HomeMy WebLinkAbout10192602 - Permit (2)EProject Address: 1429 S Mohawk Dr
Assessofs Parcel: 407 -'107 -26 lol 22
Unit Bldg: Address Range:Suite Range:
Zoning: RiBlock. NA Tract 3627 Historic No
City of Santa Ana 20 civic center ptaza (M-19), santa Ana, cA gzToz - Brilding
Permil Counler: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 1tJ1926o2
Pin #: 66092
Building Use.
Job Type:
Nature of Work:
Existing Bldg. & Use
Proposed Use:
Single Family Dwelling
Addition
Addn/Porch
Sfd Watt garage
Occupancy:
Constr Type
Code:
Flood Zone:
# of Stories:
R.3. U
VB
cBc 2016
x-0602320256J
1
Patio: 57
T.l.Area:
Yards Req'd:
Valuation: $51,121.00
Description of Work: Add 459 SF and 57 sq. ft. porch to front of house including extension of living room a"o ,ltw. bpfr8&ld. cql*ln'$tFitndtreupofr..t I'
to office.Total of 3 bedrooms and ono office/Reroof (e) sfd and garags-remove comp ano]1ip$Uldita to'inatCh'iodfl ttdtallA|ylig.ltt ih
(e) sfd-no structural members changed l,,rpt,':!:'rtl]!:jl ':, Ii,.rLrr;i lr.r,:l.iPlanning conditions: rrlir5rr!:t rtr,r r,rlni Ltt:t. ,. ,
Owner:
Address
Phone:
Tenant
Araceli & Aurelio Martinez
1429 S Mohawk Dr
Santa Ana, cA 927042462
(714) 615-3095
Contractor
Address:
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensalion lnsurance
Carrier:
Policy #:
Expires:
Oavid Li & Associates
David Li
1000 San Ga{riel Blvd #101
Rosemead. CA91770 . ,r,. ,
(626) 288-12!6
58075
Owner-Builder
Address
Architect /
Desiqner:
Address:
Phonel
License #
i
t1,i
l/?
Planning Approval By
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp. Req'd:
R 'd
lnspector
Date: 0812312017
Date: 08/23/2017
Date: 09/11/2017
Subject to Field:
No
No Accoun
Misc. Receipt
Misc. Receipt
Misc. Receipt
69402
Total
oill@Ltb, f ea+f
o t t t o o o L
( i i t I l'P6fidlt tieb/ 5 r ?
07776002 53600 Plan Check Fee
07776002 57770 Microfilm Records
08907007 21000 SMIP - Category 1
07776002 57672 Bldg. Stds. Revolving
07776002 57600 Genetal Plan Update
07776002 51601 lssuance
Orozco, lvan
Ahangian, Kathy
Hernandez, Kathy
AL,tha: r.&ia+r6
$684.70
$43.44
$79.80
$3.00
$21.25
$52.98
\,*"
Plann in t#
Landscaping lnsp. Req'd Flood Zone Cert. Req'd: No 0111600251600
Every pemil issued shall become invalid unlesslhe work on the site authoized by
such pemil is confienced wtthin 180 days after its issuance,or I the wo* authonzed
on lhe site by such permit is suspended ot abandonod for a period of180 days aftet
the time the wo* is cofirnenced .
01 1 16002 51601
01 I '16002 51612
01116002 57770
0890't001 24000
$21 .25
$690.74
$3.00
$43.44
$79.80
Fee Total:
Paid to Date:
Balance Due
No
Yes
Fire lnsp. Req'd:
Police lnsp. Req'd
MID#: 2016-133296
$1.522.93
s661 25
$861.68
1st FL Area: 469
2nd FL Area:
Other Areas:
Garage Area:
Total: 469
Engineer
Phone:
License #:
I
BUILDING. INSPECTOR RECORD
SITE-WORK DATE ID/SIG.COMMENTS O\I N ER BTI II,DfR Df,LCA R,{TION
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1,429 S. MOHAWK DR
SANTA ANA, CA927O4
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MAYOR
MiguelA. Pulido
MAYOR PRO TEM
Machele Martinez
COUNCILMEMBERS
P. David Benavides
Vicente Sarmiento
Jose Solorio
SalTinaje.o
Juan Villegas
INTERIM CITY MANAGER
Cynthaa J. Kurt
CITY ATTORNEY
Sonia R. Carvalho
CLERK OF THE COUNCIL
Maria D. Huizar
CITY OF SANTA ANA
PI.ANNINC & BUILDINC AGENCY
20 Civic Cenrer Plaza
P.O. Box I988 . Santa Ana, Californra 92702
www.santa-ana.orq lpba
NOTICE TO PROPERTY OWNER
Dear Property Owner
An application for a building permit has been submitted in r name listin g yourself as the builder of prope rty
improvements specified at
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
DIRECIIOAIS: Read and initial each statement below to signify you understand or verify this information.,)-
"aafu I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" building
l-pffiit 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 nol provide coverage for those injuries. I am willfully acting
as an r-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property
I understand building permits are not required to be signed by property owners unless they are responsible for the
on and are not hiring a licensed Contractor to assume this responsibility
,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,a I understand Contractors are required by law to be licensed and bonded in Califomia and to list their license numbers on
permits and contracts
nderstand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of
m nstruction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employe/' under state
and gleral law.
(6. I undersland if I am considered an "employer" under state and Federal law, I must register with the state and federal
government. withhold payrolltaxes, 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)]i. I undersland under California Contraclors' State License Law, an Owner-Builder who builds single-lamily residential
st#ures 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
gen eta ilding Contractor
erstand as an Owner-Builder if I sell the property for which this permit ls issued, I may be held liable for any flnancial or
linjuries sustained by any subsequent owne(s) that result from any latent construction defects in the workmanship or
SANTA ANA CITY COUNCIL
Ir,kyor fto Tem, Ward 2
vsamrenl.asa.la an3 0ro 6cronc6sa.r. a.a cro
P Davrd Eenav d6s
dbenav,d6Osanla ana oro Eile9ll@$4a-fleelq snnaEro@sa.ta-ana so
,,.)
materials.
Un d Sta
understand I may obtain more informalion regarding my obligations as an "employer" from the lnternal Revenue Service, the
tes Small Business Administration, the Califomia Department of Benefit Payments, and the Califomia Division of lndustrial
Accidents. I also understand I may contacl the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752)or
for more information about licensed contractors
I am aware of and consent to an Owner-Builder building permit applied for in my name,du erstand that I am the party
sible roand financially respon sed NS activity the fol ng
address
@,,,@)*
provrded on
gree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
ws and requirements that govem Owner-Builders as well as employers.
ree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have
this form.
Licensed contractors are regulated by laws designed to protect the public. lfyou 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 com plaint.
Youronly 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 b6 issued, this form must be compl€ted and signed by the property owner and returned to the
agency responsible for issuing the permit. Note; A copv of the propertv owner's driver's license, form notaization, or other
verification acceDtable to the aqencv is required to be Dresen ted when the Dermil is issued fo verifv the oroDertv owner's
siqnature.
Signature of Property Owner
Print name of Owner
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)
Project Location or Address
Name of Authorized Agent:
Address 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 filled 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 notaization, or other verification acceptable to the agency is required to
he presented when the permil is issued to verify the propefty owner's signature.
PL in k:Vl P 5'1 i CounterAclivity.'Asse m b yBills, Notrce io Prope(y Fo.m
SANTA ANA CITY COUNCIL
rnD! do@santa-4na-ctaq
Mayor fto Tem, Wad 2
mima.1 ne@sanla-anB oro
vrcsnte Sam'enD
Bamienlo@sanl!-an! oro
P. Daud EenaMdes
dbenasd6@sant.-ana oro MlleEs@sanla-ana oro stinale.o@sama-ena do
A.4/7
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF