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Home My WebLink About10191564 - Permit (2)q Proiect Address: 1025 N Lowell St Lot.50 Unit Bldg: Address Range Suite Range: Zoningr RlBlock. NA Tract 354 Historic: No City of Santa Ana Permit Counter: (714) 647-5800 20 Civic Center Plaza (M-19), Santa Ana, cA 92702 Building lnspection Requests: (714) 667-?738 lnspector Section: (714) 647-5853 Permit #: I Ol91 564 Pin #: 33205 Building Use: Job Type: Nature of Work: Existing Bldg. & Use Proposed Use: Single Family Dwelling Addition Addn SFD w/dot garage R-3 VB cBc 2013 x-0602320144J Patio: T.l.Area: Yards Req'd: Valuation: $19,7't3.00 1st FL Area: 2nd FL Area: Other Areas: Garage Area Total: 175 175 Description of Work: Extend (2) existing bedroom with closets and add bathroom. Auth on file. Planning Conditions: Owner: Address Phone: Tenant Contraclor: Address: Engineer Address: Phone: License #: Architect / Desiqner: Address: Phone: License #: Suzanne Furianic 1025 N Lowell St Santa Ana, CA 927032325 Owner-Builder Phone: State Lic #: Lic Type: Bus Lic #: Workers' Compensation lnsurance Ca.ner Policf f: Expires: 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 Ni, Ann Kwak, Jason Zuniga, Allissa Date: 12108/2016 Date: 05/09/2017 Date: 08/28/2017 Subject to Field: lvlisc. Receipt Misc. Receipt Misc. Receipt\(' 0 777600 2 o7776002 0 777600 2 0 777600 2 o7716002 07 77600 2 57607 53600 57770 57672 s7600 57607 $300.00 $106.93 $32.s8 $1.00 $21 .25 $s2.98 Permit Fee Plan Check Fee Microfllm Records Bldg. Stds. Revolving General Plan Updale lssuance No No No No Fire lnsp. Req'd: Police lnsp. Req'd No No Account#Total Flood Zone Cert. Req'dr No Every permit issued shall become invalid unless the wo* on the sile authorized by such pamit is cofimenced within 180 days after ils issuahce.ot if the wo* authorized on the site by such pennil is suspencled ot abandoned lot a ponod ot180 days aftet the lime tho wotk is conmenced lnspector MID#: 2016-133359 51600 51601 51612 53600 57770 $21 .25 $3s2.98 $'1 00 $106.93 $32.58 Fee Total. Paid to Date: Balance Oue: 0'11 't6002 011 16002 011 16002 01 1 16002 011 16002 $514.74 $0.00 1514.74 Assessor's Parcel: 405-283-08 Occupancy: Constr Type: Code: Flood Zone: # of Storiesl BUILDING. INSPECTOR RECORD SITE.WORK DATE ID/SIG.COMMENIS {)$\l Illr ll rr Rr)l Ir \lr\ll(,\ I llFd, .lIrm ud( F.X, or Fjury- lhn I d darr, IiDm lhc Codr8l6' l-t.E lls tor rlE follori4 asr (L /ull t Bus'nd ud Pmfsn'n Cod.) Any ('iry or Courny rhrh rquir6 a tEmit ro .otrqrud, al6. impBve dsnolilh or rlitn d, llruir. Fn.lo ir3 itsle..t$ r.+ic tlE qlPlkd fo, s.h Fmh ro 6k!3'sEddntul thr. 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Cs il s ll E E Qn )c 1 \$5q il Y\)l T I: u â‚¬- t r )'k 7.: l? a ' 2 I I s,-t fih fr fr --8 { $.n (s $.1 a 4, I {I fi *;q\ $R mt*_J \, 1 1 a\ 't r NC) { ss t *$ $ $$ I +I i E+ \ t qrf l tJ $\il U -- ' . ; ) tr f" ? iJ $f Iq 6e r r8<mf7 .i!fLI Ut - o ' ftI U $il .t ;\ ll . ' . - o' CJ&J I ,i J \ \N -j T rc 9 :!) -| / 2 qf l F fl lI :z v E5 v-{ E \9.I m -. l g J S \ Y . IS P ;$ 5 55 F$ E $s 5 i i : : ( )r 3 -r r F , 2 7 i gg *? I i ii .I \$[ = lr t ts r z tl \ D.F$CF ls t-ls rJ 1 d-1 m \i ft tt T !T J r\tfirr s .) F :\ i- l -!tZ 1I Z.t + FF72 E+ ) -r . 6 - >f t RE \s q Z- - - - L 5 __ s s^ a. F- J \\ v @ I MAYOR Miguel A. Pulido MAYOR PRO TEM Michele l\4adinez COUNCILMEI!!BERS P. David Benavides Vicente Sarmiento Jose Solorio Sal Tinajero Juan Villegas INTERIM CITY MANAGER Cynthia J. Kurtz CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar CITY OF SANTA ANA PI.ANNING & BUILDINC AGENCY 20 Civic Center Plaza P.O. 8ox 1988 . Sanra Ana, California 92702 www.santa-ana.orq i oba NOTICE TO PROPERTY OWNER Dear Property Owner: AF application for a building permit has been submitted in your name listing yourself as the builder of the property irhorovements soecified at -+- I t 75 N. t-z"ve// <*. We are providing you with an Owner-Builder Acknowledqment 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 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. SF f . t understand 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 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. SF Z t 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. JF S. t understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may prolect myself from potential flnancial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. SF a. f understand Contractors are required by law to be licensed and bonded in Califomia and to list their license numbe rs on permits and contracts. S S. tunderstand if lemploy or otherwise engage any persons, other than Califomia licensed Contractors, and the total valueof my conslruction is at least flve hundred dollars ($500), including labor and materials, I may be considered an 'employer" under state and federal law. SF A. I understand if I am considered an "employer" under state and Federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation of each "employee." I also understand my failure to abide by these laws may subject me to serious frnancial risk. F Z. f understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale. unless a// work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar years, or all of the work is performed under contract with a licensed general building Contractor. F g. t understand as an Owner-Builder if I sell the property forwhich this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. SANTA ANA CITY COUNCIL moUido@sanla'atu oro Msyor Pro Tem Ward 2 m man'ne2rOsanta.ana oro V'canle Sa.mrenlo !sam'eoloosanl,a 3na oro Ed.!!9@$!1a:!!4!9 dbe.av,desasanra a.a oro v'rreoas@san|a ana o.o snnaE.o@sanla-ena oro SF 9. I understand I may obtain more informalion regarding my obligations as an "employer" lrom the lnternal Revenue Service, the United States Small Business Administration, the Califomia Department of 3enefit Payments, and the Califomia Division of lndustrial Accidents. I also understand I may contacl the California Contractors' Stale LicenSe Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.qov for more information about licensed contractors. SF n.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 f,nancially responsible for proposed construction activity at the following address:o ?7 lF 't'tll agree that, asthe party legally and financially responsible for this proposed conslruclion activity, lwill abidebyall applicable laws and requirements that govem Owner-Builders as well as employers. ][t Z. t "gr"" to 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' 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 isalso 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 damag es. 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 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. IVote; A coDy ol the Dropeftv owner's driver's license. form notarization. or other verification acceptable to the aqencv is rcouired to be presented when the permit is issued to verifv the propeftv owner's siqnature. owner - Sfur. 1a*tt-.'Date 6.2.e. /7Signature of Property Print name of Owner A4?a{/E RtRtaN<-.. 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 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 of Work) Name of Authorized Agent Phone Number of Authorized Agent I declare under penalty of perjury that I am the property owner for the address listed above and I personally fllled out the above information and certify its accuracy. Property Owner's Signature Date 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 lo be presented when the permit is issued to veify the propefty owner's signature. PL rn k.$J P51 /C ou nte.Activity,Assenr L,lyBrlls Notrce to Property Forn'l SANTA ANA CITY COUNCIL moul'do@$nta{n. do Matlr Pro Tem Wa.d 2 oirurl nez@sant.-3.a do V6re Samisro 6ampnto@santaâ‚¬ne m Ed!!gell!la:@a-ar9 P Davd B6nsvd6 dbâ‚¬navd6@sant3.ane oro MllMs@senra-ana oro sr naâ‚¬ro@sa.ta-am oro Project Location or Address: Address of Authorized Agent: