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Home My WebLink About20165645 - Permit (2)City of Santa Ana Permit Counter: (714\ 647-5800 20 Civic Center Plaza (M-19), Santa Ana, CA92702 Electrical lnspection Requests: {'714) 667-2738 lnspector Section: (7'14) 647-5853 Proiect Address: 2202 112Ytt LaVerne Ave Unit: Block: NA Bldg: Tract 1 346 Suile Range: Zoning: R1 q AssessoisParcel: 109-122-21 Lol 22 Owneri Address: Trang Ho 2202 W LA VERNE AVE Santa Ana, CA 927043510 (7',i41726-6040 Fee Type 011 16002 5160: Subpanel 01116002 5160C General Plan Update 01'116002 51603 lssuance Amount 51.29 21 25 52 9A Qty 100 100 'L00 Fee $51 .29 $21.25 $52.98Phone: Tenant Name: Contractor: Address: Owner-Builder Phone State Lic #: Lic Type: Bus. Lic #: Workers' Compensalion lnsurance Carrier: Policy #: Expires: r,,rtrhi:43330 - +/17/vnlg l0: o;orr tlff ice: CTYH Tronsi: 8.{ 1 c,{Ar:cLi: Reff: 2r-116:16{l Rcpli:02233619 - 1/17l2QLg 2.lf-; tt1 Irqnsoct ion Totol t25l . r-r1 I r.{rri9 Ho Building Use: Job Type. Nature of Work Single Family Dwelling Miscellaneous Subpanel Occupancy: Constr Type Code: R.3 VB cEc 2016 Notes lnstall new subpanel. Auth on lile. Auth+:rl Planning Conditions: Planning Approval By: Plan Checked By: Permit lssued By: Subjecl to Field: Building Permit #: Date: Date: Date:o411712014 Account# Misc. Receipt: Misc. Receipt: Misc. Receipt: Total Every pemil issued shall becono invalid unless the work on ths slto aulhoized by such pemit is conmenced withinlSOdays after its issuance, ot il tfie wod< authonzed on the sito by such ponnit is suspended ot abandoned tot a pe od o1180 days afler lhe time the wo* is cofimenccd. lnspector MtD#. 2018-142182 01 1 16002 51600 01 1 16002 51603 $21.2s $104.27 Fee Total Paid to Date: Balance Due $125 52 $0.00 $ 125.52 Permit #: 2O165645 Pin #: 71179 Address Range: Historic: No Zuniga, Afflssap ELECTBICAL-INSPECTOR RECORD APPROVALS ID/SIG.COMMENTS OWNEN'UILDT.N DFICARATIOI\ I hceny dfinn und( Fn.h, ot Frjury !hs, I m.rcmpr tbm rh. 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(, rrur. rn.t.'i .onIf,nsrx,n (tr.ra8c '\ onh*itrI. d shsll rub(r .n .nltt,)!r n' mnuul IEUlrr\ lBl .iril tnr\ ur t, ok hurtrJ rtx,trqnd dollrr\ (!lol,.irx in lddni,n (r rh. .on .(.ofiEf,qti,,n, drms.s ts proviLJ tbr lhc S(ri)n :1076 or rh. Iillr (iiL. inr.E{ and rtrmv\ I Wtl -:tctâ‚¬lfat'l rf, I lErty ifiirfl ufl,c! FEhy o( FJu,y rhlr I m lnrnrn ur F)!irio. oaCludq 9l$'llrE_ing {nh Sdrr 7(Xn) of Dir,.r,n:l nf rl* 8u!r* rn,l l,rolt$ir$ (i .. rkl nry la(n\c A ir lull nnN dl lifL.cr drfllliANr.ll[s,l&r]x)N lh6lt'! dim ufrln Fn!lr). of Fr,tlD w oI rh. f,,ll,qi6r rld lrdir.i l).m,1'Lon I,crinir\ A\h.jo\ Norillerrion ludorl Rcgul tr'n\( l{lc 4r.1,!n6) Rrqu'dl lrn.r ol t*, 'lf,dir -l enily 'hd rtr f.ndl Ephb6 ESrdi,l3 .dBror lmql e n lpdubl ro rhir ttsF _l cniry rh, I h.E E d rhii .rtlbln. rn rd. rh, rh. rlDn i.t nnrnn ir (rr.d I .8E lo orpl, rnh rI Ct, rn A,only ,ddrEc! rd srr. l,*. RLt Btn h'Hi.8 mdftr br .,!c h.r.h, .urh,riz EFEndiEr of lhir Cny un Colnt, ro dld upon dr rlbr rnri,xri DmFnv fM inid(lion 0GEar^x::xLW\* -i+'4*'â‚¬ Site-Work Underground Light Standards Spas, Pool, Fountains Siqns (monument) Lite Safety /Low Voltaqe Fire Alarm / Dampers Communications Cable Building Under Slab / Floor Bondinq / Groundino / UFER Transformers Torqueing Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Rouqh) Ceilings (Hard & Soffit Rough Ceilings (T-Bar Rouqh) Meter Release Rough Service Meter FINAL ilplt?^/^ul<A,L>) Notes Remarks. Etc DATE C(IN\TRUCTI(IN I FNNIN(: C}'\C} I h.r6,.lfrm !nd.r FEhloaFrrurylh.l rlE n. on{nx1in. Ldina.!t-.-y tur rh. Ffi)mR of th. Qod fo. *hah rhn Fna ir fsucd (se l(r7. c'v c.r Pole Bases Sub-Panels CITY OF SANTA ANA PLANNINC & BUILDINC ACENCY 20 Crvic Center Plaza P.O. Box 1988 . Santa Ana, Calrfornia 92702 www.santa ana.org pba 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 rovements s oecifred at'\4J. ACTING CITY MANAGER Gerardo Mouet CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria O. Huizar IP'L 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 DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. Tq 1 . I 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. \k Z. tunderstand building permits are not required to be signed by property owners unless theyare responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. ^.1-f 3. 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. -I* + t understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. F* S. t 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. f+-6. I understand if lam 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 financial risk. IE:-2. t 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 SANTA ANA CITY COUNCIL mp!lrdoOsanIe-ana oro M8lor Pro Td. Ward 2 mrmartrne.@sanra-anE oro Vrcenla Samienro 6amiento@sanla-sna oro lsobno@santa-ana.oro P. Davd Bâ‚¬.aydes dbenavrd6s@sanâ‚¬-E.a oro rvrrleoaslosanta-anB oro sl'naâ‚¬ro@santa'a.a oro MAYOR l,4iguel A. Pulido MAYOR PRO TEM Michele Martinez COUNCILMEMBERS P- David Benavides Vicente Sarmienlo Jose Solorio SalTinajero Juan Mllegas 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. -T'hf 8. lunderstand as an Owner-Builder if I sell the property for which this permrt rs 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. Ttt 9. I understand I may obtain more information regarding my obligatio;rs as an 'employer" from the lnternal 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. LtO I am aware of and consent to an OwnerBuilder building permit applied for in my name, and understand that I am the party I lly and financially res nsible for proposed construction gtivity a t the fo lo.a llowing addre .;A Y* 11. 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-Builders as well as employers. t'd- lZ. I agree 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. 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' com pensation 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 p ermit. ,Vole.' A copv of the propetty owner's driver's license, form notarization, or other veritication acceDtable to the aoencv is reouired to be ented when the Dermit is Signature of Property Owne, / )fr*"q W Date: fu-tl - 2Ol p 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 Ior, sign, and flle the documents necessary to obtain an Owner-Builder Permit for my project. Scope of Construction Project (or Description of Work) Project Location or Address 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 fllled out the above information and certit its accuracy. Properly Owner's Signature Date Print Name of Owner: Note: A copy of the owner's driver's license, form notarizalion, or other verification acceplable to the agency is required to be prcsenled when the permit is issued lo verify the property owner's signature. SANTA ANA CITY COUNCIL moulrdo@sants-5na oro Mayo. Pro Teo. \tard 2 mrmanr.ea@sa.la.ana.ora isolono@sa.la-a^a o.. P D.vd Bâ‚¬naudes dben.vd6@s.nla ana oro NLlleas@s.nra-ana oro slrnaE.o@e.t.-.na.orc issued to verifu the propertv owner's sianature. Print name of Owner Name of Authorized Agent: