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Home My WebLink About10194242 - Permit (2)q Proiect Address: 2054 S Ross St Assessor's Parcel o't5-125-21 Lot: 8 Unit Suite Range: Zoning: RlBlock 5 Tract 517 Hastonc: No I city of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA127O2 Building Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853 Permit #: 1lJ154242 Pin #: 382{3 Description of Work: New bedroom, full bathroom, walk-in closet, & extend front entrance area. Reconfigure (e) bathroom with duw cloSBt Bualding Use: Job Type: Nature of Work: Existing Bldg. & Use Proposed Use: Planning Conditions: Single Family Dwelling Addition Addn Sfd Wdet garage R-3 VB cBc 2016 x-0602320276J 1 Patio: T.l.Area: Yards Req'd: Valuation: tt!/,,/)itl, $31,000.00 lt, 7 / 2t117 $9 Owner: Address Phone. Tenant: Julian Munoz 2054 S Ross St Santa Ana, CA 927072715 (7r4) 486-3168 Conlraclor Address: Phone: State Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance Carrier: Policy #: Expires: snucri'chutLsi. Yagrrt Shucri L Yaghi '112 E Chaplran,AYenue, D ,, Orange, CA 92E66 (714) 997-9130' r'lrrrrrl C43205 rrl r" rr,!l l.r ll 11 tr DRP - De Ros,E Plehninq ' ' "i.i"i'1 , Jack De Rosas 2404 E Katella " O.ange, CA 9/d66 (714) 516-0153 Owner-Builder Phone: License # Architect / Desiqner: Address: Phone: License # r r'lril]iIlri IirliIlx44?9 rr tt I Planning Approval 8y Plan Checked By: Permit lssued By; NPDES lnsp Req'd: PWA lnsp. Req'd: Planning lnsp. Req'd: Guevara, Jerry . Chehade Nabil \;fur"'n,no"', r"tnv Date Ogl21l2017 Oale: 1012612017 Date '1012712017 Subject to Field: No Misc. Receipt Misc. Receipt Misc. Receipt No 70088 Total $300.00 $370.50 $32.58 $4.03 $2.00 s21.25 $52.98NoNo Landscaping lnsp. Req'd: No Flood Zone Cert. Req'd: No Every pemit issued shal becorne invalid unless tho vtotu on the sile authorized by such permit is commenced within 180 days aftet its issuance.or if tho wo* aulhoized on lhe site by such pennil is suspendec! or abandoned for a poriod of180 days aftor lhe time lhe work is cofifienced lnspector MID#: 20'17-138456 $21 .25 $352.98 $2.00 $32.58 $4.03 Fee Total: Paid to Date; Balance Due Fire lnsp. Req'd: Police lnsp. Req'd Account# 01 1 16002 01 1 16002 01 1 16002 01 1 16002 08901001 51600 51601 5'16'12 57770 24000 s783.34 $370.50 $412.84 Bldg: Address Range 1st FL Area: 285 2nd FL Area: Other Areas: Garage Area: Total: : .,i,3& Occupancy: Constr Type Code: Flood Zone: # of Stories: Engineer: Address. 07776002 51601 Permit Fee 07776002 si600 Plan Check Fee 07776002 57770 Microfilm Records 0a907007 2!000 SMIP - Calegory 1 07776002 57612 Bldg. Stds. Revolvang 07776002 51600 General Plan Update 07776002 51601 lssuance BUILDING. INSPECTOR RECORD SITE.WORK DATE rD/slq.COMMENTS Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground l-zY-lE SLAB Floor :-----r+,F .lr,fl Subf IoorA,ren( nsuIatid)2-k./K 7nRoofSheathind-j-l-l{ Shear Wall 7- t-lY Framing 3v{;/{ ln s u latio n/E nergy J a,/ Drywall g uoL Ext./lnt Lath gx\L$t+Ih I >" Brown Coat ,({A Masonry I Pool Fence T-Bar Handicap Req Deputy Final Report Engineer Final Report Flood Zone Certif ICrtl*c tt-3-22-,*t P60 FINAL ,22 -/&.J/cJ*. Certificate of Occu pancy NoJes,_ Remarks, Etc L r/ OWNER BUII,Dl:R DEI,('ARATION I h(.q rmm und6 Fmht of Fjury lhd I m .rmpr 6om rfi. Codrdo6 ticff L.w for lhc followus r4en lst 70lr l 5 ll$i.s dn Pr.f6F. (-o&): An! ('ily or Couir *hxh r.qu,6 . F ir lo codtocr, tlr6. mFo\a d.ftni!fi o. r(Im e) {rucrrc, Fnr ro s i<um.. d$ (quG th. {,fl'c&l lor 3u.h Fmd k, 6k . risEn dffir rhd lr or slE it licaGl rred k, rh. proviJoN of th. ( o.rrmroar l.ic6s.d l3w (('haptd 9, Connocrnr *irh s<rio. 7000 of l)iviion 1 of th. tt4r..ir .nd h.f*inr (_o&) or rhlr lE o, sn. i!.rlnpr th6.6on and thr t{si! ao. rh. .lkX.n .rtrrl ion Any riohior.lsali.n 70.1I t hr lny qrtli(d f.r r Fsr sblds rh. qrlrd h . cr il p.oh) .fmr mrdha fi!. hrut<n dolm It500) l, d o*'os oflh. ForEnr, or ny .ftdoyd $1h w!a6 a! rh.t $L .omF$nio., $ill & rh. wod E rh. nnrle i nur n dt.n or oll6.d fo. sl. ( se 704,1, lt6i6 ed Pn fsi.B Cod.: Th. ('ontra.ioii l.ic6F |,tr &6 nol ,prlv to an l\ nd ol rh.I'trFit * tF tlikl or 'ryro\6 rhsFn- ,rl { tn d< s{lj {uI hinrlr or hdslao. rl$uAh hr o, h.r o*r dIh! G. Forir.d rhd ru.h mFol.trds -. d darLi or .fidln for nL rt h.s6d. iE t!,!,t* .r i'.F.\ffi it su tr .hm "E ';or.ompkri.n, rh. ()\lnd lt]lll6 *nl haE rh. trmLn or pro\ rrU lhd h. or slt. tln d hill n in{rcE lh. p.!Ft} for lh. Frt eor sk, l. s otrK.f rh. Fr.iJ. m dchln.ly cod,klrs rnh hco!.d conrrxroB r. (dru.l E,nF (sc 7(xl. ABIB .rt PFfrst'n ('o&: Th.conraroi! I-i.6sc uq d6 mr.rolyro u oun6 ofFop.n} vl$ h'lds or inproyd rhaftn, lnd s,h(.onrBd.tuiuchFojrr3{nhaC.d6cro(r)li.dsdptnustt.rh.ConrrdorsLi..Mtiv) lm.\. ,ti trFlf Sn',, ".," /o/2///o//,,".", I hddt.min und.. FMhr" oap{jr r_ oE of rh. nnhwrS tL.l,rhc I havc a.d will nri.roi. r C.nifi(at..f co,sr ro s.lf-lmtrr. for work(s- .omp.N.l i.n. 6 tmvid.d lo! l,y Sdion 1700 orrhc l itu Code ror lh. Ffolrucc o I lh. *t for sfiich lh. psnrr 6 is!.d I h,E .nd * r ll maintai. sort6' .omlE6.r io. iNurm.. F ralliEd hr Sd rcn r7{x) o f lhc l,hor C.d.. ld rh. Ffoffi. of rh. q$k tr uhich $n pdmit i, tru.d My worl6r' conpadion islra..ais EdFlicy.uhb6&c: I cdily !h,r m rh. Fforr1r,mor'h. $otl lor *h.h lhit Fnn is isal I stEllnol mploy D, F*n in uy dmnd $ a to tEcom tlur.cl h llE wd6 onFlnfn LE orc.l'rnm( &d +d rhd 't I rlbuld b.tom ebid '. 'lEN*6 comFMrion pro{ oB6lser6.lTmofrh. Ld!" ('o{c l dEll. fdnhtrirh comply wilh lho- p(ovilirB WARNING: Iiailr. ro su. sorld' .ompssdnrn covmt. ir unLwaul. sd shall iubj.<l d dnplor6 lo simi.al FElri6 ed ciil lin6 np ro o.. hund,.d drNnd &llm (1100,000). in,.ldilion l. th..os1 of conpdllion. drnus6 13 Fo1A.n for rh. nrdd MJddR s lG e q,d/ DEgtSAfio! I trqqra llfrm un& F.!ht of FJury rhd I m ltq6.d u.d.r F.tab. of(lsDlc 9 (mnnffiins s h S<rnn 7l)m) or Dn shn l of $. Burind dd PNt<iioN codc. ild ny lt.e a in tull fd.. ,!d .lldr (!)!:iIf,!JCI]ON.LI!DIMi.ACEI(I I huer rfttrm und6 Fdrt o f Fjury ihal rh@ n a cotrrddn. kndins l8acy aor rh. Ffomdc. .t rh. $tll litr s hkh rhs tlmn 6 nrld {s< ll097.Cn ( ) afllllllIJll:clJaarlats I ha$, .frm und.r Fmhy ol Frury oN oa rh. n)lr.$ inB d.cL,dioBl I).nohrion Ptuir! Arhdr$ N6.6..rio. F.d(al R.gul.rioN (Tnl. 40. PAn6) R.q!n.n ld!d olN<{ifkdbn I c6$b rhd rhc f.dsal r.sultrhons rca{diry orlEskrs roo\ il nre nor arrrl'cahl. r) rh'r Dmjd l.dih fin I h.\. r...1rhi .tpl.r' 8, &i 3rrt.rhd rh. ltirr,.aoldkrn i! cold I l*leio comDly snh lll ( nl. c.d Couir! oilidft6 &Il sr,l. tr$. Elrie ro &'ldms 6MrBrF( rrl lE.t, .dh.n,. rcF.5dr 6 o f thn ( nr $d Counlr ro 6rq ur.n 'tialx\ c mdtotr.J pmp.nr f(, 'nrpdron purlxrs rnli.rnr or Arcnr sirnin..,'.," /a./E7/zoc EU -2r1Yl-?sly I I I I I I r fA<,I,/ MAYOR Miguel A. Pulido MAYOR PRO TEI\,4 Michele Martinez COUNCILMEMBERS P. David Benavides Vicente Sarmiento Jose Solorio SalTinajero Juan Villegas INTERIM CITY MANAGER Cynthia J. Kur? CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL lMaria D. Huizar PLANNINC & BUILDING AGENCY 20 Civic Center Plaza P.O. Box I988 . Santa Ana. California 92702 www.santa- ana. orq,/ o ba 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 specified at S Ro.eS. 9r'.e.,ty'a. .22<7zo 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 ACKNOWLEDG MENT AND VERIFICATION OF INFORMATON DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. j-.41. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder' building iermit that 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 financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. l\4y homeowner's insurance may not provide coverage for those injuries. lamwillfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. J . Hr. , understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. J--42. I undersland 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. .J . H l. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbe rs on permits and contracts. J:/1 5 I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least flve hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. J4a. t understand i, I am considered an "employei' under state and Federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation ofeach "employee." I also understand my failure to abide by these laws may subject me to serious llnancial risk. Jaryr. , understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless a// work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar years, or all of the work is performed under contract with a licensed general building Contractor. J!4. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. SANTA ANA CITY COUNC L moulrdoaAsanlaâ‚¬na oro Mâ‚¬yor Pro Tem. Ward 2 m marl nez@sanla-ana oro V,cenre SarmLenlo vsarn,enloasanla-3na oro isolcno@sa.ta-ana oro P Davrd Bâ‚¬nav'des dbenav desA$nra ana oro Nlleoasaasanta-a.a oro strnaiero@sanla-ana oro CITY OF SANTA ANA I f1r. t understand I may obtain more information regarding my obligalions as an "employer" from the lnternal Revenue Service, the United States Small Business Administration, the California Department of Benelit Payments, and the California Division of lndustrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-32'1-CSLB (2752) or www.cslb.ca.oov for more information about licensed contractors. J-&'tO.l am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party , ::::,:,:^,'p2rw ",g w 3g s*"9fl*,qa")y .))f f;b*'f ,e 2 z 7a 7 Jafn't.tagree that, as the party legally and financially responsible for this proposed construction activity, lwill abide by all applicable laws and requirements that govem Owner-Builders as well as employers. JL4'z 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 lo assist you with any financial loss you may sustain as a result of a com plaint. Youronlyremedy 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 llrm 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' 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. A,lote.' A copv of the propertv owner's driver's license, f orm notarization. or other yerification acceptable to the aaency is required to be presented when the permit is issued to verify the property owner's sidnature, ru/< z,/x"zzSignature of Property Owner Date Print name of Owner Ju I nil *t uioZ AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF project ,4JScope of Construction Project (or Description of Work) Project Location or Address Name of Authorized Agent; Address of Authorized Agent: I declare under penalty of perjury that I am the property owner for the address listed above and I personally fll d out the above information and certify its accuracy oare: /d Z dProperty Owneis Signature Ju /.'t/z/,z/ct,Za Z 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- PL rk .:t'P5l Ccu.::.Aa:ii,.,ily'Assemblf 3 ls.Niiiae tc P:ipartl Fo.n SANTA ANA CITY COUNCIL 4P!lr.0.s@$-Eâ‚¬:!-03. Mayor Pro Tem, Ward 2 mrman'nez@santa anaoro Vicenie Sarmlento vsa.mrenlo@sanla ana.oro Eplplp@s4Eia@ilq P Da! d Benavides !-b.e!!!r.d.c9@sE!.8:!.!3.9ls rv eoas@sanla ana oro 9!!et9l9@s3!1ej3!3!Ig 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 Phone Number of Authorized Agent: _ Print Name of Owner: