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Home My WebLink About10193651 - Permit (3)EProject Address: 2310 W Blueberrv Ln Assessor's Parcel 399-031-11 Lot: 27 Unit Bldg: Address Range:Suile Range: Zoning: RlBlock: NA Tract: 9631 Historic. No City of Santa Ana 20 clvic center Plaza (M-19), santa Ana, cA 92702 Building Permit Counter: (714) 647-5800 lnspection Requests: (7141667-2738 lnspector Section: (714) 647-5853 Permit #: lOl9365{ Pin #: 23560 Building Use: Job Type: Nature of Work: Existing Bldg. & Use Proposed Use: Single Family Dwelling Alteration Kitchen & bathroom remodel sfd R-3 VB cBc 2016 x-0602320144J 1st FL Area: 2nd FL Areal Other Areas: Garage Area Total: Patio: T.l.Area: Yards Req'd: Valuation: 910,000.00 Description of Work: New tile & shower pan in (3) bathrooms Botchi:3?604 - flff ice: (:TYH Ficpt i:01961660 Ref+! 1019 7/31/2U7 9r13 t4?9. 1 of 2 3651 AN 7 /31/?Ul I0r oinoroleslS Inons+:28 Irqnsoct ion TotolPlanning conditions: Address bnrrg I ronOwner: Addressl Phone: Tenant: Dang Tran 2310 W Blueberry Lane Santa Ana, CA 92706 (714) 890-2838 Contractor Address: Owner-Builder Phone: State Lic #: Lic Type: Bus. Lic #: Workers' Compensalion lnsurance Carrier: Policy #: Expires: 6eneral Plcn Updote Fee 011160112- 51600000- Buildine 01116002- 51601000-glds stds Revolv ins But6002- 51612U00- (:(rsh Chonee J2L .21 i2(17 .24 $1 .ofl l5(l(l,trtl ( 320.25 ) Phone; License # Archilect / Desiqner: Address: Phone: License #: Planning Approval Byl Plan Checked By: Permil lssued NPDES lnsp. By: PWA lnsp. Req'd Planning lnsp. Req'd: Landscaping lnsp. Req'd Amsden, Julie Date: Oate: Dale: 0713112017 Subject to Field: Misc. Receipt Ir,lisc. Receipt lvlisc. Receipt $154.26 $1.00 $21.25 $52.98 d No No No No Fire lnsp. Req'd: Police lnsp. Req'd No No Account#Total Flood Zone Cert. Req'd: No Every pennit issued shall becone invalid unless the wo* on the site euthodzed by such pemil is cgfimenced within 180 days after its issuance,ot if the wo* authoized on the site by such poinit is suspended or ebandoned tot e poiod of180 days 1ftet lhe lime lhe wotk is commenced. lnspector MtD#. 2017-137676 $21.25 $207.24 $1.00 Fee Total. Paid to Date: Balance Due $229.49 $0.00 $229.49 Occupancy: Constr Type Code: Flood Zone: # of Stories: Engineer: 07776002 515'01 Permit Fee 07776002 57612 Bldg. Stds. Revolving 07776002 57600 Cenetal Plan Update 07776002 5160I lssuance 01 't16002 51600 01116002 51601 01116002 51612 BUILDING. INSPECTOR RECORD SITE.WORK DATE ID/SIG.COMMENTS OWNEI IUII,DER OEIT f, TloN I hd.b imm udq pn[ny or Ftur, rh, I m .rmfl 6ih rh. C6fr&16- l.{.k t w for rh. aolhrm3 r.{on (S< 70rl 5 Busins .n! Pr.rsh. co&) ,/\., Cry or Cody *hrh r.qun6 . Fnn ro co[rrucl. !hs. imrota &rrellh or ftFu ,ny 3lrucluc. 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F.d.nl R.guldh tlil..r0, Pd6) R.qun.,.l ld6 of Noliacdion I cdifyrhd rh. f.d.r.l rcguldioN ErddinE ahdr.. roovll e. .or +pli..bk 'o rhb pmj.d. QJr"-i1,r'trrr.,-a,rrolptilr.rFnrrdnrr.rhdth.!tsr!mforrldions(on.dIraraio.ontpr!$rh.ll(-iylnd(hunr).rdmlc lDd Sr.r. lA! ElilB io tuld'.s codrudE+ !n h.r.b .rnhrn (Fsriir6 o l rh; ( h! ,rd (-oud! !odl6 upo.lrr !b.,. mrn..d I'.rEtr rd Go<!i.n Dtrrlc I ;,;;,;,^,;,;;",,.; ' lly ^* a7 [1r rD pmr,r n.(pnno, DeNAv I[nV Forms/Steel/Holdowns Erection Pads UFER Ground J SLAB Floor Subfloor/VenVl nsulation Roof Sheathing Shear Wall Framing lnsulation/Energy Drywall Ext./lnt. Lath Brown Coat Masonry Pool Fence T-Bar Handicap Req Deputy Final Report Engineer Final Report Flood Zone Certif FINAL Blil t((,0uqa1,) Certificate of Occupancy Notes, Remarks, Etc Set Backs I I I I I I I MAYOR Miguel A. Pulido MAYOR PRO TEIV Michele Martinez COUNCILMEMBERS P. David Benavides Vicenle Sarmiento Jose Solorio SalTinajero Juan Villegas INTERIM CITY MANAGER Cynthia J KurE CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL L4aia O. Huizar CITY OF SANTA ANA PLANNING & BUILDING AGENCY 20 Civic Center Plaza P.O. Box I988 . Santa Ana. Calrfornia 92702 www.santa ana.orq/pba NOTICE TO PROPERTY OWNER Dear Property Owner An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements sp ecified at 1 We are providing you with an Owner-Builder Acknowledoment 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 oi the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. J t . t understand a frequent practice of unlicensed persons is to have the prop erty owner obtain an "Owner-Builder' building 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 sub.iect to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. l\,ly 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 property. '') 2. I understand building permits are not required to be signed by property owners unlesstheyare responsible for the construction and are not hiring a Iicensed Contractor to assume this responsibility. y' S. t understand as an "Owner-Builder" 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. t/ q. I understand Contractors are required by law to be licensed and bonded in Califomia and to list their license numbers on permits and contracts. ,/ S. I understand if I employ or otheMise engage any persons, other than Califomia licensed Contractors. and the total valueof my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer' under state and federal law. J A. 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 disabilily insurance, and contribute to unemployment compensation of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. J L 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//,,vork is performed by licensed subcontractors 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. ,{ 8. I understand as an Owner-Builder if lsell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the workmanship or materials. SANTA ANA CITY COUNCLL Mayor P.o Tem. Ward 2 nrmanrnezOsanta ana.oro M.enr. S5mrcnro 6amrenlo6sanla-sna oro $olono@sa^ta-.na oro P Oaed Benaudes db6navidBAs.nta-a.a o.o sl narerolasanta'ena oro ,/ 9. I understand I may obtain more information regarding my obligations as an 'employer' from the lnternal Revenue Service, the United States Small Business Administration, the Califomia Department of Benellt Payments, and the Califomia Division 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.oov for more information about licensed contractors. J 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 address: J 't't.l agree that, as the party legallyand financially responsible for this proposed construction activity, lwill abide by all applicable laws and requirements that govem Owner-Builders as well as employers. ---f12.I agree fo 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. lfyou contract with someone who does not havea license, the Contractors' Slate License Board may be unable to assist you with any financial loss you may sustain as a result of a com plaint. 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 verirying whether or not those Contractors are properly licensed and the status of lheir 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 coDv of the Drooeftv owner's driver's license, lorm notaization, or other rificali acce able to the a nc rs be sen e sionature. Signature of Property Owner Date Ct1 lrll t7 DANJ&f*r,.i AUTHORIZATION OF AGENT TO A 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 ot Work) Project Location or Address Name of Authorized Agent Address of Authorized Agent Phone Number oI Authorized Agent I declare under penalty of perjury that I am the property owner for the address listed above and I personally tilled out the above information and cediry its accuracy. Print Name of Owner: Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the propedy owner's signature. -..,'.-t'.,..: SANTA ANA CITY COUNC]L mouIdo6senlr-an. oro Vice.re s3mrenlo 6am e.to@sa.t! ana oro GolMo@sa.lr-ana oro P Oavrd 8â‚¬na,6es dbenBMdes@se.la-ana.o.o lylLeg!5@!e!E:!!i,9!9 snnaeroosanla a.a oro Print name of Owner Property Owner's Signature: Date:_ Mchoâ‚¬ Ma,nna Mayor Pro Tem, Ward 2 mrmedrne2@sanla-a.a oro