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Home My WebLink About10294381 - Permit (2)City of santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA,27O2 Building Permit Counter (714) 647-5800 lnspection Requests: (7'14\ 667-2738 lnspector Section: (714) 647-5853 Permit #: {029438{ Pin #: 2E422 q Proiect Address: 1048 W Pine St Assessor'sParcel: 008-212-03 Lot POR 14 Bldg. Address Range Tract: BUCKINGHAM Hrsloric No Suite Range: Zoning: R2Block A Buildrng User Single Family Dwelling Occupancy: R-3, U 1st FL Area Patio: Job Type: Alteration Constr Type: V B 2nd FL Area T l.AreA Nature of Work Demo/Remodel Code CBC 2016 Other Areas yards Req'd: Existing Bldg. & Use. sFD watt garage Flood Zone: x-0602320257J Garage Area valuation: $1,0oo.oo Proposed Use # of Stories. , ,otr, Dsscription of Work: D.llxrttmovo unpermitted addltion, removo aecurity bars, ramodal(e) kitchen & bathrooma, repair siding, remove drywall on garage ceiling, legalize drywall on garage walls, return garage to its intended use, & restore2-car garage opening. Planning Conditions: Demo unpermitted 240 sf. Restore 2-car garage opening. Owner: Address Phone Tenant: Contractor Address: Engineer Address: Architect / Desiqner: Address: Lisa Pham 504 Celestial Pt Tustin, CA 92782 /'7141260-2801 Owner-Builder 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 i/ar. Escarlet Brodowskr. Teri Dale: 1010412017 Date: Date: 10/04/2017 Subject to Field: Misc. Receipt Misc. Receipt Misc Receipt 0 777600 2 0 77760 0 2 0 771600 2 o777600 2 0777600 2 07776002 57607 51601 57607 s 7672 5 7600 57607 Permit Fee lnvesligation Penalty Bldg. Stds. Revolving General Plan Update lssuance $154.26 $93 17 $234.08 $1 00 $21 .25 $52.98 No No No No Fire lnsp. Req'd: Police lnsp. Req'd No No Account#Total Flood Zone Cert. Req'd: No Evory pgmit issued shd become invslid unless tho wod< on lhe sile authotizod by such penn is conmenced within 180 days aftet ils issuance,ot il tho wo* authoized on tho sile by such peftnit 6 suspended or abandoned lot a period o1180 days after lhe ime lhe wo* is commenced $556.74 $0.00 $556.74 lnspector MID#: 2017-139112 011 16002 s1600 01'1 16002 51601 01116002 516'12 $21 25 $s34.49 $1 00 Unit Phone: State Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance Carrier: Policy #: Expires: Phone: License #: Phone: License #: Fee Total: Paid to Date: Balance Due: BUILDING. INSPECTOR RECORD SITE.WORK DATE tD/stG.COMMENTS ()wNtiR BIJILD!:R Dl:t-(,tR TION I hrrclt, trlltn lndd F xy 6r Frjury rh,l I m ct.n{i lnnn rhc (i,ntm.bu Lkcn* L,r fot thc nnn,tr'al rtdv,n ls( Trrl t Bu('m's Nnl ttoli\q,n Cdcl Any Ci[ o, (',,unry trhrh r.rlukr i Fmi ro otr{ruci, drs, imfn.. d.nxnrh o' an:n 'tryde1r.. 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Al i l 1 t f oY ) ,. J I I ti lulF $) l- \ j I ItI I nt \1 -l iu 4 ,t atd_ ,J-{ s I il -t dy) N"- ) tT , ), + \. - :d$ .u\ .l i X r)pq) 01c I.i()dl o-F)I')'l f-.. ) .{\- c o i '1.' l :.i ., L ,, / lt l A 1< / ,L I t' i .r 't (t $ : ty \C\ ^7 '{ . oz(1 \ r: ' ) (o tIE 'I.t\\'-t _ {SLU ILF o( ) 0) H a) .r r L 6 a: 1 :a () i B^ i1't qf I :l ij :- . i ., ] ,. 1 /7 FH tl- - t I 1- tl I hf: - - = - MAYOR MiguelA. Pulido MAYOR PRO TEM Michele Martinez COUNCILMEMBERS P. David Benavides Vicenle Sarmiento Jose Solorio Sal Tinajero Juan Villegas INTERIM CITY MANAGER Cynthia J. KurE CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar CITY OF SANTA ANA PLANNING & BUILDING AGENCY 20 Civic Center Plaza P.O. 8ox 1988 . Santa Ana. California 92702 www.santa ana.orq,oba NOTICE TO PROPERTY OWNER Dear Property Owner An application for a building permit has been submitted in your name listing yourself as the bualder of the property improvements specified at io+g w. il tvâ‚¬ r /.- SANTT+ /+-^tA 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. Lfi l.l understand a frequent practice of unlicensed personsisto have the properly owner obtain an 'Owner-Builder" building pdrmit 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 flnancial risk for any injuries sustained by an unlicensed person and his or her employees while working on my properly. My homeowneis insurance may not provide coverage tor 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. I in Z. I understand building permits are nol required to be signed by property owners unless they are responsible for the corstruction and are not hiring a licensed Contractor to assume this responsibility. La 3. I understand as an "Ov/ner-Builder' I am the responsible party of record on the permit. I understand that I may protect myself froln potential flnancial risk by hiring a licensed Contractor and having the permit flled in his or her name instead of my own. lp 4. I understand Contractors are required bylawto be licensed and bonded in California and to listtheir license numbers on pdrmits and contracts. l! S. I understand if I employ or otherwise engage any persons, otherthan California licensed Contractors, and the total valueof m, construction is at least five hundred dollars ($500), including labor and materials, I may be considered an'employer" under state and federal law. / / 6. I understand if I am considered an 'employer" under state and Federal law, I must register with the state and federal f{ernment, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemploymenl compensation ofeach "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. I O 7. I understand under Cahfornia Contraclors' State License Law, an Owner-Builder who builds single-family residential s'lrlctures 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. Ln A. I understandasan Owner-Builder if lsell the property for which this permitis issued, I may be held liable for any financial or p+sonal injuries suslained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. SANTA ANA CITY COUNCIL Mayor Pro Teh, Ward 2 Vrcenre Saimrenro 6amero@sanIa ana m isolmoraslnb-a.a do P OEed Benaed6s dDgnav,dc6alsanta-ana orq pr easrasaila ana o.c W 9 I understand I may obtain more information regarding my obligations as an "employer" from the lnternal Revenue Service, the Uilt-ed States Small Business Administration, the Califomia Department of Benefit Payments, and the Califomia Division of lndustrial Actidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752)or www.cslb.ca.aov for more information about licensed contractors. UL'IO.I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party I60ally and financially responsible for proposed construction activity at the following address: 11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all a licable laws and requirements that govem Owner-Builders as well as employers 12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have p vided 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 flnancial loss you may sustain as a result of a com plaint. Youronlyremedy 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 orUrm is injured while working on your property. you may be held liable fordamages. 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. ,Vore.'A coDv ol the DroDertu owner's license, form notarization, or other a to be senled when the rmit is issued lo the Signature of Property Owner n I Date Print name of Owner AUTHORIZATION OF AGENT TO AC T 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) 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 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 to be presented when the permit is issued to verify the property owner's signature. SANTA ANA CITY COUNCIL mourdoaasanta .e oro MByot Pto 1e6. W ad 2 hfranrnâ‚¬z@sanle'ana do vEenle Samis.to v.sâ‚¬mâ‚¬nlo@sanIa-e.a oro Eoldo1e$nla-E.a oro P. Oav'd Bâ‚¬navrdes dben.sdesAsa.ta a.a.o.o v easasa.ta-a.a do sr .a e/c@sa.t. -a na oro sionature. '0, f ,', 7 Project Location or Address: Name of Authorized Agent: