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Home My WebLink About30138265 - Permit (3)city of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA127O2 Plumbing Permit Counter: (714) 647-5800 lnspection Requests: (714J 667-2738 lnspector Section: O14) 647-5853 Project Address: 610 S Driftwood Dr Unit: Block: NA Bldg: Tract: 2905 Address Range: Historic: No Suite Range: Zoning: Al N0Assesso/sParcel: 108.402-08 Lotr 40 Owner; Address: Ramona Godoy 6't0 S Driftwood Dr Santa Ana, CA 927041112 (714) 720-3396 Fee Type 0'l 116002 51602 Sewer Alter/Repair 01116002 51600 General Plan Updale 01'116002 51602 lssuance Amount 42.85 21.25 52 98 Qty 1.00 1.00 '1.00 Fss $42.85 $21.25 $52.98Phone Tenant Name: Contraclor Address: Orange Co Services lnc Dba 3801 Lenawee Avenue Culver City, CA 90232 (3r0) 838-0408 State Lic #: 679898 Lic Type: C-36, C-20 Bus. Lic *: 19117 workers' Compensation lnsurance:Carrier: Old Ropubllc lnlurance Company Policy #: A1CW99321402 Expires: 0110112015 Building Use: Job Type: Nature ot Work: Single Famlly Owâ‚¬lling Mlscellaneoua Repair Sewer R-3, U VB cPc 20t6 Notes: Letter ol auth. on file. Planning Conditions: Planning Approval By Plan Checked By Permit lssued By: Subject to Field; Building Permit #: eri Ewry ponnit issued shall be(,ome invalid unless tho lilotk o, t g silp authotized by such pemit is commencod within 1 80 days aftet its issuanc:,, ot il tllâ‚¬ wot* authotized on AD site by such pamit is suwnded o( abandgnad fgt a peiod o1180 days aflet tho time the wo* is comnpncad. $117.08 $0.00 3117.08 lnspector MID#: 2017-'137258 01 't 16002 51600 01116002 51602 $21.25 $95.83 Fee Total: Paid to Oate: Balance Due Permit #: 30{ 34265 Pin #: 9EE33 Phone: Occupancy: Conslr Type: Code: Date: Misc. Receipt: Date: Misc. Receipt: Oale: 0710612017 Misc. Receiptl Account# Total( PLUMBING.INSPECTOR RECORD APPROVALS DATE ID/SIG.COMMENTS UNDER GROUND Waste & Vent Water-Under floor Gas-Underfloor Building Sewer Area/Storm Drain lnterceptor/ Clarifier TOP OUT Waste & Vent Water Piping Gas Piping Roof Drain Tub/Shower Test Rough Water Heater POOUSPA P-trap/Drain Line Main Drain/Pool Pipino Fill Line/Back Flow Pool Heater/Gas Line Miscellaneous Gas Service Water Service Lawn Sprinkler Sanitary Sewer/Cap Back Flow Device Rough Plumbing Final Gas Test Meter Release I Notes Remarks , Etc. FINAL ol|ll[8 lulLDEtIrE[c ralloll I l'r*, .f,'m udr F.fy olFiuy rhr I fr aaq tE6 0E CdErld Lie t* b. th. fou.*.a lq[ (S<.7Otl , Bdi,d .id Pilkia Cod.): &y Ciy d Cod, *tth r.qui-. Fra ro @nrid. .t6. iq.oE &Dlifi d q.n iy !lnrd6.. Fin to i! iseq.lo,q!i6 O..!pli!n for Mh F ilio61.ritEdr.oE! {!lEorrn.ili6.d F.d!i ro rlE Flvni.d of tlE Conr.dd! 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Co(k I drll tudhwith olqly with rho. pro6ioq ir oLqtuL .,rl drll rubis a F h siminil FuIb !d civil fE up ro oE hunffi r,b6od &lEs I fa.by rlTm udb paidry ol pajury $ nl' \(rnD r0(xn.fl)'\ intr I of rlE Bdi6.n Protahd Cod.. ni iy ltag i! b fuU lod &d.IIc.r ( onln.lu co!$f,ll(IllarElDt8c-aclll,f I ha.lry lrm lrdd Frty oaFJury thr E b. otrro(lio. L.dioS !94, aor rlE FfMc ollh. Nrl lb, *tti lna pdinr a itr,.d (sc 1097, civ c.). AEUCAM.DESJAAITS! I hddt .trm und6 pa.lry of pqjury orc of ih. aollowiq d<l&riont D.trrnbn Pdnt-Artdor N.ili..rio. F.d6.l R.suLro (Tnb 40. Prn6) lqurql tlrq of N.r!6di.. qlbtd its.dlS -tdd lqfurd e 6r lpl..bL lo thb Foiir rBl rha.pplicdion an t rhd fic 6nnrdl l.*rero conl[ tr[h ill(ilt and (i]unr\ n6otrh$( ilva ( ounlylo nr6 uF,nlh. L 4r) 2-C- r'7 I I I I I I r/tD il:J YliL/ly// 1fr----/ v.--,a u MAYOR MiguelA. Pulido MAYOR PRO TEM Michele Marlinez COUNCILMEMBERS P. David Benavides Vicenle Sarmienlo Jose Solorio Sal Tinajero Juan Villegas CITY OF SANTA ANA PLANNING & BUILDING ACENCY 20 Civic Center Plaza P.O. Box I988 . Santa Ana. Calrfornia 92702 www.sanra ana.org pba NOTICE TO PROPERTY OWNER Dear Property Owner An application for a building pe rmit has been submitted in your name listing yourself as t he builder of the property improvements specif ied at (za -r, We are providing you with an Owner-B ilder kn m n lnf rmation Verif ication Form to make you aware ol 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 owner, obtain the prior approval of the permitting authority. OWNER'S ACK WLEDG MENT AND VERIFICATION OF INFORMATON otR TIONS: Read and initial each statement below to signily you understand u verify this information ACTING CITY MANAGER Gerardo Mouel CIIY ATTORNEY Sonia R. Carvalho CLERK oF THE CoUNcIL Maria D. Huizar understand a Irequent practice ol unlicensed persons is to have the property owner obtain an "Owner-Builder" rmit that erroneously implies that the property owner is providing his or her own labor and material personally. l,d rng pe as an OwnerBuilder, 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 homeowners 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 properly. t/v1_ LlE. I understand building permits are not required to be signed by property owners unless they are responsible lor the construction and are not hiring a licensed Contractor to assume this responsibility. f)u''t^ Kl1O. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect mysell f rom potential financial risk by hiring a licensed Contraclor and having the permit liled in his or her name instead ol my own. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts Cy I understand il I employ or otherwise engage any persons, other than Calilornia licensed Contractors, and the total value of my conslruction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. i( I G-funderstand if I am considered an "employef'under state and Federal law, I must register with the state and leUeral government, withhold payroll taxes, provide workers' compensation disability 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. $-L-V t undersland under Calilornia Contractors' Stale License Law, an Owner-Builder who builds singleJamily residential structures cannot legally build them with the intent to offer them for sale, unless a//work is performed by SANIA ANA CITY COUNCIL Mayor Pro Teh. W.rd 2 nmanrnez@$nta.ana oro Vrcente Sammlo v*rnentc@ef,ra .na o.o elono@sanlz'an. ord st nabro@$.ra-ana oro C)./I ,.6. licensed subcontraclors and the number ol structures does not exceed four within any calendar years, or all of the work is erformed under contract wilh a licensed general building Contractorp na cra o understand as an Owner-Builder il I sell the property lor which this permit is issued, I may be held liable for any r personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by ble laws and requirements that govern Owner-Builders as well as employers. WO manshi p or malerials I understand I may obtain more information regarding my obligations as an "employer" from the lnternal Revenue Service, the United States Small Business Administration, lhe California Department of Benefit Payments, and the California Division ol lndustrial Accidents. I also understand I may contacl the California Contractors' State License Board LB t 1-800-321-CSLB (2752) or www.cslb.ca.oov for more information about licensed contractors. I am aware of and consent to an OwnerBuilder building permit applied lor in my name, and understand that I am legally and financially responsible for proposed construction activity at the following address h ep ca (l *f ^n "" r"notity the issuer of this lorm immediately of any additions. deletions. or changes to any ot the f,lffig/on i have provided on this rorm. Licensed contraclors 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 resull of a complaint. Your only remedy against unlicensed Conlractors may be in civil courl. lt is also important for you to understand that if an unlicensed Contractor or employee ol that individual or firm is injured whlle working on your property, you may be held liable for damages. lf you obtain a permit as OwnecBuilder and wish to hire Contactors, you will be responsible for verilying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Betore 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. A/ote.' A coDv of the DrcDertv owner's driver's license, torm notarization, or other veritication acceptable to the a oencv ,s reouired to be Dresented when the Dermit is issued to verifv the Dropertv owner's sionature. Signature of Property Owne Print name ot o**-Il?^ /-t -P /a.^,lA^' - Date 6 \/\A -) v'1 a-)\f \.-7 AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner. the execulion ol which lunderstand is my personal responsibilily. lhereby aulhorize the following person(s) to act as my agent(s) to apply for. sign. and file lhe documenls necessary to obtain an Owner'Builder Permit,or my Proiect ;zo^1T oF Scope of Construction Proiect (or Description of work)2E/t.rc//,Z 6c u+-,2 /t^rL - lo rttâ‚¬ zt s h/ac K- Proiect Location or Address /o /0 S, DrUrTt .rortr) On-gqlurq 4da I -lZzo-l Name o, Authorized Agenl BoABtL l""nar' tD4r-ztnn") Phone Number of Aulhorized Age nt: 7/ / "2-i 4<q L ldeclare under penalty ol perjury th m lhe property owner for lhe address lisled above and I personally filled out the above inlormation and cerlify Property Owner's Sign Print Name of Owner: its accura alure s Dare: 7 -b'/ 2 /yl Note: A copy ol the drivet's llcense, torm notarization,verilication acceptable to the agency is required to / 6oo o'7 be presented when the permit is issued to verily the propetty owner's signatute. SANTA ANA CIIY COUNCIL r.Euhdo@sanh-ana.oro rvlayor P.o Tem. Ward 2 mnlanr.ez@san!a ana.oro Vrcentâ‚¬ Samenro vsamsnlo@santa.ana.orc 60rono@s.ra'ana.oro P Oav,d Benavdes @9qrv!dr5@!oh:a!rr!9 o llecas@sanra.ana o.o srinaâ‚¬ro@$nra-ana oro t4 n v 4 L 7 Address or Authoriz ea asentt (otL 3.r,. DZt â‚¬/z-z ooD ,D rz 3.4 . C. l7)a-/