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Home My WebLink About20166089 - Permit (2)City of Santa Ana Permit Counter: (714) 647-5800 20 Civic Center Plaza (M-19), Santa Ana, CA92702 Electrical Permit #: 2O166089 Pin #: 83E83lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853 Project Address: 521 E Beverly Pl Unit: Block: D Bldg: Trccl 226 Address Range: Historic: No Suite Range; Zoning: R'l q Assessor'sParcel: 011-082-12 Lot: 6 Owner: Address Cristobal & Silvia Cruz 521 E Beverly Pl Santa Ana, CA 927016031 (714) 604-5129 Fee Type 01116002 51603 Serv Meter 01116002 51600 General Plan Updale 011 16002 5'1603 lssuance Amount 51 .29 2',1.25 52.98 Qty 1.00 1.00 1.00 Fee $51.29 $21.2s $s2.98Phone: Tenant Name: Contractor Address: Owner-Builder Phone State Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance Carrier; Policy #: Expires: (:r istobol L Silvin Cr.u: Building Use: Job Type: Nature of Work Occupancy: Constr Type Code: R-3, U VB cEc 2016 handout givenNotes: Planning Conditions: \.)\ernandez, Kathy Date Date Date 06/07/2018 Account# Misc. Receipt: lvlisc. Receipt: Misc. Receipt: Total Every permit issued shall becone invalid unless the wotk on the site authorized by such permit is commenced within 180 days aftet ils issuance. ot if lhe work authoized on the site by such permit is suspended ot abandonec! fot a peiod of 180 days after the tifie the work is commenced. $21.25 $1O4.27 $'r 2s.52 $0.00 $125.52 lnspector MID#: 2018-143838 01 116002 51600 01116002 51603 Fee Total: Paid to Date: Balance Due: BoLchi:44188 - 6/7/ztlg 0ff ice: (;TYH Tronsi: 3 Acct+ r Refi: Rcpt+:tr2299595 - 6/7 /2tt1g Tronsq,:L ion fotol 2rlIt 12 Planning Approval By: Plan Checked By: Permit lssued By: Subjecl to Field: Building Permit #: Single Family Dwelling Miscellaneous Service Meter E ECTRICAL-INSPECTOR RECORD APPROVALS DATE COMMENTS Site-Work Underqround Pole Bases Light Standards Spas, Pool, Fountains Siqns (monument) Life Safety /Low Voltaqe Fire Alarm / Dampers Communications Cable Building Under Slab / Floor Bondino / Groundinq / UFER Translormers Torqueino Sub-Panels Air Conditioners Rool Top Equipment Factory Wired Unit Walls (Conduit) Walls (Rouqh) Ceilings (Hard & Soffit Rouoh Ceilings (T-Bar Rouoh) Meter Release Rouoh I Service lvleler //4//4 Wu,\)()*.MFINAL7l,l'tq v Notes, Remarks, Etc.r'l OWNER BUILDER DET,CARATION I hcrcbt afirn undcrycn.lty of pcrFry rhll I an c&nlPr rmo .hd C.nkacb^ Ltcnsc t w fo! thc follo*in8 ,eas,n ls( 70.1 L5 gusincs and Proaessn,n Codâ‚¬): Any Ciry or Cou.ry *hkh rcquircs r ,f,rnil lo onsltu.l- olrs- inpovc. dcn ish .r *_p!ir d.t srtu.lr'c, lrior ro ns i$udnc., slrc rcquins rhc aprlicanr for such i'cmil to lilc a signcd stareft.t rh.r h. or shc is liccnscd lunurnl ro rh. tmvnions of rlt Conrrucr.ri l-iensci Llw ichafl.,9. c.mcncnrS wiih Scclion ?()()0 of Division I .l rhc Busincs 8nd Potâ‚¬\sion. Cdc) o. rhar lE or {h. n .x.nll)r rhâ‚¬rcfron and rhc brsh for llE allc8cd excmflion. Any liolsrion orScdion 70.11.5 h, m, nttlicanrrorrp.mirsuhj..hrhc.mlicrnrlo0civilpcnlhyofrcrmrcrhanfivchn.d4dd.llm(35001 _1. !s o*ier.frhc tropcny. (, oycfrplorf,cs *irh waBcs.s rhci solc conr,'.nsarion. willdo rhc w,k &d rlt imu n nor i'trcftLd or .ft.rcd r.r el. (Se.7044. Busi,rc$ md Proic$irtrs C.de Thc Comracrors Lkcnsc Ijw d@s no' 0ndy lo !. o$ncr or rhcompcny {ho huild! or inDmwr th.d,.. srd wlk) des skh *or* hinsclf.r hcrcllor rhmogh hi\ ot h.r own cn9loyes. providrd rhtrt such inll,rokmdrs e mi inrcndct or oresl for slc li b$cvd, rt huililin! or ir{mwmnt ii sld wilhin ore y(r ofcoflplction. rh. Owrcr Buitler will hlw rhd bldcn .f pn,ving lhd hc or shc dh ml huild or in!)mt lhc lmrEly n, tu loqrr or t. $ o*B or rh. lmt ny, or qclusivcly conrrad ins wirh licenscd contacbn ro .onsrucr lh. pn+d (S( 7(HJ. Busincs lnd Pmf.\shn Cone:Ihc Conrmtr\ Lic..sc I:* tl*s not apply ro uno*mr oapropcny who builds or inProvcs lhcrmn. nnd who mnhds lbr slch pr+cls uirh a ConrBcro(s) liceoscd pursEnr ro rh. Conta.tols Licctrrc L{e) I !'ncx.mpl undcr Scct CiVtCt'{0L t)l ( t. rr \ {)\ I hcic$yrrnhnu d.i pctuiryofpcrlryorc otrhc nnk,pin8 dccllmri.n\ -l hrv. el will roinrain a Ccnificrrc of Cod{nr () Scll lNUs f(tr sortda .omNnsai i,)n- ,\ pn,lnl(l ttr by 56..r ion 37(Xr of rhc tjhn Cdc- ior lhc Friolruncc of I h. wo* for *hich rh. tcm,i! it i\{cd _l hovc trtrdsill nfinrrin sorl.N .onlicn\didr iri{trrncc. d\ rcqutcd$y56.'ri,,n.l7(x)olrhcl}lFrC.dc.lirrhcpctlolnumcoi rhc worl tur whi.h rhi\rcnnir is ksul. Mrsorkcrs c.nlntnsrlion iNuraNc crtrierMdlr,li.y nxnrltr *c Policy Numbcr -Linircs -l rtniay rh in th. pcifontuftc oirhc work f(tr whEh this rcr.ir is issucd. I rhrll n.r cmploy ony lcrbtr in lny oanEr $ .s lo bccom subjd lo rhc worken co t{r.rar io. lrss orcallorni., lnd osN lnd if I stDUld t{rctr subjccl ro thc Borkcs conrpcnstionpmvtionr orseli.n lT0oolrhc tjhor Codc.l s\rll. tonn*irn conply si'h rb$ pmvisio.s.. WARNTNC: Flilurc x, {cor sorkcrs ..nprns.rion.!rr.Bc r\ unllllul. rftl stull suhid tn cmFlolcr lo aiminal Pemhtus,nd ciril 6nc\ up ro onc hunnrcd rhors,nd dollic (Sl ).otD). in 0ddilion nr rnc co{ or conD.ns.rion, drnu8e\ us I'Dlidcd lnr rh. Sâ‚¬crion 3076 of rhc Lrr.r C.dc. i erca 1i)"CroLC^ I hd.by amrn und.r Fnally ol !,crju.y that I am liensd lndDr pmvhbn ofChlprn 9(co.nrcnciB uirh Scdhn 70m) orDivsrn:l of rhc B!\incs lnd Pbrc*ions Codc. ed my liccnsc n in tull lore od cilccr CONIIIIT TON..LENDINC.{CI!.CI I hcEl,y affirm undcr Enaliy of Dcrjry rhar rtm is , consldclion lcndin8 lscncy tin rhc FdonrEncc of lhc wo.k for which rhis pfidn i\ hsu.d (S(.109r. Civ C.). ATTLIT.ANI.DEEUTAIION I h.n:6y .RinD udcr llcnally of p.rjury om of rh. lolbwnrs ddlrdrions: Dcmlirion P.rmi'$Asbc(os Nolirrcdiotr FcdcBl Rqularions (Tillc.lo, Pd6) Rcquircd txtrft of Notitrcltion I ccnilyrl rhc tcdcrulrc-qrlrri{'ns togrdin! Nbc{or(trxtrildc nolOplicablc n, rhn pmJ..r -lccnilyrharlhNcrcldrhhrppli.,ri.trfldslrcrhdlhc$ov.irfornElioni\con.crl4lcrocomFlywithsllCnr.ndCou y orninanccsandShrcLuwsrelnrinsr.buildinecotr$fldnrn.{rdncrcbyluthnizcrcl)rc{rarn$otrhisCiryondCounlyro.nrcruIx,irlt ,h,vc rrcnrhncd pn,pcny ior inspcclionpr .\pplirml or.\!$l Sirn lur.I lvicn Crttz 6 -7 -t7 ID/SIG. trndcr 'i Nrm - hndci\ Addrc$ i- T,IAYOR l\4iguel A. Pulido MAYOR PRO TEM Nlichele Martinez COUNCILMEMBERS P. David Benavides Vicente Sarmiento Jose Solorio Sal Tinajero Juan Villegas ACTING CITY MANAGER Gerardo Mouet CITY ATTORNEY Sonaa R. Carvalho CLERK OF THE COUNCIL l aria D. Huizar CITY OF SANTA ANA PLANNINC & BUILDINC ACENCY 20 Civic Center Plaza P.O. Box 1988 . Santa Ana, California 92702 www. santa-ana.or9 . 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 improvemenls specified at6 r (^0 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 INFORMATON DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. <'/"J L 1 . I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder' building permit thal 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 iniuries. 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. <! /'Je2. 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. < ,/^J( . 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. Se+ f understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. )L S. 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 ($500), including labor and materials, I may be considered an "employer" under state and federal law. <:- /^ J-0. t understand if I am considered an "employer" under state and Federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemploymentcompensationofeach"employee.'Ialsounderstandmyfailuretoabidebytheselawsmaysubjectmeto serious financial risk. a ./'J L 7. I understand under California Contractors' State License Law, an Owner-Builder who builds singleJamily residential structures cannot legally build them with the intent to offer them for sale, unless a// work is performed by SANTA ANA CITY COUNCIL moUido@santa'ana.oro Mayor Pro Tem, Ward 2 mimartrnez@santa-â‚¬na.oro lsolorio@sanla-ana.o.o P D.vid Benavldc. dbenavides@sanla-ana.o.o ivilleoas@santa-ana.oro sl.aieroOsanta'ana orovsa.n,enlo@sanla ana oro licensed subcontractors and the number of structures does not exceed four within any calendar years, or all of the work is performed under conkact with a licensed general building Contractor. (1 .-J ! a. t understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any finf,ncial or personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the workmanship or materials. <1 .J C g. t understand I may obtain more anformation regarding my obligations as an "employer" from the lnternal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or lwvw.cslb.ca.qov for more information about licensed contractors. I) L I O. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am lhl"*I'"t'"'""t+$i"" <)/J L 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. <: /^ . \L12. 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' 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. /Vote.'owner's driver's license form notarization, or other fication acceDtable to the aoencv is required to be ted when the Dermit is Signature of Property Owner 5i\'ricn Cr oz Date c-7-t8 Print name of Owner 3,\v ic" Lt,tZ 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 Agent Phone Number of Authorized Agent I declare under penalty of perjury that I am lhe property owner for the address listed above and I personally filled out the above information and certify its accuracy. Date Print Name of Ow.rer Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presenled when the permit is issued to yerify the property owner's signature. SANTA ANA CITY COUNCIL moulido@sa.ta-ana oro Mayor P.o Tem Ward 2 mrmarl.ezrOsanla-ana oro vicenre Samienlo vsamlenlo@sanla-ana.oro so oroAsa.ta-ana oro P Oav d Bâ‚¬navdes dbenavldes@sa.la'ana oro ivi eoasosanta ana.oro strnarero@sa.ra-ana.oro issued to verifu the DroDeftv owner's signature. Property Owner's Signature: