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Home My WebLink About10193679 - Permit (2)City of Santa Ana Permit Counter: (714) 647-5800 20 Civic Center Plaza (M-19), Santa Ana, CA1:LTC? Building lnspection Requests: (714\ 667-2738 ' tnspeitor Section: (714) 647-5853 Permit #: 1O193679 Pin #: 32307 EProjectAddress: 1716 W Second St Assessor's Parcel oo7 -201-17 Lot: 4 Unit: A Bldg: Address Range Tract: PACIFIC ELECTRIC SUBBlockr 16 Historic. No Suite Range: Zoning: R2 Building Use: Single Family Dwelling Occupancy: R-3 1st FL Area: 239 Job Type: Addition Constr Type: V B 2nd FL Area: O Nature of Workt Addn code: CBC2016 Other Areas: 0 Existing Bldg. & User SFD Wdet carport Flood Zone: X-0602320257J carage Area: Proposed Use: # of Stories: , ao,",, 239 Description of Work: Add mastor bedroom, full bathroom, & walk-in closet. Convert (e) bedroom to family room. Auth on file. Planning conditions: Patio: T.l.Area: Yards Req'd: Valuation: $27,000.00 Owner: Address Phone: Tenant: Minh Ooan 1716 W Second Street Sanla Ana, CA 92703 (714) 653-834s Justin Viet Nguyen P.E. Justin Viet Nguyen 6593 Teakwood Street Cypress, CA 90630 (714) 209-3965 68232 Phone: State Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance Carrier: Policy #: Expires: Owner-Builder Engineer Address Phone: License #: Architect / Desiqner: Address: Phonei License #: Loc Ly Loc Ly 7521 Volga Drlve, #3 Huntington Beach, cA 92647 (7 141 657 -2765 Planning Approval By: Plan Checked By: Permit lssued By NPDES lnsp. Req'd: PWA lnsp. Req'd: No Planning lnsp. Req'dr No Fire lnsp. Req'd: Police lnsp. Req'd No No Account# Mar, Escarlet Date: 08/01/2017 CSE-Century Sltuclural Engineoate: 1013012017 zunisa, Atlissa tXL.-/ Dale. o1/os/2018 No t'\ subtect to Fretd: Misc. Receipt Misc. Receipt Misc. Receipt 07776002 o7 77 6002 0 77 76002 0 890 700 r 0 7776002 0 77 76002 07776002 57607 si600 57770 2400 0 57672 57600 57501 $300.00 $310 70 $28.96 $3.s1 $2.00 $21.2s $52.98 69867 Total Permit Fee Plan Check Fee Microfilm Records SMIP - Category 1 Bldg. Stds. Revolving General Plan Update lssuance Landscaping lnsp. Req'd; No Flood Zone Cert Req'd: No Every pemil issued shall become invalid unless the wo* on the sile aulhoized by such peinit is commenced withh 180 days aftet its issuance,or il the work authonzed on lhe sito by such pefinit is suspended or abandoned tot a peiod of 1 80 days afler lhe lime tha wo* iscofifienced lnspector MID# 2017-136671 01 '1 16002 0'1 1 16002 011 16002 0'1 1 16002 08901001 5'1600 5'1601 51612 57770 24000 $21.25 $352.98 $2.00 $28.96 $3.s1 $719 40 s310.70 E408.70 Fee Total: Paid to Datel Balance Due Contractor Address: . BUILDING. INSPECTOB RECORD SITE.WORK DATE rD1stc..COMMENTS OWNER BIIILDER DI:I,CNNATION I h(nhy allrnr uklL, FGht ot Frnr, rhll I !m .icmfl lnnr rhc (in r{roN l.r.nr t1tr itr th. lhlhsin8 icasn (li! ,011 s Bu\imsr rni l)lolc*tr,n C,xl.) iy C y or Coonry snah rLytuirrr s Fnnir t, on!,r1 ats- inlProve. &nr,ltl or rcnr! my nrucntrc. pritrto n\ n\un(, zlr, rnui.t rlr.lrlrrnr fin su.htf,nni n,lil. a $EtuJ {r.ftnr rh, tror \lr ir lk.nd pu^urd b 'ht l,otnnns of t Conr&ntr'\ l,rrnrd lr* {Chaflcr 9. (i'nuEEin8 *irh S(ri,n 7(rn of l)ivnio. t or rh. 8u\i'Es lnd th)lc\ri()n{(ixl.rorrh,rlror (h. F dcr{)r rh.rcfromJrt rh. h.ii\ Ior rh. f,lkld.rcnfrn,. nyvir'bri{nrorSdlnnTl)ll5byrny q'pl(r.r tu,iFitrril cuhl..h lhc urrl,.rnl ro rdiviln Mhy.lnot nnrerhrn livc hudErl doll.,r l$5{Dr -1.0\oak.nf(If,ptr'I\ny.,tr.ryctrY'[]F!1*ithsi8cl!srh. qnccnnD!tr$ttrtr,. srlld, rh. *{rk url ilr {tutst i\ dn d ln or olTrrfli li, eL ( S(-. 7(!.1. Buvft* nnd PrDr.\\iiB (i . 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I \hnll no!.trrpl,,y lnt IErsD b !n] nurr {, a\ h hr$trr \uhFcr t, rlr *Mkr\ tuhFh\aton h$\ olC3lil,,nu. !n,ll3ir! rhi i{ I rboll tftom ruhFr ro rlE urrt-\.uqkns i,n l)nrnions.(Sc(ron lTl()oI rh. Lrtrn C,xk,l+BIl, tudh$[h.onnlr $irh th* rmvnk)ns WARNIN(; lJlnuE r' *(urc srtrre^ oqtnstir r,sre. 'i u.hstu,. lnd shdl ehlccr otr cn!n,'r!r to rinnd lrDlria a'n .ivrl lin.( ut li' ofu hufil..\, rlr)uin.l d.lh^ (illl),lrXr). 'n rldntrin r) rhc ,}loFf6lidn. d:B8s rorid.{ 1,tr lt sr\rr{:1or6!rl rlf, l.Jhr (ixl.. tri('.{ inn nr 6t foel is I hcrhy rnlrrundd n!ultyol lrquy rhrl I ltn lilnrd uhkl F'rnion ol6npr.r9 (d'n,rc(rng tr hS.crirn70(tr) ofl)ilGhn.l ol rht Bunft\\.nd PmL\ri,ni(-aL, rd nrt h.cn\. iq in tullnr.rdn.flirr glltilBlg[0liLEllNtilcEgll I lErcb, lrrrn lnJd FM!'y or p.rp,y lhol rhcrc s r s,n(ru.I$n L hr 18. y nn rh Frromm. of rlE work Ln whth rhi\ lEfln ii isrkJ (sd rlD7.(iv ( ) ATTLUANLIIEI;LAEAIIA! I lrn.l)y alinm unir FnalrI oll*rory oR oI rhc f(nL'uir! dc.lnrrrtrr$ l)cn$l i'n Prnni\ A\tlios Norifi.,rxn liJcrrl Rcgulxrtr,nr l'llll 10. Pf6) Rlrttrn.,l l.rkJ ol Ntr'lf,Jrrn l(.diiv rhir rh(,rJ(rr!ngtrlrri,n\ r.giklrr! r\h!{r enitrr rrr tror rl,tlrrhk r, rlr\ l,('t (r IL 1r\ r,i Il',n.,r.(lrlir 't'ntr ,ik,,r,rli, r rh.s rlr Jh^\ rtrrn(rJrtrr,...r1\r I .'rrd r)..nInv rih xlL( nv.'nl (1trtr \ o rtri.c$lnl Srrrc liu,\ Nbin'3h hu trg.on{n'cii.n.irillEr.ht(rhrrcr..q.nrrr'v.\nlihi\('iryIrlCounrY(,.nku},nrlr !hr( m n'f,J tn,Fn, ntr inliti ^*ollr;1llB Set Backs t lt t \tlta1+, Forms/Steel/Holdowns 5 rt I I w Erection Pads l UFER Ground ) SLAB Floor 3 'lc rQ tl1/l Subf loor/VenVlnsulation Roof Sheathing I I I t Ait lO lr: tl r )l',) Shear Wall I I t-l rb I I ilHr JI Framinq 4 rla j r'\^JI tt4 lnsulation/Energy I )I lvl. 4l li Drywall tri ri'|1,1r4' lhl/11 Brown Coat \I ,lhll"1 Masonry Pool Fence T-Bar Handicap Req Deputy Final Report Engineer Final Report Flood Zone Certil. I I l t/L 1 Y 4.ll Cert iticate of Occupancy I T1 I I -7 Notes, Remarks, Etc r) Ext./lnt. Lath FINAL I\/AYOR lViguel A. Pulido MAYOR PRO TEM Michele N4artinez COUNCILMEMBERS P. David Benavides Vicente Sarmiento Jose Solorio SalTinajero Juan Villegas lNTERIM CITY IUANAGER Cynthia J. Kurtz CITY ATTORNEY Sonaa R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar CITY OF SANTA ANA PLANNING & BUILDINC AGENCY 20 Civic Center Plaza P.O. Box 1988 . Santa Ana. Calrfornia 92702 www.santa-ana.orq r0ba 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 tm Vfgve ments spe cified at We are providing you with an OwnerBuilder 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. lr \ L t understand a frequent practice of unlicensed persons is to have the property owner obtain an Owner-Builder" building 'permit 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 iniuries 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. lam willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. U_L 2. 1understand 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. IAi' t 3. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect myself iffiotential financial risk by hiring a licensed Contractoi and having ihe permit flled in his or her name instead of my own. 4. I understand Contractors are required by law to be licensed and bonded in Califomia and to list their license numbers on permits an d contracts Ir/vl 5. I understand if I employ or otheMise engage any persons, other than Califomia licensed Contractors, and the total valueof my construction is at leasi five hundred dollars ($500). including labor and materials, I may be considered an'employer' under state and federal law. 14 U. , understand if I am considered an "employel' under state and Federal law, I must register with the state and federal government, withhold payrolltaxes, provide workers' compensation disability insurance, and contribute to unemployment compensation of each "employee.' I also understand my failure to abide by these laws may subject me to serious financial risk. M t. I understand under California Contraclors' State License Law, an Owner-Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless a// work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar years, or all of the work is performed under contract with a licensed general building Contractor. M A. t understand as an Owner-Builder ii I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owne(s)that result trom any latent construction defects in the workmanship or materials. SANTA ANA CITY COUNCIL Mayor Pro Teh. ward 2 mo!hdo@senla-ana m Ed!!.s@$da=r!!-9!9 P Oavid Be.aedes dbenavrdes@sanla anaoro Mlleaslosanta-5nE do st'na6cAsant! ana dd [-l g. f understand I may obtain more information regarding my obligations as an employer" from the lnternal Revenue Service, the United States Small Business Administration, the Califomia Departmen: of Beneflt Payments, and the Califomia Division of lndustrial Accidents. lalso understand lmaycontactthe Calirornia Contractors' State L:.ense Board (CSLB) at 1-800-321-CSLB (2752) or wyyw.cslb.ca.oov for more information about licensed contractors. 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 a nanciall re spon lr ble for p posed onstruct activity at the followi ng 3add re 11. I agree that, as the party legally and flnancially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govem Owner-Builders as well as employers. -I4-r, 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 linancial loss you may sustain as a result of a com plaint. Youronly 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 maybe held liable for damages. lfyou obtain a permit as Owner-Builder and wish to hire Contactors, you will be responsible for verifying whether or not those Contractors are propedy 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 propertv owner's driver's license, form notarization, or other verification acceptable to the aqency is required to be presented when the permit is issued to verify the propefty owner's sionaturc. Signature of Property Owne 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 rlle the documents necessary to obtain an Owner-Builder Permit for my project. Scope of Construction Project (or Description of Work) lz--- -9.o 1K DDAN \/ANI M IU T Project Location or Address Name of Authorized Agent: Phone Number of Authorized Agent I declare under penalty of perjury that I am lhe 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 verification acceptable to the agency is required to be presented when the permit is issued to verify the propedy owner's signature. PL i'kl|t P:1 C'lu:ri.r:Aiii',1)'ASS,i ilr )Eills ll!lr:e lo Pr\ii,arir;o.m SANTA ANA CITY COUNCIL mouIdo@$.taâ‚¬na o.o MBts Frc Td, Ward 2 mrnadrnez@sa.laâ‚¬na oro V co.le Samrento lsaimrento(DsanE-ana,orc sorono@sanlE ana oro P Oavid Benavides dbenavrdeslOsanla-ana oro vl6as6santa a^a mo slrnaE.o@sant -aoa do ^ Address of Authorized Agent: