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Home My WebLink About10195044 - Permit (2)q Project Address: 2238 S Kilson Dr Assessor's Parcel. 016-102-20 Lot: 20 Bldg: Address Range Suite Range: Zoning: RiBlock: L Tract 668 Historic: No city of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA,27O2 Building Permit Counter: (7141647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853 Permit #: {O195044 Pin #: 84557 Building Use: Single Family Dwelling Occupancy: R-3 1sl FL Area: Job Type: Reroof Constr Type: v B 2nd FL Area: Nature ofwork: Reroof Code: CBC 2016 Other Areas: Existing Bldg. & User SFD Flood Zone: x-0602320278J Garage Area Proposed Use: # of Stories: Total: Description of Work: Reroof w/t.o.-Removo and appl comp shingles/shoathing to remain/handout givâ‚¬n Planning Conditions: SFD roof layer to match now ADU roof in style and color Patio: T.l.Area: Yards Req'd: Valuation:$2,830.00 Owner: Address Phone: Tenant: Agustin Gonzalez 2238 S Kilson Dr Santa Ana, CA 92707 (7141 469-2s42 Owner-Builder Engineer Address ,",1 ir Phone: State Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance Carrier: Policy #: Expires: Phone: License # Architect / Desiqner: Address: Phone: License # Planning Approval By: Plan Checked By: Permil lssued By: NPDES lnsp. Req'd: PWA lnsp. Req'd: Planning lnsp. Req'd: Landscaping lnsp. Req'd \ /'"'n"no"t, ^'tn, Guevara, Jerry Dale:1211A2017 Date: Oale: 1211212017 Subject to Field: Misc. Receipt Misc. Receipt Misc. Receipt 07776002 57607 Petmil Fee 07776002 57672 Bldg. Stds. Revolving 07776002 51600 General Plan Update 07776002 51601 lssuance $308.52 $1.00 $21 .2s $52.98 No No No No Fire lnsp. Req'd: Police lnsp. Req'd No No Account#Total Flood Zone Cert. Req'd: No Every pefinit issued shall becofie invalid unless the wotu on the site authorized by such pemit is commenced within 180 days after ils issuanc'.or if the wo* authonzed on the site by such pefinit is suspended ot abandoned for a podod o1180 days dftor the lime the wotu is comfienced . lnspector MID#: 2017-'140395 011 16002 51600 01116002 51601 01 1 16002 51612 $21.25 $361.50 $1.00 Fee Tolal: Paid to Date: Balance Due: $383.75 $0.00 $383.75 Unit Contractor: Address: BUILDING- INSPECTOR RECOHD SITE-WORK DATE COMMENTS owNl:ta BUu,DfR t Et_(-AtaaTtoN Lr..tty .inrm unL. FMry of rErrr.t rh.r I m .r.nT, fn,m rh. (idkro^ Lrd<La*nnrltfoll)*n3rcrqti(sdToll1 Au!n.r( dnd Prot *i6 (irl.): Aiy Cny or Cnuniy *hih EquiEs tr F mi t,.r,ndrucr, itd, impn,v.. &mnnh rr Ep(tmy nndur.. rin h i\ itae?..lq',npn (rh.lmlrdr fi,$ctF mr !r lik r {3rJ irl.rEd iMlror\lErh..<J ItrHr L' rh. rnrvlrnr of rh (i' rrld'1l.ftnr.d lx! rchaF? e. 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David Benavides Vicente Sarmiento Jose Solorio SalTinajero Juan Villegas lNTERll\,4 CITY I\,IANAGER Cynthia J. Kurtz CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar CITY OF SANTA ANA PLANNINC & BUILDINC AGENCY 20 Civic Center Plaza P.O. 8ox I 988 . Santa Ana, Calio,nia 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 builder of the property improvements specifled at 22.78 K,L-Sa'--r ><, <ALr fa A,-J A, zA, nZ-1e7 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 DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. A6" '1. lunderstand a frequent practice of unlicensed persons isto havethe 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 llnancial risk for any injuries sustained by an unlicensed person and his or her employees while workjng 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. &; 2. I 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. a6 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 flnancial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. q4. I understand Contractors are required by law to be licensed and bonded in Califomia and to list their license numbers on permits and contracts. LS. t understand if I employ or otheMise 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. q6. I understand if I am 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." lalso understand my failure to abide bytheselaws may subject me to serious financial risk ^G 7. I 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 ail 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. tâ‚¬-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 workmanship or materials. SANTA ANA CITY COUNCIL Mayo. Pro Ten Wa.d 2 m'marlr.e26sanI''a.a oro Vicenre Sarmlenlo !EEf mienlo@sanE-3na oro 6olono@santa 6na do dbe.a! des sa.ta.ana oro Nr leoasaosa.la ana oro st'naâ‚¬roosa.la-ana oro AG 9. lunderstand lmay oblain more information regarding my obligations as an "employer" from the lnternal Revenue Service, the United States Small Business Administration, the Califomia Department of Benefit Payments, and the Califomia Division of lndustrial Accidents. I also understand I may contact the Calilomia Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752)or www.cslb.ca-qo! for more information about licensed contractors. AG 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 legally and frnancially responsible for proposed co address: z23t K,L:;6{ E nstruction activity at the following 4 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 govem Owner-Builders as well as employers. 4: l2.l agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information l 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 flnancial 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 firm 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 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. A,lore A coov of the Dropertv owner's license. form notarization, ot other <-^.-J i--b. A.-J A ..-A, t c-12-1d-7 to the nc ,s re to be is issued to Dale: l2 the siqnature. Signature of Property Owner ->-- ^2_) print name of Owner A(. - .: n "--.r 6.> .J 2--A Le-z_ 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 Owneas Signature Date Print Name of Owner Note: A copy of the owner's driver's license, form notarization, or other verification accâ‚¬ptable to the agency is required to be presented when the permit is issued to verify the prcperty owner's signature- ?rirk I'rrP..1 rl r.r.i.j.Ar.:tr, r1! ASS.-:xri)lf BiilS N-at,.c io Pro;tCil".Fo.n'l SANTA ANA CITY COUNCIL mour doao$nrr,anE o M.yo. Pro Teh, Ward 2 mrhad nd@sanla -ana oro Vicente Samiento 6amr&lo@snL{nB do 60l601asanla.ana do tr4le9!l@llq!:i!!-gg slnaâ‚¬ro@sanra-s.a do '7 AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF