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Home My WebLink About102102745 - Permit (3)City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, cAg27o2 Building Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853 Permit #: 1()2102745 Pin #: t871J Assessor's Parcel:198-171-'l l Lot. 142 Unit Bldg: Address Range Suite Range: Zoning: RlBlock: NA Tract: 554 Hrstorac: No Planning Approval By: Plan Checked By: Permit lssued By: NPDES lnsp. Req'd: PWA lnsp Req'd; Planning lnsp. Req'd: Landscaping lnsp. Req'd Graham, Jeflery Hernandez, Kathy Misc. Receipt Misc. Receipt NIisc. Receipt No No No No Frre lnsp Req'd: Police lnsp. Req'd No No Account#Total $499.59 $3.91 $'100.57 $252.69 $1.00 $57.20 Permit Fee lvlicrofilm Records lnvestigation Penalty Bldg. Stds. Revolving General Plan Update lssuance Flood zone Cert Req'dr No $937.91 $0.00 $937.91 lnspector MID#: 2019-156786 011 16002 51600 011 16002 51601 01 1 16002 51612 01116002 57770 $910 05 $1.00 $3.91 Project Address: 706 N Jackson St Building Use: Single Family Dwelling Occupancy: R-3, U 1st FL Area Patio: Job Type: Reroof Constr Type: V B 2nd FL Area T.l.Area: Nature of Work: Reroof/windows Code: cBc 2019 other Areas yards Req,d Existing Bldg. & Use: SFD Watt gaarge Flood Zone: X-0602320143J Garage Area Valuation: $6,660.00 Proposed Use: # of Stories:Total Description of Work: Reroof w/t.o.-Remove and apply comp shingles/sheathing to remain/handout given Legalize window changeouts/handout given t ,ri.,:Jl,; :.:,.j,,11 l,/,J/:lr:r?r,r tl]r {.i.:l-t .t Bj,, Ir{:: I I iH l|urrs.}i 1rr 1 (]t j. Engineer ,lrirrr, ,: ton 'lotr.,l $y.i/"rlOwner: Juan Serano Contractor: Owner-Builder Address; 706 N Jackson St Address: Address: rr:lri irlrTflrrir santa Ana, cA 927032747 n Lrrr!*i.t,. r i,Ei i:,!7 " ),1:lPhone: ,7141877-5474 Phone: Phone: :r'rir'ni I (n Tenant state Lic#: License#: i,",'] . 'i l{r{-rr-rl-rr-ll-r ,ii,,,iir,!.ra Lic Type: Architect / iri,iirr-r' :i lJrl-1ll,ll-rLr" . ' Bus.Lic#: Designer ,: r,.',.:.,, lr..rri carrier: ( li)r_rr'r;l ::r ir r/ '/I-II'lI'll_I_' -- Policy #: Phone: L,.l,qr' ..r.,., nrt,,l;",,'.1 Expires: License #: - r. i i "' : ," r r, r x r't * * r:'/ i I c,th+l{rli':riJil Date: 01/03/2020 Date: Date: 01/03/2020 Subject to Field: 0 777 600 2 0 777600 2 017760 0 2 o777500 2 0177500 2 0177500 2 0 777600 2 5760 7 57770 5760 7 5760 7 57672 s 7600 57607 Fee Total Paid to Date: Balance Due: Every permit issued shall become invalid unless lhe work orl lho site authonzed by such pemit is commenced wilhin360 days after its issuance,or if the wo* aulholized on the site by such permit is suspended ot abandoned for a period of360 days aftet the time the wo* is cofimencod BUILDING- INSPECTOR RECORD SITE.WORK DATE ID/SIG.COMMENTS OWNER BI]ILOER DELCARATION I h.rcby aljim uftlcr lrmlly i)l Frrury lhar I u crcmni lioar rh. Conrrrcn,6' l-icn\c liw nr rhc iiil,,*ine rcrn'n (S( 70.11 | Bunnc$ ,nd Prutas\ion Cirl.): An, Ciry or CDUtrry wh,ch rcqurc\ a pcm t) .onnnrr. .llcr, ,mpRrvc. dcmol$h or qrftny dru.rulc. pi{tr r' ils ts..nuc. ako rcquircs rhe amlic{d tu su.h Fm r. tilc a srnc'l daremnr lhar hc or shc i\ licc!{d pu. ant ro rhc prvisknrs ot Ih. Contrlctor's Lf,cnsd L.* (Chdt'r( 9, Commkinf * h Selbn T(xxJ ol Diri\ion .l olrhc Ansircss rnd Pnrf.soff Culc) or rhd h. or:hc ir crcmpr rhnclrom rn'l rh. basi\ tor rhc rllqcJ.r.,halion Any vn,hhonolSerionl0ll.5 hy rny applrc, tutrr.mnrsrhjc.h thc qlllrant loa.iv,lp..axyol nornurrhrn tivc hundrcJ dollatr (5500) l1-\.r!run.'ufrh.Irindr.o'm,cn'nr,,Jcc!wrh*Jee.Irhcu\,l., ntn. i,'n.uillJ',rh.riiAnl'h.{tu,mi.nnr i, cnLd or oflircd for $lc (Scd.?(x4, aurincss md Ptuf.$ions Cdl. Thc Co.tacktr-s Liccnsc ljw dG. nol !!dy lo u owncr ol rhc F,rf,n, wtx' hu d\or i,q,,,ks rhcN)n,,nl wh,&f,ssuchunt himsclr orhcrscllorrhruurhhi\o!hcrowntnlnloyccs. ,rcvklcd lhdr su.h ifrpDkmn* m tu! inrctulcJ or of,trc]] ,6r $k ll lx*.Er, rh. huium8 or ihln,rmni tr sru wi6in nnc )rr of.o!ryhlot. rh. Own$ BurLr will hrE thc hunknofnruvin8 rhrrhcorshcJrl rcr hu l or unl,rulc r l,uFny for rhc tl{rlxM nl -1, as.*Nr olllE pn,Frly. !m qclusivciy .onlr&rina villr liccnsc! conlncloN lo mnsrd.r rlE pojcclise. r0.t4, Blsincs Md Pnlfasiln Codc: Thc Conkicktr r l-(.ns. Lrw dkr nor ,pply b rn own.r ol ttun fly wh(, hu ilds or mprDv.( Ih.r.on, lnd sno otrl@ls iitr su.h pmtccls w h o Ctnhclorls) lirc.s.n pu6u. n, rhc Cotrlr.ckn s Lnen* L.w). -I anctcmpr trndcr Scctnl ll & l,C tur thr rcr*)n. t*-z'ry'""", l- 7- 2aizs .-^,,XJA-.,,s fâ‚¬DPffiDEII IAUSN I hcrchyrll NunJ.r |].Mk!ol Frltrry .nc ol rhc l(nLia ! ,ic.hr. nn\: I hrlc lil wiu nDonar i Ccnntrrc of Con*nr ro Sclitnnrd nr wdrkcrf onrt'.nurirr rs t'n,vilcd tu hy Seton l70O ol lhc khtr Cc{c, Lrrhc P,rtamuc. ofrh. wor* fd whkh rhc p.m trLr{d. I havc and vill nrainhm workcrr q'mp.nsarb, rtrsurrEc. !s lcqurcd hy Sc.l i,)n l70O oI rhc l-lho! O,Jc, ttr rhc Frrnmec oi rhc work,nr vhich lhis oâ‚¬mil is niucd. My *orkcN .ompctrs0tn,n insurun c.rier a.n Flicy numt . uc: Pohy Nunb.r Ernias: I.cnily rhir in rhc lcr,nrrone of rhc work tor whal rhr Fcm,t is issucd. I drll nor cmfloy any pcron in rny mmncr e' 6 to bed,E uhjcd h rh. krrkcn @mr.nsalbn llws ol Cslinrmia, anl 4rec lhar iI I should hccome subjccl k' lhc M,rtcs comrcnsarn,n provisn,ns oi Scdbn 1700 of rhe hhr Grlc, I shall. thnh* nh con y wirh ihoE pmlhions WARNIN(;: Frilurc h Elrc M)rkcri comp.nsarn,n $wasc ir unhwtul. ud sluu subjer an cnrlloycr lo dinDrl lleMlrFs a, civil tin.! up ro one hunJE{ lh.us ,l d{,llan (Sloo.mo), in a&l(r}n l. rhc.osr of$mFnsrlion. damscs as Brvided for rhc 50ri,n l0l4ulrhc hll{ C,nc. d.r^J dtl,nt,m} \ r.c.l-l . zn z- DECL{RATION I lEEby ltltrnundcr F..llyorp.rjury ttut I n Lc.nsol undcr pNvlrion.l Chrplcr 9 (coflmrinS wilh Sation rUJo) ol DivGion l ol thc Busin.s e Pbfc*ir.s Codc. Mt ny lrcnsc 6 in full fimc all .ftacr. Liene Cla$r_Licenic Nomh.. Conl*tor.- c0xirBu!:lroN.ltll)tx(iiclNcv I h.rhy lirnund.r p.nrlry ot Flurytharth.6 r r.oi{ructron LnJma d8.my ntr rhc !.dnnnrtuc ofrh. work ior wh(h rhir IEmd ( nsuell (Scc 10r7. Crv. C.) l AIIIIC NLrEcl A{MN I Lfttry.rlim r.'ld Fnrlryofp.rjlry onc otrh. nnkrwmS Jclrari,ns: D.nr,lnon Pcr.nB Ash.no\ Notlicari(,n F.Jcrdl RcAuhro,r(-l lcr(). Pr16) _Rcqumd ktr&dl Notiiorion l.cnrlythlr rhc lclcnl rcrulatotrs r8ndin3 a$csros r.ft,vrl rrc n.t {t'h.$lc n, rhh pDjc.r <ll ccn,ry rhd I h,k rca'l rhi\ rppliurionrJ dricrh,r rh.rh,vc rn rmdn,n treor.cr.I r[rLrbc.mrly w hdlcryrndcounrt ordlrrk.l rnd Slarc ljws r.lnu4 ro huildi.! cohdtucrn'n. anl hcret y aurhorr. rl,c\cir*v.\ ofrhr C y$d Cdudlyrocnrd ulm rh. ahrv. nrnrk'ncJFrpcny tnr i Anplicsnl or AFenl SiENlure t-r-2,80 Set Backs Erection Pads UFER Ground SLAB Floor Subf looriVenVlnsulation Rool Sheathinq Shear Wall Framing lnsulation/Energy Drywall Brown Coat Masonry T-Bar Handicap Req Deputy Final Report Engineer Final Report Flood Zone Certil. FINAL 1l*o t lt;'- l 2<,)knntrt-&X-1 Certificate of Occu pancy NeteF, Flemarks, Etc. {-d c -b I I o a-o'wlr- 20.-5 -lt Forms/Steel/Holdowns Ext./lnt. Lath Pool Fence I tl II t Drt :_ I{ftlcr'. A,lJrc$ p.nrn@na "en ,,\-'-'t f tfi--+ â‚¬'t>/12F4a.?' tt I 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 PROPERTY OWNER Dear Property Owner An applicati specified at on for a buildin gpe rmit has been submitted in your name listing yourself as the builder of the property improvements -.1?:J 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 atour 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 AN VERIFICATION OF INFORMATON DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. . L L 1. 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 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. cons tr 2. I understand building permits are not required to be signed by property owners unless they are responsible for the uction and are not hiring a licensed Contractor to assume this responsibility. 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- personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the workman- -aid. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on-permits and contracts. i r'-S. t understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total val-ue of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employef under state and federal law. Tr'6. Iunderstand ifIam considered an "employer" under state and Federal law, I must register with the state and federa l govi:rnment, 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. -al5 7 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 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 Iicensed general building Contractor. .n- cial or ship or materials. JjS. 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 filed in his or her name instead of my own. :19 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 Beneflt Payments, and the California Divi- sion of lndustrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1 -800- 321-CSLB (2752) or www.cslb.ca.qov for more information about licensed contractors. a-C-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 d ress legally and financially responsible for o constru .4-/ activi the followin I ad: /t-' Signature of Property owner j7 c-- /1 -,--{ e, LlZD 4...a Print name of Owner 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. Prolect Location or Address Name 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 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 ve fy the propefty ownet's signature. 3, t' ll.I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements thal govern Owner-Builders as well as employers. -t42. 1agree 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 permit. ,Vofe.' A copv of the proDertv owner's d ver's license. form notariza- tion. or other veification acceDtable to the aaencv is reduired to be Dresented when the Dermit is issued to verifu the p roo e rtv ow n e r's si d n atu re. Date: /)(,.' ScopeofConStruCtionProject(orDeScrlptlonofWork): Address of Authorized Agent: w L .lUt, .ii '"1 -t-----1D7 -'lt t-.,,,.Y ( t l .,t r^ ^ 5k {t: -.) ,,1 \(^ I I i t .s- ,( t b^vq l.*F|SHNlilG DIVISION ,,J&to -E[%9 --x { \9 \-^ la{L L^_Kl \PLANNER iRANSFE DATE DATE lfe/to -I I I I t I I j i I ?re rn n'.1 F\'41 RED BY ]LANNING INSPECTrc*.i REOUIRED IOUGH FINAL X (714\ \ I I i i \ t^-.t ,l U -i >'t8'>)3 u/t/ - l4lot; * l0'lt''tuos 1 ,,l,lo7'pl" $L rb-/.* sL+lt " r-vt, o y*'7"f1,.' EB%t|7 qStb -) \ JUA ',1 ,<i,*-a e.1 X S?; t '-( , I I \-^lt- ON _--= , .. , , .rro'-' *!!t'Ua'l t 5h L .L 0l adl.L ltrtu:-Jl r ,ii'rc !i'{l