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Home My WebLink About20165452 - Permit (2)City of Santa Ana Permit Counter: (714) 647-5800 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical lnspection Requests: (7 1 41 667-27 38 lnspector Section: (714) 647-5853 Project Address: 1716 W Second St Un :A Block: 16 Bldg: Address Range: Tract: PACIFIC ELECTRlChlistoric: No Suite Range: Zoning: R2 q Assessor'sParcel. OO7-201-17 Lot: 4 Owner: Address Minh Doan 1715 W Second Street Santa Ana, CA 92703 (714) 653-834s 01 1 16002 0't 't 16002 01 'l 16002 01 1 16002 01 1 16002 51603 51603 51603 51600 51603 Fee Type Amount 125 Volt Receptacle 1.40 Light Switches. Occ. Se 1.52 Light Fixtures '1.01 General Plan Update 21.25 lssuance 52.98 Q(y 6.00 5.00 10.00 1.00 1 .00 Fee $8.40 $7.60 $ 1 0.10 $21 .25 $52.98 Phone: Tenant Name Owner-Builder Phone Slate Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance Carrier: Policy #: Expires: Building Use: Job Type: Nature of Work Sing16 Family Dwelling Addltion Addn Occupancy: Constr Type Code: R-3 VB cEc 2016 Notes Add master bedroom, full bathroom, & walk-in closet. Convert (e) bedroom to family room. Auth on file. Planning Conditions: Planning Approval By Plan Checked By: Permil lssued By: Subject to Field: Building Permil #: ChaYez, DaYZl,a, Date: Date: Date:o3122t2014 Account# Misc. Receipt: Misc. Receipt: Misc. Receipt: Total 10193679 $100 33 $0.00 $100.33 Every pennit issued shall become invalid unlesslhe wod< on the site aulhonzod by such pennil is commenced within 180 days afrer s $suance, ot if the wotk outhonzed on lhe site by such petuit is suspended or abandohod lgt o pedod ol 180 days eftot the lrne the wotu is lnspector MID#: 2017-136671 011 16002 51600 011 16002 51603 s21.25 $79.08 Permit #: 2lJ165452 Pin #: 2E647 Contractor Address:t,:h + :,( f ice: pt.+:tri +:TII*IITTXITi Fee Total: Paid to Date: Balance Due: ELECTRICAL.INSPECTOR RECORD APPBOVALS ID/SIG.COMMENTS OWNP-X AUILDEI DELCAR TION I 1116, .rrn ud.r Fn lry .r Fiur, lhd I d.r.ftfl 6on IE Contxro. l-a.nE lia tu, thc folftrlht Er$n rsd m:lr t Burim$ .d Pmfc\hn Cod.) Ary Cir, or Cd y whtn rqlis r Fsi k' $nrMr. rlrd, in{,bt!, d.m'lnn or EFn my stuh^, Fn lo ils i1w. .k lrtuEs tlE.I'l,lt.d r.r uh Ftu b 6h r nSrd {r.rmr rha lE or slE i. lirn*n |lulsd ni rh. Fmvnhnr of ih. ('onhmrrr'i l-i.cn!.rr lrs lCnapr.r 9. 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Pulido I\,IAYOR PRO TEM Michele Martanez COUNCILMEMBERS P. David Benavides Vicente Sarmiento Jose Solorio SalTinajero Juan Vlllegas CITY OF SANTA ANA PLANNINC & BUILDINC AGENCY 20 Civic Center Plaza P.O. Box 1988 . Sanra Ana, Caltfornra 92702 www.saTta a na.or g 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 'mprovements speciried at 4 1 I r.\A) - r) Ir/ r) <1k", .f tuhyo. Pro Ten Wa.d 2 q!!!!rirn!:Osanta-a.a orq V'cenre Ssrftâ‚¬nlo 6adr6lolasnla-s.a oro P Davrd Eenarde dbâ‚¬navd6s@s.nla-ana oro Mrl6oas@sanl5'ana o.o ACTING CITY MANAGER Gerardo Mouet CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar 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 INF ORMATON D/RECflOIVS: Read and initial each statement below to signify you understand or verify this information. 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "OwnerBuilder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. l, as an OwnerBuilder, may be held liable and subject to serjous 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 nol provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injurles to workers on my property. M Z. f 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. M a f 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. M-+. f understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. M S f understand if I em ploy or otherwise engage any persons, other than California licensed Contractors, and the total value of my constructlon is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. M O f 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' com pensation 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 , f 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 sclonc,asanra-a.a.ro slinaâ‚¬ro@sanra ana ora 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"1 U , 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. M S. 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 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. M ,O I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am risctivitv-Et f h. followins M I f. I agree that, as the party legally and financially responsable for this proposed construction activaty, I will abide by all applicable laws and requirements that govern Owner-Builders as well as employers. [.1 ', r. ' agree to notify the issuer oi 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 financia! loss you may sustain as a result of a complaint. Your only remedy agaanst unlicensed Contractors may be in civil court. lt is also important for you to understand that if an unlicensed Contractor or employee of that lndividual 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' 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 pe rmit. A/ote: A copv of the propettv owner's driver's license, form nota zation, or other ation acceDtable to the aqency is required to be sented when the Dermit is issued ao ve the Signature of Property Owner Print name of Owner owner's si Date 9l-r( lN rt ANI OANI 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 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 Aoent: 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 lilled out the above information and certify its accuracy. Date Print Name of Owner Note: A copy of the owner's driyer's license, form nolarizalion, or other verification acceptable to the agency is required to be presented when the permit is,.iss.ued to verify the property owner's signature. SANTA ANA CITY COUNCIL Msyd Pro T6m. Ward 2 hrman'nez@santa.ana orq Vrcenre Sâ‚¬mrenro vsamronro@sEnia aru do Eolono@sanla-ana.o.o P Oasd Bena,d6 db6nBudes@s3nr6.ana oro ivrr60asiosanIa-an6 oro snnare'oasa.ra.ana oro Property Owner's Signature; mo!irdo(Os6nte'ana oro