HomeMy WebLinkAbout10193434 - Permit (3)City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA127O2 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714\ 667-2738 lnspector Section: (714) 647-5853
Permit #: 1O{93434
Pin #: 175E1
Project Address: 2518 W Curie Ave
Assesso/s Parcel 414-',171-24 Lol 21
U nrt Bldg: Address Range Suite Range:
Zoning: R2Block NA Tract.9444 Historic: No
Building Use: Duplex Occupancy: R-3, U 1st FLArea: Patio:
Job Type: Reroof Consk Type: V B 2nd FL Area: T.l.Area:
Nature of Work: Reroof Code: CBC 2016 Other Areas: yards Req,d:
Existing Bldg. &use: Duplsx w/att garage Flood zone: x-0602320259J Garage Area: Vatuation: $9,056.00
Proposed Use: # of Stories:
Total:
Descriplion of Work: Reroof duplex & attached garage - rsmove tile, replace any damaged shsathing, inatall 32 squares comp shingles. Handouts given.
Planning Conditions: Color to be dark.
Owner:
Address
Phonel
Tenant:
Binh Nguyen
2618 W Curie Avenue
Sanla Ana, CA 92704
17141240-7708
Owner-Builder
Engineer
Address:
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Phone:
License #:
Architect /
Desiqner:
Address:
Phone:
License #:
Planning Approval By
Plan Checked By:
Permit lssued By: /
NPDES lnsp. Reqd:
PWA lnsp. Req'd:
Kelaher, Selena
Amsden, Julie
Date: 07/05/2017
Oate:
Dale: O7lOSl2O17
Subject to Field:
Misc. Receipt
Misc. Receipt
Misc. Receipt
$308.52
$1.00
$21.25
$52.98
07776002 51501 Permit Fee
07776002 57672 Bldg. Stds. Revolving
07776002 57600 Genelal Plan Updale
07776002 51501 lssuance
Planning lnsp. Req'd:
Landscaping lnsp. Req'd
Fire lnsp. Req'd:
Police lnsp. Req'd
No
No Account#
No
No
No
No
Total
Flood Zone Cert. Req'dr No
Every peftnit issued shall becono ihvalicl unlesslhe wod on the site authorized by
such po nl is commenced within 180 days aftor its issuance,ot if the wod< authoized
on the sito by such pemil is suspended or abandoned fot a petiod of180 deys afier
the time tho wotk is commenced .
lnspector
011 16002 51600
011 16002 51601
01116002 51612
$21 .25
$361.50
$1.00
Fee Toial
Paid to Date:
Balance Due:
$383.75
$0.00
$383.75
Contraclor
Address:
MtD# 2017-137222
BUILDING- INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS OWNER BUII-DER DEI.(' TATloN
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(ppri."nr u.,r*"nr sisn"r,,"
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Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bf loor/Ve nUln s u la tion
Roof Sheathinq 7n /t't ,. i.8.cen+S(
Shear Wall
Framing
lnsulation/Energy
Drywall
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Engineer Final Report
FINAL i11-t1 i(.l4Jd\
Certificate of Occupancy UV
Notes, Remarks, Etc.
\
J
Ext./lnt. Lath
Flood Zone Certif.I
I
*,SNIA
NA.ffi
Planning & Building Agency
20 Civic Center Plaza Ross Annex
P.O. Box 1988 (M-19)
Santa Ana. CA 92702
(711) 647-5800
wr/l^& sanlS-ana.oll
Smoke & CO
Alarm Affidavit
tNSP-02 2C13 CR3
fhis document moy be found ot..http./irv\rw. sant3-ana.o rclpbai
{P/ease use a black or blue ink ball-point pen)
Permit N umber:/o/?i{-3+
Property Owner:t/7 h/"C:-/ c(L
Contractor:N/rt Lice nse #/1, /fr
State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential
buildings.
California Residential Code (CRC) Section R314.1and R315.2 states in part that existing dwellings be
"retrofitted with srnoke alarms and carbon monoxide alarms. CRC Section R31.4.3 and R314.3.3 define
the required locations.
4l rorn boxes betow must be checked:
[S Carbon monoxide alarms: Are installed outside of each sleeping area in the inn.nediate vicinity of
bedrooms and also on each levei of the dwelling. Alarms are required in bedrooms with gas-fired
apgylnces (i. e. hot water heater, cooktop, furnace) or a fireplace.
dSrnof" alarms: Are installed in each room used tor sleeping, in each hallway outside ot a sleeprng
room, and on each level of the dwelling.
Retrofitted detectors may be battery-operated for buildings where no lnterior alterations are
performed. Combinalion Smoke/Co alarms must comply with all applicable standards and be approved
by the State Firs Marshall (sFM). Battery life must be 1C yeai's.
I hereby certjfy that I am the contractor or the property owner of the abo,ze project. I further certify
that smoke alarms and carbon monoxide alarms have been installed in compliance with the governing
Codes and have been tested to be functional. l, also, hereby certify that I will retest the alarms per the
manuf acturer's instructions.
t Signolure: .dYL 9X,rlVe-*Do f-/7-/7e.t
Project Address:Cur, e 4u .)fr cl17-/v
lcheck one)a*"@;G.t",.V P r.p"rty o**.
NOTE: fhis sef-c eftilication is only used Jot ptojeds thot dffect the EXTERIOR ol the structute. This
ptoce$ is opplicoble ONLY to projects where occess to the intetior ol the dwelling by a Santo Ano
lnspector is not tequired.
Have this completed form and the job-card readily available on final inspectionl
tr
Dear Property Owner
ACIING CITY MANAGER
Gerardo Mouet
CITY ATTORNEY
Sonia B. Carvalho
CLERK OF THE COUNCIL
Maria D. Huizar
CIry OF SANTA ANA
PLANNINC & BUILDINC ACENCY
20 Civic Center Plaza
P.O. Box I988 . Santa Ana. Calrfornra 92702
wwl,!.5anta-ana.or9 pba
NOTICE TO PROPERTY OWNER
ing permit has been submitted in your name listing yoursell as the builder of the p rtytoAn application for a build
improvements specif ied at d, -2
/
We are providing you with an Own u ild n m n lnf rTn rfl t nF rm to make you aware of
your responsibililies 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 ol each provision, signed, and returned
this form to us al our otficial 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 ACKNOWLEDG MENT AND VERIFICATION OF INFORMATON
DIRE 'S: Read and initial each statement below to signify you understand or verify this information.
1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder"
building permit that erroneously implies that the prope(y owner is providing his or her own labor and material personally. I,
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 property.
leN, 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.
,1 ,lV.'Z::_3. I understand as an Owner-Builder" I am the responsible party ol 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.
,'tro. I understand Contractors are required by law to be licensed and bonded in Calilornia and to list their license
numbers on permits and contracts.
/nkI!s. I understand if I employ or otherwise engage any persons, other than California licensed Contraclors, and the
total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an
"emplo/ef under state and federal law.
ru I understand if I am considered an ''employea' under state and Federal law, I must register with the state and
federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to
unemployment compensatlon of each "employee." I also understand my failure to abide by these laws may subjecl me to
serious f inanciai risk.
^ rfNl
/ ; I I u7 . 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 lor sale, unless a//work is performed by
SANTA ANA CITY OOI]NCIL
f,.ul'do@sa.la.ana o.o
Ma/or Pro Tem, Wad 2
mmadrne:@sanra an5 oro 6olono@sanla.ana o@
P Oavd Benav'des
dbe.aedes@sa.ra ana ord !'!9!a@lafla: a-a!!itr-!3E!o@laqr:r!!-9!9
MAYOB
Miguel A. Pulido
t!,lAYOR PRO TEM
Michele Maninez
COUNCILMEMBEBS
P. Oavid Benavides
Vicenle Sarmiento
Jose Solorio
SalTinajero
Juan Villegas
\acenle Samenlo
,sarnento@snla.ana oro
Iicensed subcontractors and lhe number of slructures does not exceed four within any calendar years, or all of the work is
pe d rmed under contract with a licensed general building Contractor
rnancra
I understand as an Owner-Builder il I sell the property for which this permit is issued, I may be held liable for any
or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the
workr5ranship or malerials.
/lfllr. ,understand I may obtain more information regarding my obligations as an "employea'from the lnternal Revenue
'Seri,ice, the United States Small Business Administration, the Calilornia Department of Benefit Payments, and the
Calilornia Division of lndustrial Accidents. I also understand I may contact the California Contractors' State License Board
(6SLBI at 1-800-321-CSLB (2752) or www.cslb.ca.oov for more information about licensed contraclors.
m\r l am aware of and consent to an Owner-Builder building permlt applied lor in my name, and understand that I am
tne party legally and financially responsible for proposed construction activiiy at the following
addresq:IN,/t-tlappltp
4L',rl
informati
. I agree that, as the party legally and Iinancially responsible lor this proposed construction activity, Iwill abide by
able laws and requirements that govern Owner-Builders as well as employers.
I agree to notify the issuer ol this lorm immediately of any additions, deletions, or changes to any of the
on lhave provided on this form.
Licensed contractors are regulated by laws designed to protect the public. ll 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 lhat 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. ll you obtain a permit as Owner-Builder and wish to hire Contactors, you will
be responsible for verifying whether or nol 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. l/ole.'t owner's driver's I icense
lorm notarization. or other ve rification acceotable to the adencv is reouired to be sented when the Dermit is
the e owner s s natu
Signature ol Property Owner Date V--s-zt-
Print name of Owner
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Excluding the Notice to Properly Owner. the execution ol which I undersland is my personal responsibility, I hereby authorize the
tollowing person(s) to act as my agent(s) to apply lor. sign. and li e the documenis necessary to oblain an OwnerBullder Permit for my
prolect.
Scope of Construction Project (or Description ol Work)
Project Location or Address
Narne ol Authorized Agent
Address ol Aulhorized Agent
Phone Number ol Authorized Agent
I declare under penalty of perjury that I am the property owner for the address listed above and I personally lilled out lhe above
information and certify its accuracy.
Property Owners Signature Date
Print Name of Owner
Note: A copy ot the owner's driver's license, form notarization, or other veritication acceptable to the agency is required lo
be presenled when the permit ls issued to verify the propetty owner's signature.
SANTA ANA CITY COUNCIL
muldo@sanla-ana o.o
Mayoi Pio Tem. Wa.d 2
a-aa!ag@!a4a qc &loiio@sa.la..na oro
P Orvd Banauder
dbenavdes@sanla.a.a oro ivr!e!tr@rt!E: ruIc