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Home My WebLink About20170746 - Permit (4)City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana CA92702 Permit Counter (714) 647-5800 lnspection Requests: i714) 667-2738 lnspector Sectron: (714) 647-5853 Electrical Permit #: 2lJ17lJ746 Pin #: f 466\( Project Address: 200 W First St Assessor'sParcel: 398-277-09 Lot l -12 Bldg: Address Range: 2OO.22O " Tracl: PALMER'S ADD Historic No Owner: Address: Phone: Tenant Name Contractor Address: Micha Mottale 7604 Via Capri La Jolla, CA 92037 (619) 2184812 Another Level Smoke Shop Owner-Builder 01116002 51603 01116002 51603 011 16002 51600 011 16002 51603 011 16002 57770 Amount 55.37 16.98 22 95 57 .20 3.91 Fse $ss.37 $16.98 $22.95 $57.20 $3.91 Fee Type Serv Meter Min Fee Adj General Plan Update lssuance Microfilm Records Qt)' 1.00 100 100 100 1 .00 Phone State Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance Carrier: Policy #: Expiresl Building Use: Job Type: Nature of Work Planning Approval By Plan Checked By Permit lssued Byl Subjecl lo Field: Building Permit # Commercial Alteration Service meter Occupancy: Constr Type Code:Notes -IlI5 Letter of authonrile msden, Julie Date: Oate: Dale: \ 02to6t2020 Account# Misc Receipt: Misc. Receipt: Misc. Receipt: Total Every pefinil issued shall bocomo tnvahd uhless the wod< on lhe s e authoized by such parmtt is comfiencod wtlhin360 days aftet tts ssuance or I the work aulnonzec! on lhe stte by such po ntl ts suspended ot abancloned lor d ponod of360 days dftet lhe ttme the wo l ts cofimenced $156 41 $0.00 $156.41 lnspector MID#: 2020-157600 011 16002 51600 01116002 51603 01116002 57770 $22 95 $129.55 $3.91 Fee Total: Paid lo Date: Balance Due unit: 105 Block: 2 Suile Range: Zoning: SDlo Planning conditions: B VB cEc 2019 ELECTRICAL-INSPECTOR RECORD APPROVALS DATE ID/SIG.COMMENTS OWtEn BUILDIR DEITCAI.^TION t h6.by lffm uidd Fuh, of pqiEy rhr I m aatg fiM fi. comrrd lj(E* uw ior lh. blbwirB ,a^ (Sa lollj EBilB ri Prot{i.n Co&): Ary Cny or Coury whth r.quiE r Fda lo @,r.ur .!c. i,4.Dvc, &elil or !9.! Ey .trucre Firto iu 6ll&E. .ho rlqui6 'rE 4plaol for sh Frn b frL r rtr'.d nroEr 0'r tE d aE i ltdlr.d F,$dr to rnc F!6b6 of dE CorlrEd.' Licd!.d l,w (ClIItq 9. Coffiins *nt lslio, 7000 of Divilion I of lh. BuiE! &d PmfdsioN Cod.) or rhll lE d dr ir ddF lhEcton md rh. balN aor d! dLt.d .r@E ion. Any viohbn of Sdb. l0l I .5 by oy rpplicer for ! p@t rubj<E lh. lpplicrl ro r civil p. llyofrcl moElhe fiv. huodrcd doll4(l5m) Y&r.. o*orru p.opo,r. orD, dpl,r6 eirt w.BB 6 rh.n ok onpdlnb.! will do dE wot an 0E ntudw i mr iIlod.d ooftd.d td eL (Sd.7044. Buir Dd Pmtushd Codc Th.Conr.d6. U.a* t sd.< @t +lytoso*Eofrh.FoFiy *l$t! 6d i,!.o6 rkbr rn u'ho dG srn wt nilBlf u hd*lr or rkoug! lir nlE oM qtpLy..., FoviLd rhn $dr ir{rE6$ edl -rd'd.dorotlctd for.l lt ho@. dE hrfii'r c lqud i' nld *nhn @ rdofoqLrirl.tlto\rE Bolddsil h.E rhr&rofFlrt3dr lEn{E (H 'Fl hildm iryot{E FoFt} &.dEpt F*of l, 6 own6 ofrlE rr$rEly, m dclsivcly snlndla sah hcdE d .onrdo6 '. rodM 'lE projcl (56. 7044, BBuB d h!ftsiM Cod.: rh. Conr.lcloas Licd3. Irw do6 nor .IPly ro M oma o f Fopdy wno build. or idprove lh6@n, md who .onr6dr aor $ch projcls wilfi o Conrsto(, licsaaj puB@l r rh. Cu fttoi3 Lic.g L5w) I m crcnlt undd SdDn -"-4crlau !04[l8llauPidtArp! IECIJAAIIO! I hqchy !fiim unrrd ps yofpdruryo(oltn follo*[g d.cl&dioN: I h,E.nd will roinrnn. cdili.d. oaco.gr t' Scla.lns@ for *0116 @oFB.l,on. a ForiLd for bysdion 1700 oalhc Lrb.r Cod., for rhc pdfolruc. of llE worl for which lh. panit G i$ucd. Ihavc.ndwillndirrlinworld.omr.tu{nii urri.., d rqtutcn by s.!1iof, 1700 of th. libor Co{k, for lh. Fforffi. of rh. wrt for whth U! Fan ; ir!.d My *ort6 .omFMion ilrlllru. ffi n Frky nmbE &: l"{Ll carirr rru . rl," lEr,,.*. orth. $orl ao, *hi.h !hi! Fnn is is.d. I !h.ller anplot my F$n in oy nsna s c b beomc rub6l k' rh. *ort6' coEpqBnrn L*. olcilifomir .nd r{re rld if I ehould bcom 3ut d lo rrE wolt6' .dnpâ‚¬uti.n pr.virioN of Sa-lion 1700 of lh. LltDr Codq I slull, Ianhyilh .dmtly wnh tbo- pmvi.iou WARNINC F.iturâ‚¬ ro RU. *$rt6' conFnrdnn covdsc L! unhwlul !n rhiil subj.<r e .,rployq lo ainin l FEIE ud .nil fd6 up ro oB hlBi.d thousrd d.l!6 (llOO.000). in .rldniotr lo llE .on of co,rFMior drES6 a Forid.d for tlE I Sdio. J07h ol rh. t:hc rhr.: z ltr l (oL.i 6d.rddhn,!a6 ).) t_tcl.l\sul, (1)\ rlL\( l()RDt(rt&tro} I hglby .rm unds Fulry ot pqju.y lhn I m li.q$6d unda Flviiion of Ch.F. , (mnffiins vnh Setb. 7000) o[ Dnitio. ] ol thc Buind Dd PDf.gioB Codc, ,,n dy lkce i! in tull lor.. arl .fi..1 Conln.lor ca! alJcra!.rEdDlrq GIlq I My .rfm urda Fuly of Fjury $r thsr it . @'nndbi ladds .s*, for th. FfollrE. of 1II. *!rt 6r *tth rhir Fnn it is.d (Sc. 1097. Civ C.) L.nd6 s Noc: affu(ldlDEctdEAl]a! I ha!4 .iin u,ldf Frt, oa Fjury oE of rh. folbwiry &(lr.IFc: rrdhlnior PnirlA.tdq Noriasrio. Fsl6.l R.BuhioB {ThL .O. Par6) R.qund lnr6 of Nd'ldbn / I cd irv r hd rh. f.d6dl rcsuht nN rBedirs 6t'c'r$ ,d.\.1B not afi,hc.hl. h rh! pfl JEl /ftsr,-i6,r,, t r'".. -l,t's lpplkdrion ed acrhdfi.!b.,.'ntomdMscon*r rrraro{mpr, ordmnc6 ed sr.r. l lNt rcbr,nr lo blildins.o(rtudtr,hd.bt aurhoriz rcF6.rndiv6 ol rhii C'ry itEr. nHrren d FoFry fn iBp.(lion appli..nl or Agdl SItn.lur. Prmita tr.n. tFltrr): I L llTLDLvLtz>, ed coulty lo otE won th. zlsl1. Site-Work Underqround Pole Bases Light Standards Spas, Pool, Fountains Signs (monument) Life Safety /Low Voltage Fire Alarm / Dampers Communications Cable Building Under Slab / Floor Bonding / Grounding / UFER 7-4 - ,a-o W lo', Transformers Torqueino Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Rouoh) Ceilings (Hard & Soffit Rough Ceilinqs (T-Bar Rough) 7 --lo-?,e -frLA t6.'IE Rough a 9 Service Meter 4-ro-?,i--Q lo\ FINAL 2-to-an >tC t ot Notes, Remarks, Etc. Rev.08-07-2015 I I I I lr,4eter Release ,r'art Planning & Building Agency Building Safety Division 20 Civic Center Plaza P.O. Box 1988 (M-19) Santa Ana, CA 92702 (714) 647â‚¬800 www.santa-ana.org APP-13 CBC 2016 NOTICE TO PROPERTY OWNER Dear Property Owner: An application for bu drn ermit has been submio 9rYtro our me li ting y urself s the buil rofth perty i provements specified at r 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 OWNER'S ACKNOWLEG MENT AND VERIFICATION OF INFORMATON DIRECTIONS: Read and initial each statement below to signity you understand or verify this infomation. J 'l I 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 actlng as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my prop- erty. 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 thas responsibility. 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 financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. " 4. I understand Contractors are required by la\M to be licensed and bonded in California and to list their license numbers -on permits and contracts. " 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 five hundred dollars ($500), including labor and materials, I may be considered an "employe/ under state and federal law. ' 6. 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 workeri' compensation disability insurance, and contribute to unemployment com- pensation of each "employee." I also understand my failure to abide by these laws may sub.iect me to serious financial risk. ' 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 all work is performed by Icensed 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. ' 8. 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. 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. / g. I understand I may obtain more information regarding my obligations as an "employer'from the lnternal Revenue Ser- vice, the United States Small Buslness Administration, the California Department of Beneflt Payments, and the California Divi- sion of lndustrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 'l -800- 321-CSLB (2752) or www.cslb.ca.oov for more information about licensed contractors. v 10. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the ffiTegally and financially responsible for proposed constructio; activity aiihe fotlowing iO- dress: r 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 govern Owner-Builders as well as employers. / lZ. I agree to notify the issuer of this form ammediately 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 civil 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 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 pe;mit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuin the p ermit, l/ote. Atglry ot the propefty owner's driver's license, form notariza- tio other verification a ented when the ermit is issued to propertv owner's siqnature Signature of Property Owner W)->l lo Date Print name of Owner l'\rct{q 11 cilRe-s 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 flle the documents necessary to obtain an Owner-Builder Permit for my project. Scope of Construction Project (or Description of Work)f,/1,4 5z/r)< Project Location or Address )& DtO, J,)o D n)k * 5la,n4- ,er, cA Name of Authorized Agent:/{ouwr(l Aile n a-, Address of Authorized Agent tw tD (J+ ST +'^ \ov#- A". a4 Phone Number of Authorized Agent qqq -U* - o>oto I declare under penalty of perjury that information and certify its accuracy. lam e property owner for the address listed above and I personally filled out the above Property Owner's Signature Date: I \ Print Name of Owner:htc,urr lae lr AC- Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is re- quired to be presented when the permit is issued to verify the property owner's signature. LA