The URL can be used to link to this page

Home My WebLink About104103093 - Permit (4)Project Address: 2434 S Broadwav Unrt Eldg: Address Range Suite Range: Zoning: MlAssessor's Parcel 410-381-03 Lot NA Block NA Tract NA Hisloflc: No City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building Permit Counter: (714) 647-5800 lnspection Requests: 1714) 667-?738 lnspector Section: (714) 647-5853 Permit #: {O4lO3O93 Pin #: 854s3\l Building Use: Job Type: Nature of Work: Existing Bldg. & Use Proposed Use: lndustrial Tenant lmprovement N/V - Bathroom lndustrial Occupancy: Constr Type Code; Flood Zone # of Stories: B VB cBc 2019 x-0602320278J 'l st FL Area: 2nd FL Area: Other Areas: Garage Area Total: Patio: T.l.Area: Yards Req'd Valuation:$1,500.00 Description of Work: Remove unpermitted bathroom facility and restore back to point of origin Planning Conditions: Owner. Address Phone Tenanl: GENE L FELLING 2220 S LOARA ST Anaheim, CA 928023914 l'7141775-7735 Contractor Address: Owner-Builder Engineer Address Phone: State Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance Carrier: Policy #: Expires: P hone License # Architect / Desiqner: Address: Phone: License # ;t60 tr:r0t.r ievol v ine i 1.( l ?r'liflr.- Planning Approval By: Plan Checked By: Permit lssued By: NPOES lnsp. Req'dr PWA lnsp. Req'd: Planning lnsp. Req'd. Landscaping lnsp. Req'd lnspector Graham, Jeffery Chavez. Da Dale: 0211112020 Date Dale: O2l1'll2O2O Subject to Field Misc. Receipt Misc. Receipt Misc. Receipt*o, $166.53 $3.91 $100.57 $252.69 $1 .00 $22.95 $57.20 No No No No Fire lnsp. Req'd: Police lnsp. Req'd Flood Zone Cert. Req'd: No MID#: 2020-157688 No No Account# Every pemil issued shallbecome tnvalid unlossthe wo*on tho site authorized by such pormlt is comfienced within 360 days altet its issuance.ot i lhe wo* authonzed on the sile by such peml ts suspended ot abandoned fot a period ol 360 daysaftet lhe tifie lhe woi< is commenced. 01 1 16002 51600 0'1 1 't 6002 5'1 60'1 01 1 16002 5'1612 01 116002 57770 $22.95 $576 99 $1 00 $3.91 $604 8s s0 00 $604.85 07776002 5.1601 Permit Fee 07776002 57770 Microfilm Records 07776002 5I60I lnvestigation 07776002 57607 Penally 07775002 s7512 Bldg Stds. Revolving 07775002 sl600 General Plan Update 07776002 51601 lssuance Fee Total. Paid lo Date Balance Due: Total BUILDING- INSPECTOR RECORD SITE.WORK DATE tD/stG.COMMENTS OWNER BI]II-DI]II DI'LC I' TION I hsctry ,lftrn undd Frliy oa tEjory rhd I dn .rcmpl lion rh. Co r&1od l,rc.* tis lor rh. 6llo*in8 re)n (S<.,01I J &6ihs .,n Proftsrsn (-o&) Any City or ( ouny utxh ..qur6 r Fni ro .odtu1, .lE, mFove &rmluh or tF.! &y srrudu.. r's ro ils suffiq algr rqpc rh. la,r,lrtut fs ruch p6m h 6L ! 3i8.ai ndffil thd tE or 3lE it lKoa.d li@d ro U. t ovisioN oflhc contrero.s l-icmcd tr* (Ctapld 'J. (nnmcnciiB wilh sdn{ 7000 of Division I otlhc Busincs lnd PmfBionr aNL) .r th.t lE or dE ir crcnpl rhg.fren ad rh< barar fo. rh. rll.8.d .rmBion Ary viohti..ofs.di,.70ll5 ty..! amlicar (, . Fn( ebr.<rs rh. ipprkMr ro i cr ,l Frlr) Df mr mr. rhe fi\ . hundtqj dollrs trtool t, s os.d of lh. FoFnr. or ny mplo)6 w h was6 s rhcn $E codtEadiod. trill.ld tlE Nrl $d tlE dnxl@ i, mt mrdi.d or oE6.d for d. (Sa 704,1. DBi"d ed Prcl<io6 ('on : Th. conlEcloa! Licru t s d.d not tpgly ro 0*6of rlE FrFq slF hrit! $ unFot6 ils6( an *|r] d6 uh slt hirell or hdslf or itn'ush hi d hs o*n nDk'yG. Forii.d rh.r rBh mForrEr! G ld rrnri.d o. olh n). !,l.. l( h.ffi, llr hluu\s r unF$EEn n $!d snnm m )d of &.n9ktli[ rh. O*c 8o]lta *i[ h.\t rh. hirldr olFoviB lhi lE or sl'. dri 6l hild or dt4..E $c fmFry 6r tlE FrFo- of l. 6 o$ ffi of$. Ford). m .tclutr cly cotnrxlos *'irh tr.du.d offa1oB ro c.dM rlE Fl<( (S(. 7olt, &!i6 .d Fok in Cod. Tnc Co.rrrro.t L'cot. Irw do3 mr .ry y to m or n( oI F.Fnr $ho b{il& or iopror6 rhdoo rid sl'o roita.rsld suh pnrld s urh a (i)ntmclo(s) licdBl puEuur r(, rh.Conrodor3 Lictr lju) ,rrr'r"""'r"y:ii-YJq ( DECIJSAIIq! I ha.b rmm unrkr Fcty.l Frury oe 01lh. folh*itr3 &rbrs6 I har. !t trillrohroin a C.nifi.lr. or Cnngr t' s.lrlnruE lor *0116'.omposn'n, a Fmr idd lor by sElion lT00 orrh. tib.r ( od., lD. fic DdnhMcc o f lhc $orr for *hich :h. Fn i! isu.d I h!r. .nd r ill m.'nr.'n worid rooFE r{i 'nsllftc d r.qut l t, Sdio. 17r.)0 oI rh. Litsr Co&. fot th. Ffollj4. of rh. $ML lor shth lhn Fnn i ileEd. My*orld ooFar.Dn i6uffc (4i, -d policy nunb.r sc. PolKr_ Nlmb.r - E\pm -l câ‚¬nify thrr i. rh. dforon.c.flh. worl for shich lhi! p6,nil is isu.d.l shlu not dploy any rrsn ir lhy mmnd b 6 to tEoft iubid io rlE ftrt6'mnFBlion bB of Cilifomi4 !,ri isE !h, ill Jhuld bd.rc sbicl lo llE r.s.rta <omFdbn F!\ iim of Sdbn l70O of rlE L.tu ('o<k, I itl!. tdh$nh Nstt * nh rbr FlrEioE *ARltlNC tnM. h suc *ul6 coniFlnir. or6rs. 6 utretul, !d slEll rubra! e aplorn ro (m6,1 FEi6 d D}:CI.ABAIIO! I h6r5! imm undd D.nahy of Fiory rhal I m liGBal und.r Fovni.nor( haprd9(.onrnHcin8 r of lh. uunB 6nd Phf6b6 ( od.. d nr lt.e 6 in full f!y.. rn cfldr rallrBucuollElDr!(i-acllcr I hdltt.lfm u,i.r lEshy o lFgu.]'lh, lls. u.sn*ucl.i lddi.g.]4, for tn FLtrffi. otllE uorl lor shrh $n pqhir ir N!.d (5â‚¬ 1097,Civ ( ) L.nd6 s \e. AIILICAILDECJ.ASAIIA! I ho*y arm uodd p.n.lry of pojury o.. of rh. lollowinS ddla.t ions: l).mlilr. PcTnr'ArtBt6 Nonti.alon F.d.rrl R.8uhrio.r ( riE 40. PM6) - R.quftd t 116 orNdiadio. I (dify rhd rh. tun(d r.gul{nrN rqadina sbâ‚¬los r{Nvrl &c &rr arpl'r.6lc b (hit prcjal. ?,f*l,mmr*rppncahn arj nir.rh.r thc ah'v. 'iromnxr 6..dd l.r|ia'o comoly trIh lllCnylnd Counry r.,..ddi!6of thn( y dd Cou.ry ro dr6 upo. rh.tr! r' lI'lJtr,t c.nsi,rrrk)n. in ,'luc nrctrrkft1t pn)t).nl lt, ,lpplicrrl or ,\Bol Shn.lox*L,N6 .s -rr-7a Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Subf loorA/enUl nsulation Roof Sheathing Shear Wall Framinq ln su lation/Energ y Drpvall Ext./lnt. Lath Brown Coat Masonry Pool Fence T-Bar Handicap Req De y Final Report Enqineer Final Report Flood Zone Certif FINAL ) ltLl?)Dffvtl n Jt51 Certificate of Occupancy '10 I I l.1t+o I I I I IrI I I I Notes, Remarks, Etc. Planning & Building Agency Buildlng Safety Division 20 Clvlc Center Plaza P.O. Box 1988 (M-19) Santa Ana, CA 92702 (714) 647-s800 www.santa{na.org APP.t3 CBC 2016 Dear Property Owner: An application for a building pe ,flt ^ ha been "t mitted i NOTICE TO PROPERTY OWNER y9{r-name t.0 /+/) listin yo urself as the builder of the property im ments specified at rr+ *NA 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 atourotflcial address indicated. An agent of the owner cannot execute this notice unless you, the property owne r, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEGMENT ANO VERIFICAT ION OF INFORMATON DIRECTIONS: Read and initial each statement below to signify you underctand or verify this information., Bt+L{f I t understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder build- ing 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 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 not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the llmits of my insurance coverage for in1uries to workers on my prop- erty.6lt ZID 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.?t* -Lrt , 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 havrng the permit flled in his or her name instead of my own.!?3 (!ta. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts.let 4!fS. t understand if I employ or otherwise engage any persons, other than Callfornia 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 "employe/ under state and federal law. 3t_e / t['A. 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 com- pensation of each "employee." I also understand my failure to abide by these laws may subject me to serious flnancial risk. ZLtu 3- . I understand under Califomia 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 subcontrac- tors 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. ,1s s 4lltsA. I understand as an owner-Builder if I sell the property for which this permit is issued, I may be held liable for any finan- cial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workman- ship or materials. .fn.g 0:,b ,understand I may obtain more information regarding my obligations as an "employe/ from the lnternal Revenue Ser- vice, the United States Small Business Administration, the Californa Department of Benefit Payments, and the California Divi- sion 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..3t t' 'l'LlO.l am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the legally and fi n anct pon le for activity rng 4J4-e Zu--11.1 agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all ap6licable laws and requirements that govern Owner-Builders as well as employers. ,4ts_ f<-ghZ 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 flnancial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civll court. lt is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held Iiable 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/ofe:A coov of the DroDertv owner's driver's license. form notariza- tion, or other verification acceotable to the aoencv is reouired to be Dresented when the permit is issued to verifv the Dropertv owner's siqnature party dress: ,4+ Signature of Property Owner Print name of owner L t ns l-f -?o @U BZo? oQd qav L. ilt\NO .,b 1 AUTHORIZATION OF AGENT TO ACT ON PROPERW 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 prolect. Scope of Construction Project (or Description of Work) AqSq J Bâ‚¬omuto"l /Prolect Location or Address Name of Authorized Agent ---------------^ Ka*Lkz^ A - Nu o( 6- Address of Authorized Agent )3zq S B.oaol-- Phone Number of Authorized Agent:1lLl-o-t'71 ( 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 Owner's Signature 7-T-20 print Name of own"r, 6a h b-r-1c 8c, verification acceptable to the agency is re-Note: A copy of the owner's driver's license, form nota zation, or other quired to be prcsented when the permit is issued to verify the Property owner's signature -2*