The URL can be used to link to this page

Home My WebLink About10191475 - Permit (2)q Assessor's Parcel 410-171-25 Lot: 70 Unit Bldg: Address Range Tracl 6703 Hisloric 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 Permit #: 1lJ191475 Pin #: 323l)7 Building Use: Job Type: Nature of Work: Existing Bldg. & Use Proposed Use: Single Family Dwelling Addition Addn/Oen SFD WATT GAR.RESIDENTIAL R-3, U VB cBc 2013 x-0602320259J 2 Patio: T.l.Area: Yards Req'd Valuation: 0@0 s37,060.00 Description of Work: Legalize 340 sq ft den including the removal of (2) walls. Auth on file.I'i 0?t , ti Owner: Address Phone: Tenant Thi v. Tongffhien Nguyen 621 Murphy Ave. Santa Ara, CA 92707 (71417g',t-7214 Contraclor Address: Engineer Address Phone: State Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance Carrier: Policy #: Expires: Architect / Desiqner: Address: Phone License # Phone: License # L6uLrL 16Lr1Ul-lr 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 Dale 0912112017 Oale 0912112017 Date: 09/25/2017 Subject to Field: {v \' Account# 68900 Total [.4asc. Receipt lvlisc. Receipt Misc. Receipt 0 77 76002 07776002 07776002 07776002 07776002 07716002 57607 5 3600 57770 57672 57600 57607 $353.60 $442.00 $21 .72 $2.00 $21.25 $s2.98 Permit Fee Plan Check Fee Microfilm Records Bldg. Slds. Revolving General Plan Update lssuance No No No No Fire lnsp Req'dr No Polrce lnsp. Req'd: No Flood Zone Cert. Req'd No Every permit issued shall become nvalid unless the work on the site authoized by such permit is comfienced within 180 days anet its issuance,ot I the wot* authoizad on the site by such peinil is suspendec! ot abandoned lor a period 01180 days after the ltme the wo* tscommenced lnspector MID#: 20't6-'133059 01116002 01116002 011 16002 01 '116002 01 1 16002 51600 51601 516'1 2 53600 57770 $21.25 $406.s8 $2.00 $17 00 $21.72 Fee Total. Paid to Date: Balance Due: $893.55 $425 00 s468.s5 Project Address: 621 W Murphy Ave Suite Range: Zoning: R1Block: NA Occupancy Constr Type Code: Flood Zone. # of Stories: 1st FL Area: 340 2nd FL Area: Other Areasl Garage Area: rotar: ;ii',ip$'ii Planning Conditions: Owner-Builder *:rr*rtvrrlxlr BUILDING- INSPECTOR RECORD SITE.WORK DATE ID/SIG.COMMENTS OWNEE B!ILDf,R DEr-(-ARATION I hq.t'y Emnn ulds p6d'y otFjury rhd t m.rmP 6om rh. ContrE(loB l'c.e l,* for !h. follosi.s.@sn (s.t 70:rl5 Burre\ ori E f<io. Cod.) Anr Cty or C.urt, s'hrh r.qur6 ! Fsi ro sdDd. .ns. inr.ovc {t nolBh or r.Fn d!. srtuciui Fior lo nr Lsiuecc. ds. r.qun6 th. apglrMl for such tEf,r b lil. t Un.d idtul rha h. or sh. ! li.nsd p!N!,Ir kr rt Fovii'od of rh. ( odrfor ! l.icar.d lj* t(14tc 0. ( onEtrD! \'irh sdirin 1,00 of Dtrnhn I of rh. Bsina tnd ProfBrFns (idc) or d h.or ih. i!.tml)l lhd.fio'. Dd lh. h.sir nn l hc alka.! .raplion Anyvnnilionoas(ibn70115 bydnv aptli..n! aor r Fmn ebJdr rh. q?li.!nl lo . (iyil p.Elr) of hr frtr. the n\. huidr.ri &lls ( i50O) I, s ownd of rhc F.Fry, o. my mpk',6 wnh s.s6 B th.r $h NnFdion, *ill rb rlE {st !d tlE nnrrd i! d iiai.d dorEld for nl.(s< 7044, Bui6d sd Pnrlsios ('D& llE (:onlrrioir l-tds lrw d\6 nol .Pply lo d osns ol th.F$Fi, who hril& n itrFrDE riEBs lxl slE &E nEn Nd hinr.lf or h*lf or tlmtrh nii G hd oe, .npL)c Fovid.d lh.i rucfi iEFnEGu & mr idnrlat or.ft*d lor sL lt, lssM. th. tlildilli o, in{relocd it $ld wilh'n orc }@ ofcompkioq rlE (nG tuiEs rin h.r. trt hrdi orFwB tlti lE o. iE did d hill G irqoE 0E FtrFty ijr dr F,D.E oI l. os osn( ofrh. For6r', d.rrkn.ly..ntrdin8 sith licd.d or r&loRl,r c.nnrucr rh. Fq(t (S(. 7014. Bunndl .rl th'tsrh Cod. lh.conr.dorsIrc.n*ksdo6enqtDio.no$idorprop.n!trhoburd!orimp drhdon. lnd trh. codrdr for s.h F.jds h r i,nldk'(sl li(4Ed pun@r ro rh. (tnlrdoi. Licdr t{s) ,,,,'")'l[i?/+ I h6.n) aftrm und.r Frh! .r Flurr oft of rh. folhtr im .k L'd Ih.Erdwilltui'ri.rC.nit(d.oa(oEdroSdf-lMt rvt6 st9csrior d Fvli.d fo. bYS<1itn 1700 ofrh. L.hor ( ode lor rh. FlollMcc o f rh. wot fo, *{rd rh. p6nir . au.d I h!\. .rd r ill dajnr.in wod6 .omp.Ml io. irouanc.. 6 rcquiEd by sdrion l70o of lh. l,tnr Cod.. for lh. Ffolllmc. of rh. *nI fd rnih fii! Fnn i iB.d Mt $ort6 onpaEiion idurft.6it rld polty mnbc c CriE Polic, NuDbsr - ErPiB I Griry rhd in rlE Ffolrlw. orllE so* lor rtrh rhir Fii i! isrn I irll ml dphy 6y F$, it xy m46 $ sro b6.ft rubjcr ro rhc wo{4'comFurion hBolcrlitomi4 sd.sGlhd if I slbsld beom tuts d lo llt uo 6' orpdqb. Forec 6lsdbn lT0o 6f rh. t t { co& l Jrll- fonlNii @nplr *ith rnor FornbB WARNTN(; F.,ltrr. h sur. qorlds (ompdsalk'n co!di!. N unh\n,okt rhall rubjsl olpl6r( 'D .mm.l p6utis lnd ro.R hund..n rhousd {hll,r ltl00.O0o). r x!]nhn )n, d,nu!6 a mrid.d tor rh. 2 DI'CIJEAIIA! I ffi, .ilrm ud.r FlXy or Fru.,v rhn I m lk.iEdl und.r lr!vti'. oI ((.ommins rnfi Sdir ]0()o, oaDnfn'n I nl rh. RurinRi ind lk adrn'E(id. md nv licd\. il in tull f ..tu .lT(l qqILtIA!(fIANl.llDllClli!!(} I h<!l'! rrtri un& Frh) of FJury rhd llE i3rcoldrudni lqdie a*o.y lit th. Ffroc. oarh.{.rt tor {hich lhG lEmil ir Esu.d (sâ‚¬ lro97. ci! c) AITU(ANI.0ECIASAIIq! I ho*),.n'd undd Fill! olFjory on. oathc follosinr d(lsrtion. D.noliion Pmik-A3b6r.r No(ficdion F.d@lRlsrhhn! ( I nk.$, Prl6) R.q!t.d LlrqorNdftin. I .drq rhd rh. f.nd.l rcsul.rioB r.ardD8 lrh6rx..fuu|tu. mr amlt.6k u rhu F.j.al I (dit rhd lh.!crcdlhs qid'ctrxrn drl nar rsra r. compb qnh rll Cir! !.d (-oun!\ ir6 ofthir cirysd Counryro 016 uFrn rh..i'linin(6 a.d Sr.lc ltrrs r.lln rh\. mdruftd,ropdr for 1 L4 !/') -Ll/16rwtz ?12'/tt- Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Subf loor/VenUl nsulation Roof Sheathinq Shear Wall Framinq In su lation/E nerg y Drywall pllt-l rt T,Ut*'y,<'f-*,'r/r)Ext./lnt. Lath UI Masonry Pool Fence T-Bar Handicap Req Deputy Final Report Engineer Final Report Flood Zone Certif ll FINAL '!ol)7 l8 '0>at-/ I I U\Certificate of Occupancy Notes, Remarks, Etc J------:-- t I I I I I I I I I I Brown Coat I I I I I I MAYOR MiguelA. Pulido MAYOR PRO TEM Michele Martinez COUNCILII4EI,lBERS P. David Benavides Vicenle Sarmiento Jose Solorio Sal Tinajero Juan Villegas INTERIi,I CITY MANAGER Cynthia J. KurE CITY ATTORNEY Sonia R. CaNalho CLERK OF THE COUNCIL Maria O. Huizar CITY OF SANTA ANA PI.ANNING & BUILDING AGENCY 20 Crvrc Center Plaza P.O. Box I988 . Sanra Ana, California 92702 www.Santa-ana.orqlpba 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 prov NtS S ecified at LI I 7 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 unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON DIREqTIONS: Read and initial each statement below to signify you understand or verify this information. 14, ,understand a frequent practice of unlicensed persons is to have the property owner obtaan 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 dsk for any injuries sustained by an unlicensed person and his or her employees while working on my property. ijty 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 properly. I'i7V ,. runderstand building permits are not required to be signed by property owners unlesstheyare responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. 3. lunderstand as an "Owner-Builder" lam the responsible party of record on the permit. lunderstand that lmayprotecl myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. I I I v q. t u nderstand Contractors are required by law to be licensed and bonded in Califomia a nd to list their license n umbe rs on oermits and contracts.'I @1-a. ' understand if I employ or otherwise 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. llV A. I understand if lam considered an "employer" under state and Federal law, lmust register with the state and federal governmenl, 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. N-r. , 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. '[ l\/ A. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the wo*manship or materials. SANTA ANA CITY COUNClL Marq Pro Teh Ward 2 \sam e.l.asanla an. or.rid-a!-a@s!4a:@a.el9 P Oavd Benavrdes dbe.avrdes@sanla-ana oro Mlleas@saob ana do -70 7 United States Small Business Administration, the California Departm.ent of Benefit Payments. and the Califomia 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.L legally L l understand I may obtain more information regarding my obligations as an employer'from the lnternal Revenue Service, the 10. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party p n ble for posed on ac at foll sa address 4) til, i-ppri* '1. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all ble laws and requirements that govem Owner-Builders as well as employers. Ts?/:Z. , agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have rprovided on 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. 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 ofthat individual or flrm is injured while working on your property, you may be held liable for damag es. lfyou obtain a permit as Owner-Builder and wish to hire Contactors, you will be responsible for verirying 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. Nore A coDv of the DroDerty owner's driver's license, form notarization. or other verification acc to the /s n he il is issued ,o ve the o siqnature. Signature of Property Ow Print name of Owner Date /)- 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) 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 notarization, or other verilication acceptable to the agency is required to be presented when the permit is,ssued to verify the propefty owner's signature. SANTA ANA CITY COUNCIL t moul'do@sanL-ane do Mayd Pro Tem. Ward 2 n'man,nezlosanE ana oro vi.srE s5mrsro !6amL6nto@sa.t3-ana oro Eefgllaletella:lli-gc dbe.aedesosa.la'anaorc r9l]!9!!@5a!E:r!!-e9 sll.arero@santa-an, oro + - 1 </1-