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Home My WebLink About10293699 - Permit (2)Assessofs Parcel 408462-04 Lotr 69 Bldg: Address Range Block NA Tracl 2207 Historic: No city of Santa Ana 20 civic center Plaza (M-19), santa Ana, cAg27o2 Building Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853 Building Use: Job Type: Nature of Work: Existing Bldg. & Use Proposed Use: Single Family Dwelling Altoration Alter/demo/nv Sfd Wattached Garage R-3, U VB cBc 2016 x-0602320257J 1 Patio: T.l.Area: Yards Req'd: Valuation: $1,000.00 Occupancy: Constr Type Code: Flood Zone: # of Stories: Description of Work: Remove unpermitted 2nd dwelling unit at rear yard with attached patio cover Planning Conditions It Owner: Address: Phone: Tenanl: HOANG TRAN 1514 W SAINT GERTRUDE PL Santa Ana, CA 927045108 (714146'.t-2678 Contractor Address: Owner-Builder Engineer Address Phone: State Lic #i Lic Type: Bus. Lic #: Workers' Compensation lnsurance Hfi$I Expires: Phone; License # Architect / Desiqner: Address: SUCn; . r 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 Amsden, Julie Da|â‚¬: 0A10212017 Date: Oale: 0810212017 Subject to Field: Misc. Receipt Misc. Receipl Misc. Receipt Fire lnsp. Req'd: Police lnsp. Req'd Flood Zone Cert. Req'd: No o 777600 2 017760 0 2 077 760 0 2 o 777600 2 077760 02 071760 0 2 $154.26 $93.17 $234.08 $1.00 $21.25 $52.98 01 1 16002 51600 01 1 16002 51601 01 't 16002 51612 $21.2s $534.49 $1.00 57607 57607 57 607 57672 57600 s7 607 Permit Fee lnvestigalion Penalty Bldg. Stds. Revolving General Plan Update lssuance* {.,Jo No No No No Account#Total Every permit issuod shall become invalid unless the wo* on the site authoized by such pemil is cofimenced within 180 days aftor its issuance,or il the wod< authonzod on tho site by such pemil is suspended or sbandoned tor a pedod of 1 80 days after tho lime the wo* is commenced lnspector MtD# 2017-137776 $556.74 $0.00 $556.74 Permit #: {0293699 Pin #: {6E35 Proiect Address: 1514 W St Gertrude Pl Unit Suite Range: Zoning: Rl 1st FL Area: 0 2nd FL Area: 0 Other Areas: 0 Garage Area: Total: 0 Nel i:'7 i iiii Phone: License # b 1(}50iirt V iso i.i i; Orozco. lvan Fee Total: Paid to Date: Balance Due: BUILDING. INSPECTOR RECORD SITE.WORK DATE ID/SIG.COMMENTS o\INER BTJII-DEX DEI,('AIATION I hdqr.L lIIm undd poahy of p.4ury rhr. I d .rdpr nom fi. Codrrro6 l-tag t,* for fi. lollo*'is @si (sâ‚¬ 70:l l 5 Bd.6 rnd Prof4t'n Cod.): An, ( iry or Couiy shlch Equt6 ! 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' - + ! t\sf,I (,-,-l 6- v\T \)xn \) I , 1'mll3 -t r-m() I !r @ ozo TmI = o C)aaflo 8z(/ ) iI O Cr(-ooom m(] TI r-o o No so E 5Ili- 8 $ ,J ilFr if ' I: ,r t } U \c\ "r . - \N C7-=) Jn - F: \ 7+ I I I F -1 #$i tt ' T I o { z N4AYOR Maguel A. Pulido MAYOR PRO TEM Michele Martinez COUNCILMEMBERS P. David Benavides Vicente Sarmiento Jose Solorio Sal Tinarero Juan Villegas INTERIi,4 CITY MANAGER Cynthia J. Kurtz CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar PLANNING & BUILDING AGENCY 20 Civic Center Plaza P.O. Box 1988 . Santa Ana, California 92702 www.santa-ana.orq i oba NOTICE TO PROPERTY OWNER Dear Property Owner An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specifled at A We are providing you with an Owner-Bu ilder Acknowled m nt n ln rm rifi rm 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 AN D VERIFICATION OF INFORMATON DIRECTIONS: Read and initial each statement below to signify you understand or verifur this information. +IL1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder' building'pefihil lhat enoneously 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 flnancial 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. l7-LZ. I understand building permits are not required to be signed by property owners unless they are responsible for the' co struction and are not hiring a licensed Contractor to assume this responsibility. ftlS. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect myself' frorfi potential flnancial risk by hiring a licensed Contractor and having the permit filed in hisorher name instead of myown. HJq. t understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on penhits and contracts. t t /i- l-u_s. I understand rf l employ or otheMise engage any persons, other than Califomia licensed Contractors, and the total value of 'my bonslruction is at least flve hundred dollars ($500), including labor and materials, I may be considered an "employeil under state and federal law. fr-LA I understand if I am considered an "employer" under state and Federal law, I must register with the state and federal govdrnment, withhold payroll taxes, provide workers' compensation disability insurance. and contribute to unemployment compensation ofeach "employee." I also understand my failu re to abide by these laws may subject me to serious llnancial risk. H ll . t understand under California Contraclors' State License Law, an Owner-Builder who builds single-family residential struclures 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. fl lA t understand as an Owner-Builder iflsell the property forwhich this permit is issued, lmay be held liable for any financia I or pdrsonal injuries sustained by any subsequent owner(s)that result trom any latent construction defects in the workmanship or materials. SANTA ANA CITY COUNCIL mou do@sema-a.a oro Mayor Pro Tem, Ward 2 mrmanrnez@sEnla 6na oro vsarm'e.ro6s3.la-anaoro 60ronc@sa.la-a.aoro dbonavrdesasanlaanaoro iv sas@sanla-ana oro str.6lero@sanr6-affi orc CITY OF SANTA ANA t t.{ ff_Lg. I understand I may obtain more information regarding my obligations as an "employer" from the lnternal Revenue Service, the' Unlted States Small Business Administration, the Califomia Department of Benefit Payments, and the Califomia Division of lndustrial Accidents. I also understand I may contact the Calilornia Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752)or www.cslb.ca.oov for more information about licensed contractors. tt1- fi_L10.1 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 financially responsible for proposed construction activity at the following address:ffi #lp ffiIio"o . I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all le laws and requirements that govem Owner-Builders as well as employers. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have 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 com plaint. Youronly remedy against unlicensed Contractors may be in civil cou(. lt is also important for you to undersland that if an unlicensed Contractor or employee of that individual or firm is injured while wofting 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 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. ,Voae. A copv of the propertv owner's driver's license. form notarization. or other verificalion acce able to lhe rs re uired to be nted when the rmit is issued to ve the o er's siqnature. Signature of Property Owner Date ?/z/ / 7 Print name of Owner 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 flle the documents necessary to obtain an Owner-Builder Permit for my Scope of struction Proiect(or p PLin k:W P51 ption of Work) Project Location Address Name of Authorized nt: Address of Authorized Age Phone Number of Authoriz Ag I declare under penalty perjury that I a ounterActivitylxssemblyBillslNotic informaten and Property Oilrngr accuracy 's Si ature Note: A copy the owner's driver's ,icense, be presented en the permit is issued to r the address listed abovc and I personzllly lllled out the above Date: ble to lhe agency is required lo SANTA ANA CITY UNCIL e o Property Fonri property owner tion, or other verification ac wner's signature. Itcâ‚¬nre S6n'enro #mrdlo@sant!'ane m P Oaud B6naedes dbâ‚¬na$d6@samr-3n, nd sr'naao@srnll-ana do <t' Print Name of Owler: .r*" s/* oDrâ‚¬--tso'Mgasan', ana & o ot! , " l!-cc tr tl . , ] F ll ja at! +Z dl .. ) (LFc)JUJ ri ' . ioFEtrut o_ -Lx dS,JF' \r+\s \DL(\3(q-< . (,ztl o/k. \ \ ood?8 Fulou) Lu E.i00FzLJ (E ii JzoNc- . r (fJ lJ - af-oUJ tl looO 0- t-rF(/ )8 =G(,d()o c\ N V\\5I (\R a I Ntr& -u - (=zD I * s 5i r: I, lz l; - af \$ ->Mq k. t Z i >( r ( L F -a I H ,$ d d d 1 I >\ \ -z - = : : ' -