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Home My WebLink About10293433 - Permit (3)Assessor'sParcel. 0'16-112-09 Lot. 1 Unrt Bldg: Address Range Suile Range: Zoning: Rl lr Block: K Tract: 668 Historic No I City of Santa Ana 20 Clvic Center Plaza (M-19), Santa Ana, CA g27OZ Building Permit Counter: (714) 647-5800 lnspection Requests: (714\ 667-2738 lnspector Section: (714) 647-5853 Permit #: {0293433 Pin #: 20349 Building Use: Single Family Dwelling Occupancy: R-3, U 1st FL Area: Job Type: Oemolition Constr Type: v B 2nd FL Area: Nature of Work: N/V-Domo Code: CBC 2016 Other Areas: Existing Bldg. & Use: SFR WDET GARAGE Flood Zone: X-0602320278J Garage Area Proposed Use: # of Stories: Totatl Description of Work: Oomo unpormittod drywall in garage and cap sxterior laundry connections. Auth on file. Planning Conditions: Patio: T.l.Area: Yards Req'd: Valuation: 0@0 $1,000.00 Owner: Address Phone: Tenant Contractor Address: Owner-Builder Engineer Address: Architect / Desiqner: Address: Phone: License # Victor Gonzalez 1225 E. Frontage Rd. Chula Vista, CA 91911 Phone: Siate Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance Carrier: Policy #: Expires: Planning Approval By: Plan Checked By: Permit lssued Byl NPDES lnsp. Req'd: PWA lnsp. Req'd: Planning lnsp. Req'd: Landscaping lnsp. Req'd Date: Date: Oale: O7lOSl2017 Subject to Field: Misc. Receipl Misc. Receipl Misc. Receipt 077760 0 2 0177600 2 077760 0 2 07776002 0777600 2 077760 0 2 57607 57601 s7607 5 7672 57 600 57 607 $154.26 $93.17 $234.08 $1.00 $21.25 $52.98 Permit Fee lnvestigalion Penalty Bldg. Stds. Revolving General Plan Update lssuance No No No No Fire lnsp. Req'd: Police lnsp. Req'd ffi Account#Total Flood Zone Cert Req'd: No Every pemit issued sha becorne invalid unless lhe wotk on the silo aulhonzed by such pemit is cofinonced within 180 days aftet its issuance.ot iflhe wo* authoized on the sile by such permit is suspended or abandoned fot a penod of180 days aftet the time lhe wo* is cornmenced. lnspector MtD#. 2017-137221 01 1 16002 51600 01116002 51601 01116002 51612 $21.25 $534.49 $1.00 Fee Total: Paid to Date: Balance Due $556 74 $0.00 $556.74 ProjectAddress: 2135 S Oak St Phone: License # zunisa, errissaN/ BUILDING. INSPECTOR RECORD SITE.WORK COMMENTS OWNER BUII-DIR DEI,CARAT(}N I h6.by lltrm und.t F.ah' of FJ!r) rhd I â‚¬rmF ft'm rh. codrdoB Lrre lr$ lor rn iolh$ i.3 ren ( nq* 7o1 l 5 BcihB !d Profdion C.d.): Any ( ily or (iu y sh'(h rcqon6 a p6nil to $[(rucl. trlts. rmprovc. dsnalirh r r.rBtr an! srtu.1r.. F.r b n! sue.. .b. r.qur6 rh. 4drsr for u.h rErnn lo fik . 3,sa<d {rtur rhd rE or slr a l'.dF.ri F*ler lo lh. 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Calrforn a 92702 www.santa ana.org pba NOTICE TO PROPERTY OWNER Dear Property Owner An application for a building pe rmit has bee submi in your name listing yoursell as th ilder ol the property p rovements s pecified at 7 We are providing you with an Owner-Builder Acknowledoment and lnlormation Verification Form to make you aware ol your responsibilities and possible risk you may incur by having this permit issued in your names as lhe Owner-Builder. We will not issue a building permil until you have read, inilialed your understanding of each provision, signed, and returned this form to us at our oflicial address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNEB'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON DIRECTIONS: Bead and initial each statement below to signity you understand ot verity this intormation. !q . ' understand a frequent practice ol unlicensed persons is to have the property owner obtain an "Owner-Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an OwnerBuilder, may be held liable and subjecl to serious financial risk for any in.juries 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 inluries. I am willfully acting as an Owner-Builder and am aware of the limits ol my insurance coverage for injuries to workers on my property. VC,-2. t understand building permits are not required to be signed by property owners unless they are responsible for lhe construction and are not hiring a licensed Contractor to assume this responsibility. \)-eZ. t understand as an "Owner-Buildef' I am the responsible party ol record on the permit. I understand that I may protect mysell from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. l-Ca. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. VGaU. , understand il I employ or otherwise engage any persons, other than Calilornia licensed Contractors, and the total value ol my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employei' under state and federal law. VA A. I undersland il 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 disability insurance, and contribule to unemployment compensation of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. I G ,. I understand under Calilornia Contractors' State License Law, an Owner-Builder who builds single-family residential structures cannot legally build them with the intent to offer them lor sale, unless a// work is performed by SANTA ANA CIry COUNCIL ACTING CIry MANAGEB Gerardo Mouel CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar nouldo@sanla-ana do Mayor Pro Tem. Ward 2 dm:n'ieu @enra ana o,o Mlono@sra ana oro P Oaed Bâ‚¬navrdes dben.vides(asn1a-ana o.o N eoasosaira a.a orc srnaiero@safla.a.a.oro licensed subcontractors and the number ol structures does not exceed lour within any calendar years, or all of the work is perFormed under contract with a licensed general building Contractor. \IaA. I understand as an Owner-Builder it I sell the property tor which this permit is issued, I may be held liable for any linancial or personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the workmanship or materials. U_49. I understand I may obtain more intormation regarding my obligations as an "employer" from the lnternal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of lndustrial Accidents. I also undersland 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. \)_C"-t O. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am lhe party legall van d linanciall y responsiblq lor proPos5 oaz !t-nstr ron clivity at followl YzzaTaddres Q_Ql I .l agree that, as the party legally and f inancially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern OwnerBuilders as well as employers. l)eJZ+agree to notify the issuer ol this lorm immediately of any additions, deletions, or changes to any ol the information I have provided on this form. Licensed contraclors 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 lor you to understand that il an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable lor 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 slatus 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 lor issuing the pe it. lvole: A copy of the property owner's driver's licensc, rm notarization or other veritication acce obe ted when the it is owner na Signature ol Property Own Date Print name of Owne lr l,.Ir'r AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Nolice lo Property Owner. the execution ol which I understand is my personal responsibility. I hereby aulhorize the following person(s) to act as my agent(s) to apply lor, sign, and file the documents necessary to oblain an OwnerBuilder Permit lor my project. Scope of Construction Project (or Descriplion of Work) Project Location or Address Name ol Authorized Agenl Address of Authorized Agent ldeclare under penalty of perjury that I am the property owner for the address listed above and I personally filled out lhe above inlormation and certify its accuracy. Property Owner's Signature Date Print Name of Owner Nole: A copy ol the owner's driver's license, torm notarization, or olher verilication acceptable to the agency is required to be presented when the permit is issued to verity the property owner's signature. SANTA ANA CITY COUNCIL mouldo@sa.ta ana oro Mayor Pro Te6. Wad ? mrmrlr.ez@sanla.a.. oro Vicenre Sarmronlo vsa.rrxento(asanla.ana.aI!ir9lp!!@l34la3!r.!!q Phone Number ol Aulhorized Agenl:_