cglificatc ol Co6m to Sclal6dc for wort6 onrpâ‚¬.s3lion. 6 Fovid.d lor by S..lion 1700 oflh. Lahor Code lor lhc pstbmucc of lhc ert fo. rvhich rh. pdmn b isNd I hav. dd will nai.tah wod(6 comp.Nation iGur.ncc, d r.quied by sd iod 1700 oath. L{bor Codc. fot the pslonnu.c ol thc mrt for shicb this !.flnil is i\ru.d My *ork6 codp.ns.lion i6urdc. ceid &d policy numbr ee: Cmiâ‚¬r - dll eniryrhar inrhe pdfomd.c oarh. wort ro, whi.h rhis pmir is issued. I shlllnor dplo, a., pdson in m, ms.d $ db bdon subjet to th. $rrt6'.omp.Ntion lss ofcaliromin dd asr that ifl should baomc subjdl lo llE poltsl compoerion prov6ioN ofsdion 3700olrh. t b.r aodc I slull. aonhwith cohpry qnh iho* pblisirN. WARNINC: l:ailuc to suc w 6 .onpotsaion cov@g. i, unlawtul. md shall subjd a dployd lo oimital F.lti6 sd civil lin6 up h onc hun&.d thoued dolld (SlOO.0oo). i. 0dditioD to thc ssr of comp.Blion. ddag6 s Providol for fi. I SNUon 107i,orrh. Lak Cd( inlcrcsl dd Dr* zlctft " A !!e [ls!:uroNMcrcautct aalIor I haâ‚¬b, altum lndd p.elly olpâ‚¬dury lhar I d licds.d undr p.ovi5ion of ch.pt6 I (commdcins vnh Sction 7000) oa Division l oi th. Bsin6 ud PDf6sioa Codc, ad b, li.@ G in arll aor.. ed .rd. COTiIBUqIION.I,EIDIIC.dCEICI I h.Eby aflird undd poally of pojory lh, rh@ i5 a onrruclion lodir8 agaâ‚¬y foi lh. pahmd.. oflh. wo.k aor vlich this Fnil b isu.d (Sâ‚¬c. 1097. Civ. C.). AITUCANI.AES.dAAIIO! I @ afrn undd pqaI, of pdj!ry one of lhe fouowing del4alios: D.oolilio. P.mils-,{sb6tos Nolificalion F.dEol R.suldions (TilL 40, Pan6) Rcquir.d lntd of Noi6clr@n ._ I .d! i6 rhd !h. f.d6d r.srhxoN Esrdrs sbdros rmwl e nor 4pl'.ablc !o rhB pmjd Nd- I [l cai& rhar I hav. .ad thb .pplicaliob Md sisl. thdt th. ahove infomarion is .orccl. I .grc lo @mply wit lll cily and cou y oft1in.n.6 ed Srare La$s Elnrin3 to blildins aurhortc r.prMt.liv6 of this Ciry ed Counlyto o16 upon rh. rbok hsriond prcpedy aor iNpâ‚¬liofl AIIli.trnl or Ax tSigtrtrrtr.r L DaZS?t ,.,. zfofto Site-Work Underground Pole Bases Light Standards Spas, Pool, Fountains Signs (monument) Life Safety /Low Voltage Fire Alarm / Dampers Communications Cable Building Under Slab / Floor Bondino / Groundinq / UFER ?--t ^ rt-o v.r lo\ Transformers Torqueing Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Rough) Ceilings (Hard & Soffit Rouqh Ceilinqs (T-Bar Rouoh) Ivleler Release 7,-lo-?o -E'*ta.;!E Rouqh a 9 Service l\,4eter 4-ro-2)**1 lo, FINAL z-t6-zn flâ‚¬Lot Notes, Remarks, Etc Rev. 08'07-2015 Sub-Panels Erpn6: - L'cc6. \unbd APP-13 CBC 2016 An application for din ermit has been subm d r lrl'Ytr our me li tng y UTSE the bui rof perty i pfovements specified at o ,.o 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 owne r, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEGMENT AN VERIFICATION OF INFORMATON DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. J 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. " 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 llcensed Contractor to assume this responsibility. 3. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential flnancial risk by hiring a licensed Contractor and having the permit flled in his or her name instead of my own. 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. J 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 flve hundred dollars ($500), including labor and materials, I may be considered an "employel' under state and federal law. -!-U , understand if I am considered an "employer" under state and Federal law, I musl 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 financial risk. " l. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential -skuctures cannot legally build them with the intent to offer them for sale, unless a// work is performed by iicensed 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_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 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) 647-5800 www,santa-ana.org NOTICE TO PROPERTY OWNER Dear Property Owner: -!-5. I understand I may obtain more information regarding my obligations as an "employef'from the lnternal Revenue Ser- vice, the United States Small Business Administration, the California Department of Benefit Payments, and the California DivF sion of lndustrial Accidents. lalso understand lmaycontactthe California Contractors' State License Board (CSLB) at'l-800- 321-CSLB (2752)or www.cslb.ca.qov for more information about licensed contractors / lO.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 flnancially responsible for proposed construction activity at the following ad- dress: / ,a .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. / lZ. 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 issuin the permit. Note: A copv of the DroDertv owner's driver's license, form notariza- ac the it is issued to the proDertv owner's siqnatu re. Signature of Property Owne >l ,LO Date Print name of Owner frrcuq I'l oil o r-i AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, lhe 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)fuA sLcr)< )& D@, 3-)o tJ fuk * 5zn4- ,4,r, cA Name of Authorized Agent:/{a.yutr{l A,ilonra^ Address of Authorized Agent )ttt tD {5t ST +'^ 5ov}4- A*. CA q4q-U* - olato I declare under penalty of perjury lam e property owner for the address listed above and I personally fllled out the above information and certify its accura Date: i '1 \LO Print Name of Owner:t\o1l 4c't- Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is rc- quired to be ptesented when the permit is issued to verify the propefty owner's signature. Project Location or Address: Phone Number of Authorized Agent: I Property Ownels Signature: t