HomeMy WebLinkAbout10197080 - Permit (2)Ciff of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building
Permit Counter: (714],647-5800 lnspection Requests: (714) 667-2738 lnspector Sectionr 17'14) 647-5853
Permit #: {O{97O8O
Pin #: 72599
@
Project Address: 2530 S Deegan Dr
Assessor's Parcel 412-322-O1 Lot 7'l
Unit Bldg: Address Range Suile Range:
Zoning: R1Block: NA Tract: 8342 Historic: No
Building Use:
Job Type:
Nature of Work:
Existing Bldg. & Use:
Proposed Use:
Single Family Dwelling
Alteration
Pool demo
SFD w/att garage
Occupancy:
Constr Type
Code:
Flood Zone:
# of Stories:
R.3, U
VB
cBc 2016
x-0602320259J
1st FL Area
2nd FL Area
Other Areas
Garage Area:
Total
Valuation:
Patio:
T.l.Area:
Yards Req'd 0@0
$5,500.00
Planning Conditions:
In0n€0'--l ii]n [{]L0l
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(lesernl F1{n tjpd(lte Fee
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tll rls $tds Revolv ins
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Engineer
Address
Owner:
Address
Phone:
Tenant:
Contractor
Address:
Owner-BuilderI
Phone:
State Lic #:
Lic Type:
Bus Lic #l
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Phonel
License #
Architect /
Designer:
Address:
Phone:
License #:
-it-l
Aut h+ t 7li,ll;:i
Planning Approval By Orozco, lvan
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd
sden, Julie
PWA lnsp. Req'd: .- No Fire lnsp. Req'd: No
Planning lnsp. Req'd: No Police lnsp. Req'd: No
Landscaping lnsp. Req'd: No Flood Zone Cert. Req'd: No
Every pormit issued shall become invalid unless lhe wo* on the site authotized by
such permit is commencod within 180 days aftet its issuance,or if the work authorized
on tho site by such permit is suspanded ot abandoned for a period o1180 days after
lhe tine the work is commenced
Dale O7l2Ol2O18 Misc. Receipt
Date: Misc. Receipt
Date: oTl2ot21la Misc. Receipt
Subject to Field:
Account#
07776002 5]60I Permit Fee
07776002 57672 gldg. Stds. Revolving
07776002 57600 Gene.al Plan Update
07776002 51601 lssuance
$160.2s
$1.00
$22.08
$55.04
o
Total
$238 37
$0 00
$238.37
lnspector MID#. 2018-144797
011 16002 51600
011 '16002 51601
011'16002 51612
$22.O8
$215.29
$1.00
Fee Total;
Paid to Datel
Balance Due:
Description of Work: Demo swimming pool & spa. Handout given.
Paul Han
2530 S Oeegan Drive
Santa Ana, CA 92704
(714) 623-82s5
BUILDING- INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS OWNER BUII-I'TIR DELCARATION
Iherchy.{lnmu $ lci(lry oi pcrj'rr} lhir Iancxcnfr rior Ihc c,n nIos l.iccnse ltrr'ihr rhc iolLvir8 rcrson (sd 70.115
Rtr\inc$ and Pror'c$iotr Crlc) try Ciry or Counl! which r.quncs ! pcfl.ir k, con{tocr. rlhr. i rtov.. ddtuliih ,tr (t'Jtr Jn!
{tucrtrrc. priort, ir\ i$urncc. rko rcqrtcsrhc applicanr lor $.h pcrrnirlo lllca \igncd irrctu rhd h..rshc is liccnscd l'uFurnr
t, lhc F)visir,$ ol ih. C.ntri.ttr s Licctrscn Lrs (Chn0rcr e. corncrcirA siln Sccriofl 70{)0 of Divi\hn :l or rh. Bus;'cs riJ
Pnn.si,nNCodc)orrhrr tu or \hc tcrcn,rrrhcrclnnnr rhc htr\i\ in rhcxllcAcdcxc llrhn Anyvnndio.olScdionTo.tl 5hylny
ip!licrtrr r d!cnnir subjc.hrhc rpfli.0ri lo rcivi!pcnrxtortroi ror. rhdn fivc hundr.d rl.llrr (S500)
I. r\ owturofrh. px,Icny. ornlyc'nftof.i wthw"Cc\ N rh.ir v,ld conrpcnsrrion. willdo rhc work a rhcnMUrchnor
inlcnd orofiircd nn *t (Ss ?044- Busims md Pnrt$iB cftl.: Thc Conlrlclrtr x Licc"sc L,$ doc\ nor aprly ro a.owncr.r
rhcfn!.ny wb hlilds or nvn)va rhcd)n. tuxl wh) dft\ $rh ${)* hinsclfor hcsclfor rhmugh hh or hcr own employecs-
pnvidcd rha, such impnrlmlrr 6c mr inrc'dcd orotllr.n !i,r eh l[ h.wera rhc trilding or iq'mvcftm i\ $ld wiib,n oft ]tr
olonDlcrion. rh Ownci auilld willha\t rhc huftlcn ofFJvin! rhrr hc or shc did mr buikl or inlmw rhc Impcny fo.lhc !u,FN of
!L .s owmr of rhc tld,p.n y. rtrrcx.llsivclrcontncrirg wirh li..nsd .onrncrns h coNlrct ttE tmjccr (Sec 7044. Bu\inds
Pnnlssi[ Co'lc lheConrrocrnr'sl.iccnscLawdQsnol!pnl!lo!tro*ncrolpro,r ysh. huildr or nn|)rortsrhcrcon.
who.oira.rsntrsuch|n.,c.rrwirhrCbtrtrtrtr(rli.ci*dpfruMrrorhcCbnrricrolsLictrstjw)
Id cr. rpr und$ Slrrit
\,,,"-tlzo l& h(
DECI.AMIII}N
I ncrcby ofilrmundcr t'.MI'yollajuryom oI lhc follo*ir8 dNlarnrnnrs
-lhovc
ondwill mntroin u Ctnifictrrc or Consnl to Scll.l.sur.lorqo.kcc'cor.p.nsario.- 6 povided ir by s..ri,,n lT0oorrhc
tjhrr Co<lc. for Ih. tdf.ioancc oI thc work l'or shi.n rhc fnnir i\ i\suql
PolicyNumhcr:-
-![""niry rUr in rr," a,t"rtuncc ol Ihc work rd *hi.h rhit r^-rmir is issocd, I shrll nol crnpby rny pcrsotr rn any .rnncr l'o .s lo bco'f, sbjL{ ro
'hc
$o cs conrynsd ion l.ss ol calitu.nitr, a asrcc lhl( ill sl.iuld trconr suhjcd rorrr
sortcr conll)cnsatn F,vthnsofSc.rbn 3?00o1'rnc Lahr Cdc.l shlll. nrnh$irhconrplyNirhrhospnrvisions.
WARNINC Fnibft i, *.ud workcrs c\)mpctrs[n,n ..v.ragc i\ u lawltl. n d shdll subjccr an cnrtloycr io o'ninalpcuhas d
.i\il hrc! uf kJ onc hunlr.d rhru\rnrl doll { lSllx).(XX)). in addfi( r t, rhc co{
u,&Frert
n. d!mc8 * eovidcd fo h.'
Sccrion 1076urrhc t-rhtr ctdc. inlcrcsr rnd !lktrrEy\ r!':i.
1l>o l&
\0"
DT&IAB{IION
I hcahyrfll Drd.rpcrdlryofp.rJurylh.rI rr lrcnscd trdcr !ro!nn olChrprci 9lcnmnEncirrg $ith Scclion 7(n0) ofDirision:1
oI thc Rlrincs.nd Prel!$ion\ C.dc, xnd n,y liccrsc i ir lirlllnrcc !fflcffc.r
CANSIN.IJEIIANII'IDIIC.>N.(;.I
I hcrchy ltfirm undcr p(nalryoipcrjurr rhlr rhcrc n r con\rrucliD bdira o8.ncy nn rhc l,.rLrnbi.. orrh. work tu uhich rhh p.rmjr n
i$ucdlse-. 1097. Civ. C )
A}IIIIANIDEII,I3AIION
I hort y afim undcr pcnlhy of pcrjtry.nc ofrhc aolk,NinA dcclararions:
Dcnroljrion Pc nirs Ashcstor Notill.artn F-encral Rcsulrli(,.s flillc.l0. P!n6)
-Rcquted
Ltlcr of Notilrnrhtr
l.cnili rhut rtc fedcrll rcsuldrioni dg,rdihg Ntrdor rcmovslrrc ornnpli.ibhio lhn[onrl.
tu(.n'ryrhr I hrh rcrJ rhrs rpplrdr rnd {arc rh. rh. .hovc innrmrion h.omcr I osre lo o'nply *irh ,ll Cny a.d Connry
zc rcprcrnrariv.s ofrhi\ Ciry rnd Coonrt b cnr$ qhfl rlf,o'dinrrccs !trd srarc ljws Ehrin8 ro huikiin8 coNrdcr,on. md hc#Ejllilryi
ahnc,tunriuned nmpcdy finnsN.r on lurto{\
1n*,n".,.. ^*",,.,**,.(."]).r, ug v \/\
J"*ir*.,..rca,,,, ?A!r- L\6NJ
>olK..
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loor/VenVlnsulation
Roof Sheathinq
Shear Wall x
Framing
ln s u latio n/E nergy
Drywall
Ext./lnt. Lath
Brown Coat
N,4ason rY
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Engineer Final Report
Flood Zone Cedif
tl
FINAL z rrz//{ -.-vvD
Certificate ol Occupancy /7- 7e
Notes, Remarks, Etc ,t)
rleo",o '|-ot d2- *" i I 1T.JI
7
-l
hrvc ud *illmnirrain *orkc^ co'nr^-n$ri{r! insunncc. as rc{tuircd hySccrion:17(norrhc lltxtr Codc. for rh. pcnonmncc ol
rhc sork n which lhht--rmil i! i!\u.i Mtsork.n .rm|rnsarim ir\uBtr.c.rd.ra Fni.y m rhcr nrc
kdcis AddrB.
-
I
--r------
=
=
MAYOR
Miguel A. Pulido
I\4AYOR PRO TEM
l\4ichele Martinez
COUNCILMEMBERS
P. David Benavides
Vicente Sa.miento
Jose Solorio
SalTinajero
Juan Villegas
CITY I\,,IANAGER
Raul Godinez ll
CITY ATTORNEY
Sonia R. Carvalho
CLERK OF THE COUNCIL
Maria D. Huizar
CITY OF SANTA ANA
PLANNING & BUILDING ACENCY
20 Civic Center Plaza
P.O. Box I 988 . Santa Ana. Califo.nia 92702
www.santa-ana. org / 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
improvements specified at J53O a, De6&AiJ 02. .)ApaA A i'lA' cl97r +
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 agentofthe ownercannot 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.
V I . I understand a frequent practice of unlicensed persons is to have the 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 financial risk for any injuraes sustained by an unlicensed
person and his or her employees while working on my property. My homeowner's insurance maynot 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.
v 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.
-r' Z I understand as an "Owner-Builder' I am the responsible party of record on the permjt. 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.
v" 4. I understand Contractors are required by law 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
"employer" under state and federal law.
-v' 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' 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.
',/ l. 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 a// work is performed by
SANTA ANA CITY COUNCIL
moulido@sanla-a.a oro
Mayo. Pro Tem Ward 2
himanrnezrosanla ana oro
vicenle Samienro
vsamlenlo@sanla-ana oro 60lonoaAsaola ana.oro sl'naiero@s.nla-ana.ro
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.
-Utr. t 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 resull from any latent construction defects in the
workmanship or materials.
,, '9. I 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 ticensed contractors.
\/ 10.1 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 finar-rcially responsible for pro
address: 7;3a S. bL-<l.r AN, DA.
posed construction activity-at the following
Sr\ Nl r\ ,\ Cr.tA I2)a)s
--r/ll I agree that, as the pa(y 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.
t,/ lZ. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the
informalion 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 financial loss you may sustain
as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. lt js 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.
Signature of Property Owne Date: * lzoltL
Print name of owner PA U L \f A fJ
AUTHORIZATION OF AGENT TO ACT ON PROPERry 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 lile the documents necessary to obtain an Owner-Builder Permit for my
project.
Scope of Construction Project (or Description of Work)
Project Location or Address
Address of Authorized Agent
I declare under penalty of perjury that I am the property owner for the address listed above and I personally frlled 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 properly owner's signature,
SANTA ANA CITY COUNCIL
moulido@sanla-a.a.o.o
Vlcente Sa.mienlo
vsamiento(asa.la-ana.oro lcqlprig@s3lE:a!3lrs dbe.avLdes@santa-araoro v eoas@sa.la-snaoro sl naiero@sa.la-a.a ora
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. /Vofe; A coDv of the proDertv owner's driver's license,
form notarization, or other verification acceptable to the aoencv is reouircd to be presented when the permit is
issued to verifu the Dropeftv owner's siqnature.
Name of Authorized Agent: _
Phone Number of Authorized Agent: _
Mayor Pro Tem. Ward ?
m marlr.ez@santa-a.a oro