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Home My WebLink About10296875 - Permit (2)E Proiect Address: 525 E Adams St Assessor's Parcel:016-082-25 Lot: 19 Bldg: Address Range Suite Range: Zoning: R2Block 6 Tractr 39 Historicr No City of Santa Ana 20 Civic Center Plaza (M-'19), Santa Ana, CA127O2 Building Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 Inspector Section: (714) 647-5853 Permit #: {O296E75 Pin #: 97340 Building Use: Job Type: Nature of Work: Existing Bldg. & Use Proposed Use: Single Family Dwelling Alteration N/V - Demo Sfd Watt garage Occupancy: Constr Type Code: Flood Zone: # of Stories: R-3, U VB cBc 2016 x-0602320278J ,| '1st FL Area: Patio: 2nd FL Area: T.l.Area: Other Areas: Yards Req'd: Garage Area: Valuation: $1,000.00 Total: Bot,:hi:445tr7 - 6/27/2t1f8 I0: (:tut_{. tlfi'icP: CTYH Tr(tns+: :14 1 ofAc,:t,i: Ref+ r lt.t't96'n /. ricpt.+!U?3U4671 . 6/27/1tt\l 1|t:.11 ,'l'r'rn jiq':l ion Iob{l ,i:'.,/t,} 4 Description of Work: Demolish unpermitted shade structure at rear of SFD Planning Conditions: Oemo 36' x 10' shade structure. Owner: Address Phone: Tenant: Maria C. Hernandez 525 E. Adamg Santa Ana, CA 92707 Contractor Address: Owner-Builder Engineer Address Phone: State Lac #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance Carrier: Policy #: Expires: P hone License # ,tt1rJ2- 516r-r t r:[-fl]- Stds l.(evol v ins 6r:r02- 5161?rlr.rtl- Architect / Desiqner: Address: ttlde r1111 Cnsh fll rt I (:h fln Phone: License # Planning Approval By: Plan Checked By: Permil lssued By; NPDES lnsp. Req'd: PWA lnsp. Req'd: Planning lnsp. Req'd: Landscaping lnsp. Req'd /<tu,tt*, 9ac"tt â‚¬fozcu-,1 n- Chavez, Dave 017160 0 2 o177600 2 0717600 2 011160 0 2 0 777600 2 0 77760 0 2 51601 57607 57601 57672 57600 57607 $154.26 $93.17 $234.08 $1 .00 $21.25 $52.98Fire lnsp. Req'd: Police lnsp. Req'd Flood Zone Cert Req'd: No lnspector MID#: 2018-144319 No No No No ffi Account#Total 01 1 16002 51600 01 1 16002 51601 01 1 16002 51612 $21 .25 $534.49 $1 00 $556.74 $0.00 $s56.74 Unit. Dale: OEl27l2O18 Date. Dale: 0612712018 Subject to Field: Permit Fee lnvestigation Penalty Bldg. Slds. Revolving General Pian Updale lssuance Fee Total: Paid to Datel Balance Oue: Misc. Receipt: Misc. Receipt: Misc. Receipt: Evory pe nit issued shall becone invalid unless lhe work on the site authorizod by such pemit is cofifienced within 180 days aftet its issuance,or if the wo* authoized on the site by such permit is suspended or abandoned lot a peiod ol 180 daysaftet the lime the wo* is cofifiencecl. BUILDING- INSPECTOR RECOHD SITE-WORK DATE ID/SIG.OWNER NUILDER DELCARATION I h.reby rflt'n unds ltnrlry {)t F+ry rhrr I d dxrnpr In,m rhr coiLr.u^' Liccnsc hq lor lhc lbllowirs rcr{,n (SN 70ll 5 Busirc* ,trd Profcs\ioi Cl)dc): Any Cny or Coutrry whi.h Btun* r Frnir to con(nrc1. allcr. improvc. dcmoli\h nr ruldn uny slruciurc. nl ior Io irs (surkc. also rcquncs lhc alplicnnt lor sucn fnnir Io filc a sirn.d {dc,tunr rhar lr o. sh. 's liccn*d Puisumr o rh. fovirhns of r)f Contrr.lofs Li.c.scd tiw l(hapt.r 9, C.nnncn.ing wirh S.diofl 7000 ol Divhn'n .] otrhc Buiinc\s !trd Pmfc$iotrsCoJc) orrharh. orshc iscxcmpt lh.rcnomr rlthrstforihcrllc3cdcxcmpri.n. Aoyvi{,lnrhiorskrk{70]l.5byrny irnlicrtrr ro!apcn.il s!hjcch lhc aprlicrnlro !civilpctrrlryofn.lnDrcrhan ti!c hundrddollnr\ ($5fi)) -1. ns osrc, oi rhc I'n'pc.ry. (tr my cmnkry.cs * irh wuacs !s r[cn {,b co'nF \ari,nr, will do rhi work dxl ihc nrurm h nor n[c'r]cd orotlcrcd fG strld (Scc T0,l4, Busircss rrd Pmfcsst r\ Codc I'hcContacusLiccnscLrwdocsn.llptlyrosn.$n.rol rhc pmpcny who builds or inrp(,B rh.d4 el who des su.h work hrmsclior hc'Ellor rhrotgh his or hct orn cmPloyccs. [ovnbr rhar such inuorcnror\ @ nor inrcEhi or oficrsl iir vh lr. h,w.\e, rh. hoiklin8 or impmv.mN h sld wihin one ]qr .f..nplcrir[ rh. Owncr au,k]d will hlr rlr hurd.n nl ptuvrng rh h. or shc dd mr huitl or irqmrc $c pmpcny fo lhc J]U!F{ of l,trsownc'olrhcptutcdy,ir.rctusnrlyc.rdi'rBwirhli.cn\cd.onrr0crorroconslrucllhcpo]ccr(Sec?O44.Buvncsl md Pmltshn Codc lhcConhcrols l,ice.sc l-awdocs nor aptlyr. !oo*ocr ofpiopcny wh. build\.r rnrprovcs riercon. rnd *ho conrBchfffsuchptulcct\wirhaG,nrBct,n\)li.cnscdluiiudtrrorh.Cont rtrsLi.cnsu*l "b.("X)7'Qotr!"""",V<t@/c"\I()RI(trRs (()lIfliN5,\ l l()N I2[ClulS IION I hcr.l,y Jlltnr uflcr F-nrlry ol !.rJury oN ofrhc f,,ll,)*ing drcltrri(trr I hrvc { u ill nui'nri0 r Ctnill.nlc ol Coilcd ro S.lf.ln\urc lir \'*cr' omncn\rrion. a\ nmlidcd fu by Sccnotr l7(D . r rhc tjtxr Cfth. nn rh. Il.rfonMftc.frh. *ork n *hi.h ihc pcflnir is issuLrt I hrvc0nd wrll 0inloin sorkcrs corrpcnut oo inurrmc. !\ rcquncd h,Srcrion 170) ofrh- tihor Codc,lor rhc Pcrtinumc of rhc Nort frtrsti.hthk p.nil is hs,ol My*ork.^ conp.ns,ri,n, nr\!rrm.cnicr turl Policy numt'c. arc, CFi.r:------ Policy Numbcr:-Expncs: _lc.niryrhrr lnrhc plrIni,umeol ihc *ork nr ahirhrhn plnir is asu.d,I rhrll not c,ryloylny pcrsor ir lnynuncr v, r\ b trcotu \lbjccr h rhc so*ci\' .ompctr\arir r lrwl or Cilirdnru rnd r8rcdh iil \h)uld lt\ornc \uhj.{r kr rh. workcri Lunpcnsrr i{'n pmlision\ of Sc.r im 17(x) ol Ihc hLh(tr ('(xtc. I dhll. lir thwlth c mply s ilh lh'{ nnrisnnr\ WARNING I'rilure b *.urc w),kcr'c.nrF srlirnr fuv.n8c i\ unltr*tl. rnd \hrll \uhBr ,rr. rrloltr ro dinrinrlf.nrlris anl .iv1l fircs ut, ki otrc htrndrcd Ihou\a.d dollar (:ll(D.0()()r. in Jddirn t)ihcronof.o rtrtrsrriotr. d!fluscs C DECI,AIAIION I hcrcl,y rfirm u'xlcr pcnalry.l p.rjurr rhd I un liccns.rl nndcr nrovhion olCh!!lc' 9 (conwtins wirh Sc.riun 70u)) olDivirion ] ol rhc Busincs md Pmfcssions Codc. dd my lic.n\c is in full forcctukl.lltcr I-i.cnrc Chs:- Dore: Conlra.lo.: CA!flf,I]!:UANIENIIN!.A!iEN3;I I hcrcby amrmunncr poslry orrcrjdry rhd rhdd n r.oiitu.ri.i lrndin.! iBc cy k)r lhc ncrlomance otlhc Nor( ror rhi.h rhis rciinir is tsucd lsc. 109?. Civ. C.). AITUIANLI]ECLAAIIION I lxrhyrlimundcr pcnrtry olpcrlrr, onc ofrlt ftnk)winE dcclrarbn\: t)cnFlirtrn PcnnillAslEslos Norilirnri(r l-cd.rul RcruhliqN (l'nF 40. Prno R.quirci L.rl., ol Norill.alior .rdinrmcsi.d SrarcLrws rclarilr3 ro huiktingcon(rucrion- aBl h.rchIaurh,iu. rrl ollhh Ciry and Gutrry t,.nrcr u,n rh. rlbuc rnii(,rd ptuprnyf.r bs,Ecriotr!urlts\ ,*" . O*,\DDliutrl o, .\rctrt Siu lur. l'entritN nrnmlndd): X lfuftar Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Sublloor/Vent/lnsulation Roof Shealhinq Shear Wall Framing ln su lation/E n e rqy Drywall Ext./lnt. Lath Brown Coat Masonry Pool Fence T-Bar Handicap Req. Deputy Final Report Engineer Final Report Flood Zone Cenif FINAL 7.L- B J/ebh Certilicate ol Occu pancy Notes, Remarks, Elc -+ COMMENTS Set Backs kndrl\ \.nr _ _ L,nr'J rlrr rh. rcJ.'Jl 'rlulJn'{r. (g.rd'n!..h\ra. rc'nrJr. c n.i Jnfl'.Jl"h L,,h\ nf icrr -#"',I# ".* -. 'n,'onnrrdnnlnr{Jrc,hrl rh h,vc inrnrnuri{ is..rc.r. I rgre ro con,rry * hauc yxndLl,rmy MAYOR lvliguelA. Pulido MAYOR PRO TEM Michele N4a(inez COUNCILI\4EMBERS P. David Benavides Vicente Sarmiento Jose Solorio SalTinajero Juan Villegas CITY OF SANTA ANA PLANNING & BUILDINC ACENCY 20 Civic Center Plaza P.O. Box 1988 . Santa Ana, California 92702 www.santa-ana.orglpba NOTICE TO PROPERTY OWNER Dear Property Owner An application for a build improvements specified ing permit has been submitted in you r name listin g yourself as the builder of the property 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 We will not issue a building permit until you have read, initialed your underslanding 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. M 4 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 injuries sustained by an unlicensed person and his or her employees while working on my property. L4y homeowner's insurance may not 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. lvl l), I understand building permits are nol 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. Ml) t,understandasan"Owner-Builder"Iamtheresponsiblepartyofrecordonthepermit. 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-{q I understand Contractors are required by law to be licensed and bonded in Californja and to list their license numbers on permits and contracts. i"1t) 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 ($500), including labor and materials, I may be considered an "employer" under state and federai law. il-fL6 I understand if I am considered an "employer" under state and Federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability jnsurance, and contribute to unemployment compensation of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. MHl. t understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless a// work is performed by SANTA ANA CITY COUNCIL ACTING CITY MANAGER Gerardo Mouet CITY ATTORNEY Sonia R Carvalho CLERK OF THE COUNCIL Maria D. Huizar mouldo@santa ana.o.o Mayor Pro Teh Ward 2 m manr.e2@sanla'ana o.o lsolo.io@$.la-ana.oro!sa16entc,asanla-3.a oro P. David Eenavdes dbenavrdes@santa-ana orc iv eoas@sanla-ana.orc sl naero@sanla a.a oro 07 licensed subcontractors and the number of struclures does not exceed four wrthin any calendar years, or all of the work is performed under contract with a licensed general building Contractor. MLA. I understand as an OwnerBuilder if I sell the property for which this permit is issued, I may be held liable for any linancial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. M11 9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal 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. Ml{to the party address: I am aware of and consent to an OwnerBuilder building permit applied for in my name, and understand that I am e y and ncia I resp nsr le for proposed co nstruction activi ty at llowin N H ll . 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. f\ il1z. 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 financial 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' com pensation insurance coverage. Signature of Property Owner Date Print name of Owner e- 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 fotlowing 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: Address of Authonzed Agent:_ 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 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 yerify the property owner's signature, ir:., iLi-: l....r.jr'r.i. r,".'.::-r:: -i:, ri!--.!-li,ij'-;,1, i_ r i.ir i.r.'l'rl SANTA ANA CITY COUNCIL mpur doOsa.la-ana oro Mayor P.o Ten Ward 2 oihartinez@sanla-a.a oro Vrcenle Samiento vsarm'eitoasanta ana.oro isolono@sania-sna oro P Davd Bâ‚¬.avides dbe.av des@sa.la-a.a.oro &illeoas@santa ana oro stinaiero@santa-ana o/o 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. /Vote.' A copv of the proDerw owner's driver's license. form notarization, or other verification acceptable to the aoencv is required to be presented when the permit is issued to verifu the propertv owner's siqnature. 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