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Home My WebLink About10193340 - Permit (2)E Proiect Address: 402W Fourth St Unit: Bldg: BASEMT Tract: BIRCH ADD Address Range Assesso/s Parcel:398-593-05 Lot: POR 36, POR 37 Blockr NA Historic: Yes City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CAg27o2 Building Permit Counter: (714) 647-5800 lnspection Requests: (714], 667-?738 lnspector Section: (714) 647-5853 Permit#: {O193340 Pin #: 93826 Building Use: Job Type: Nature of Work: Existing Bldg. & Use Proposed Use: Commercial Tenant lmprovement T.t. Commorcial/Offices Occupancy: Constr Type Code: Flood Zone: # of Stories: B VB cBc 2016 x-0602320276J 1st FL Area: 2nd FL Area: Other Areas: Garage Area Total: Patio: T.l.Area: 1609 Yards Req'd: Valuation: S57,763.00 Doscription of work: Tenant improvement - partitions to create rooms for music studio. Auth on file. Planning Conditions: Owner: Address: Phone: Tenant: Broadway lmprovemenl Co 129 W. Wilson Ste 100 Costa Mesa, CA 92627 Contractor Address: Owner-Builder Engineer: Address Phone: Stale Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance Carrier: Policy f: Expires: Gani Dino Gani Dino 3412 Chapman St. Apt. 20 Los Angeles, CA 90065 (323) 217-3558 Phone: License # Architecl / Desiqner: Address: 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 Fregoso, Vince So, Anson Zuniga, Allissa\f Date: 05/03/2017 Date: 06/06/2017 Dale: OBl29l2O17 Subjecl to Field: Misc. Receipt Misc. Receipt Misc. Receipt 69729 Total o7776002 07776402 07776002 0 777600 2 07776002 o777600 2 5760 7 53600 57770 5 7672 57600 57607 $1s4.26 $213,86 $ 10.86 $3.00 $21 .25 $52.98 Permlt Fee PIan Check Fee Mcrof kll Reclrds Bldg. Stds Revolving General PIan Updale lssuance No No No No Fire lnsp. Req'd: Police lnsp. Req'd NoNo Account# Flood Zone Cert. Req'd: No Every ponnit issued shall becomo invalid unless the wo on the sile authorizod by such pemit is commenced within 180 days aftet its issuance,or if lhe wo* authonzed on tho site by such pemit is suspended ot abandoned lor a poriod ot180 days aftot the time the wod< is commenced lnspector MID#: 2017-136607 01 1 16002 0't 1 16002 01 1 16002 01 1 16002 01 't 16002 51600 51601 5'1612 53600 57770 $21 .25 $207 .24 $3.00 $6.95 $ 10.86 $456.21 s206.91 0249.30 Fee Total: Paid to Date: Balance Due: Suite Range: Zoning: SD84 Phone: License # BUILDING- INSPECTOR RECORD SITE-WORK DATE ID/SIG.COMMENTS O* EN BUII,D}:R DEITAR TION I h6.b, rrtrn' u.dâ‚¬ F.d, of Fju.y thd I m ddpl fron 'h< (.ll1rd6B' l.roF lls for !h. rolhrin8 r@n ls( ?0ll 5 BNm6s lrvl Prof8ion Codc): Any Cny or (tunlr whi(h ..qui,6 0 lEnil lo conrlruct, ahq, impi('$e ddolish or al[tr e, 'loclu., Iri! lo its i$uuc, also rcqut6 rnc lpllicor aor such nâ‚¬mtr to filc 6 tixr.d $atul thll n or lhc b li.6!d puMd lo ttE FN6ioN of tlE co.kdor's Licarn Ir* I('1DpG 9, (inmein! *i'h sdiion 7000 of Divshn I oflh. lruritrd .od ProtsnN (ild.) or rh, lE or rlE ir qmpl rhc.froo !d rlE h.r6 for th. oll.sal.raq'lxr. Any \rhrN.of&.rnn Torl ! b) an!' rrpli.&i nn ! Fnn ebJ.cr3 rl prli.an ro r ctr il poulry of mr mor. llu. fi\ c hundr.d &,116 ( l5lrc, l. a oM( of th. pmFny. or my mplo]6 *iih we8B a lh.t &n. comp.nslion. will& th. *o* ,d llE $nd@ b ml i cicl d ottn d for s.lc (Sd 7u4, BBin* ed PNfBioB Co& I'lE Conrrlciofi l-id@ L!* do6 mr .9ply to e owF of ItE FoFl, sho hil& or ulD.!6 dEEr:n *ho dE sh N niletaor tsrlf or rtmurn ha or hd os.opby6, Foridd rhd.u.h imFo\drdt md drldl dolE d 6r !L I( h.rtr tlr htitli'v or in{roâ‚¬d i Fld vihm ot ta .t@rplr.lr $.O*G hllh sill hr*tlEh(b! ofFoiitBfir lE(rlr dd ml but] 6 in!.o\.t FDF, for E FrtrEof h,[,'a ol,.d otrh. propqry, @ dclciv.ly conrerins *nh licm.! co.'rracroE ro c.do.l rlE p6l<r lsd 7044, a$ilK Eotosnn Cod.: Tn Conrdor'sLicN l-s do6 mr.ppb ro e ou'n6 o( pror.ny *ho build! or inptu\6rhdon, rt$ qrntut3 fd ,uch FbjGr3 trirh . (bdr.ro(r) lkss.d FEun ro llE ( 6drard'r Li.G l^ ) ,,*};i;n"a &t I ha.b, dm,m un&r FEll! of Fjurj orc.trh. aollou in3 &(luarNB I hsr. arl *rll m.inr.in ! CdrlEar.olcorst kr S.lfJBur. nr so'L6-co'np. don,s rmrid.d for qq sa16n uurolrh. lio. C$jc lor rh. pafom@c olrhc m aor *hirh fi. pdmn B isu.d I h.tc ed will naidlin *ort6 cotrDdnhn iEulEc. s ratun.d by S61io. 17({) of rh. L.bor Cod.. lor lll Ffo,r1e. of llE *o* for shth lhis D6nil i isr.d My wort6 onEdMh. iffi. cai, !n lolay.mbs rc. k t .or'fy rhll in llE Flotu. orrh. *orl tu uhEh rhlt p6ni ! su.d I sh,ll nI dnpby &li p.e. i. a., iMB B to bdom sbi6t ro th. qdrd 6r4ft.bn L*! olcdiromir lrd .sE rhr ir I lhold bdom $Uâ‚¬l to llE 6 $mFur 6r F.8k'd of Sdiof, !70o of llr td.r Co{t , I JdL fonn* r h comply $ nh rhor proyirn6 WARNIN(I lrailur.lo su. trorlG comFsrnon co!6ar. s htrful. ed shlll .ubj{l d oplo)n ro aininal FEhB dd rn'l fin.s uI n, otre hunl'!l rl'otr\rnd {tolLrs llll)i).1)lx). 'n io! r,r lh. cosr ofcomlxffirion, damate.s pro\iddl lnr thâ‚¬ "rr? p-, I hmby 0finm undd p.n llyofp6juD-'lhd l';li(dr6i ontLr pnrrilhn .ach.prd e (urmtrinr siln S&1ion 7000) ofr)'vt(t.r rl rl'.lltrrnss md Prnian.rN ( odc, irxl trr\ I'r. \r is in lirll lrtrlr rnl.rIi.r grdslauquaNl.ElDtNc_&cEx(l I hott )' ifr6 un<16 Frny o f Frury $, rhc. i . on{rucrFi Llrlos rsfty tor rh. Ffo,M. of rlE e t"l i1. s hi(h rhi! Fna it is.d (S( 109'7, Cir. C ). affucaxfllrljaallox I h.dl, lrmu ls polhr of Fju,t- oc ofth. nnn'sts d.rladnrB lxmolirion Pdnn$kbdG N.rilicolior r.dcol Rc3uldrioB (Tir l. .10. Pan6) R.quir.J ldrooaNorinl'li.n I cdrD rhd rh. f.ddal,.x!hrhB E8&l'ry .rh6us rmvrl e. Bn .pplt3hk b rh! proF ,,h;:llll n r.tj (ar. rhrr rh. ahr\c htumd'on 6 cotrBl ltrrrdr. omtly *irh rll Chy Md ( otrnr! i.g.onnEdioq dd hs.t,'t aurk u! rcrr6drlr iv6 6lrhis Ciry turd ( oumr ro ald uF,n the ,h\cmtrtoncd prupcny for (5-r\ fl) c..,^,. 41, Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Subf loor/VenUlnsulation Roof Sheathing Shear Wall Framing ) t.t lnsulation/Energy \ \., \\'l t., 19 o\ Drywall ,,1\'' \J0- $) Ext./lnt. Lath Brown Coat Masonry Pool Fence T-Bar Handicap Req Deputy Final Report Engineer Final Report FINAL 6-\'V Uel*t d.q,( ) Certificate of Occu pancy Notes, Remark6, Etc , ,ll I Pemnft n.ne(pnnd I I I Flood Zone Certif. I MAYOR Miguel A. Pulido MAYOR PRO TEM Vincenl F. Sarmlenlo COUNCILMEMBERS Angelca Amezcua P. David Benavides Michele Manhez Roman Reyna Sal Trna,ero Dear Prope(y Owner An application for a building perm improvements specified at I ta() CITY i'TqNAGER Davrd Cavazos CITY ATTORNEY Sonra R Carvalho CLERK OF THE COUNCIL Mana D. Huzar CITY OF SANTA ANA PLANNINC & BUILDINC ACENCY 20 Clvrc Center Plaza P.O Box 1968 . Sanra Ana. Calrfornra 92702 wwl^,.5anIa-ana.org pba NOTICE TO PROPERTY OWNER it has been submitted in your na 'l n -lh 3.Y6 t me listing yourself as the builder of the property B 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 of the owner cannot execute this notice unlesJ you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATI ON OF INFORMATON DIREC TIONS: Read and initial each statement below to signify you understand or verify this information. $f-unO"rstand a frequent practice of 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. L 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 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 injuiies to workers on my property. the cons L, 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 financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. *0. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. 4u I understand if I employ or otheruise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an"employer" under state and federal law. ?u 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 disability insurance, and contribute to unemployment compensation of each "employee.' I also understand my failure to abide by these laws may subject me to senous financial risk. C?*'-7 I understand under California Contractors' State Llcense Law, an Owner-Builder who builds single-family teliOentiat structures cannot legally build them with the intent to offer them for sale, unless a// work is peiormed 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. SANTA ANA CITY COUNCIL I understand building permits are not required to be signed by property owners unless they are responsible for truction and are not hiring a licensed Contractor to assume this responsibility vrlcsr t !blr.r. liaasr P.o Te, Wei ' \.sar'lre lo66anlB.e. @ MMan,.e:iA sr^rr sn3 ... A,!Eu.Os!nL-.8 60 4A I understand as an Owner-Builder if I sell the property for which this permit is issued. I may be held liable for any finarrcial or personal iniuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. tâ‚¬n I understand I may obtain more information regarding my obligations as an'employer'' from the lntemal Revenue Service, the United States Small Business Administration. the California Department of Benefit Payments, and the California 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. '/Q- rc I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party addressl leoallv and financiallv res- 4o'1 (,\J qr\ponsible for proposed construction activity at the following 5 rvzeS tA, &, I agree that. as the party legally and financially responsible for this proposed construction activity. I will abide by all applicable laws and requirements that govern Owner-Buiiders as well as employers. 4, I agree to notffy 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 psrmit can be issued, this form must be completod and signed by the property owner and returned to the agency responsible for issuing the permit. /Vote:coov of the Drooedv owner's driver's license form notarization, or other verification acceptable to the aoencv is reouired to be Dresented when the Dermit is issued to veri fu the Drooertv owner's sionature. Signature of Properly Owner Print name of Owner Date Z<;t') (La.* 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 tollowrng person(s) to act as my agent(s) to apply for, srgn, and file the documents necessary to obtain an Owner-Builder Permit for my proJect. Scope of Construction Project (or Description of Work)(Z< ^arr-r.- r)ftsevr<-xrf ftfd AL ctf6r a= Proiect Location or Address c{o'l w.4^ +b Name of Authorized Agent :.I})rf BeYOo,l Addrsss of Authorized Agent lL9 u. tltLrr^f 9f +tbc) <b4 mia\.G) gZaZ-\ Phone Number of Authorized Agent 1'(1 122'71{u) I declare under penalty of periury that I am the property owner for the address listed above and I personally fillsd out the above information and certify its accuracy Property Owner's Signature Date .zd / 'l \Q-nr* C/,r",'-rc--Print Name of Owner: Note: A copy of lhe owner's driver's license, form notarization, or olher verification acceplable to the agency is required ao be presented when lhe permit is issued to verify the property owner's signature. SANTA ANA CITY COUNCIL Mncern F Srrlcik M.yo Pro lfi W..d j Vs.frsllo6sel'-s. 0.6 Mlbn'n.zrasla s. d. AAftzclaJaenla ani m O8en.yld6osnG-aa r..RR.6!O3rn -,E do -rztL-