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Home My WebLink About10196723 - Permit (2)oY Project Address: 1416 W Hall Ave Assessor's Parcel 140-234-O2 Lot.56 Unit Bldg: Address Range Suite Range: Zoning: R'lBlock: NA Tract: 5952 Historic: No City of Santa Ana 20 Cavic Center Plaza (M-19), Santa Ana, CAg27o2 Building Permit Counter: (714) 647-5800 lnspection Requests: (714\ 667-2738 lnspector Section: (714) 647-5853 Single Family Dwelling Occupancy: R-3, U 1st FL Area: 0 Patio Job Type: Reroof Constr Type: V B 2nd FL Area: O T.l.Area: Nature ofwork: Reroof codel cBc 2016 other Areas: o yards Req,d: Exastjng Bldg. & Use: SFD Watt garage Flood Zone: X-0602320259J Garage Area: Valuation: $2,830.00 Proposed Use: # ol Stories: Total: 0 Description of Work: Tear off existing remaining roof materiat and install new comp shingle material. Handoutgiven. Owner-Builder form onfile. I t,: :it . l.rlf r,:q Owner: Address: Phone: Tenant: Francisco D & Laura Delgado 1416 w Hall Ave Santa Ana, CA 927045731 (71415744755 Contractor Address: Owner-Builder Engineer Address f0t, o I I Lflur0 oel Phone: State Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance Carrier: Policy #: Expires: Architect / Designer: Address: Phone: License #: l6ultrfrtr.. cvo 1v ine t 61?utro' n Updote Fee t6rr0r-r(ir-r* i**rr(tI4, fiLrt.l Planning Approval By: Plan Checked By: Permit lssued By: NPDES lnsp. Req'd: PWA lnsp. Req'd: Planning lnsp. Req'd; Landscaping lnsp. Req'd $308.52 $1.00 $21.25 $52.98 No No No No Fire lnsp. Req'd: Police lnsp. Req'd Flood Zone Cert. Req'd: No Evory pefinit issued sha become invalid unless tho work on the site authoized by such permit is cofimenced within 180 days aftet its issuance.ot il the work authorizod on the site by such pemit is suspended or abandoned fot a peiod of 180 days aftet tho time the wo* is commenced. lnspector MID#: 20'17-139909 H Account#Total 01 1 16002 5'1600 011'16002 51601 011'16002 5'1612 $21.2s $361.50 $1 .00 Fee Total: Paid to Date: Balance Oue: $383.75 $0.00 $383.75 Permit #: lO{96723 Pin #: 43738 Building Use: Planning Conditions: Phonel License #: b/ 1,!/ 1LtlE Iuild ins r i i 16u12- Elds 5[dr Lrll16tt(r2-,liener'rl I r"{l116trr-r2- ( +: rr*r Orozco, lvan Dale: 1111412017 Misc. Receipt: Date: Misc. Receipt: Chavez, Davega , Date: o$l12l2ola lvisc' Receipt' Subject to Field: 01776002 51601 Permit Fee 07776002 51672 Bldg. Stds. Revolving 07776002 57600 General Plan Update 07776002 51601 lssuance BUILDING. INSPECTOR RECORD SITE-WORK DATE ID/SIG.owNER ltull-Dlifi DaLCARAI toN I hctbyrlrlr tndcr pâ‚¬nalrr otFdu.y rhrl I am cxcmpl lrcm rhc Co racroF l,iccnsc ltre forrhct Uowin8 tulv,n ls.c7).115 Ausincs nM Prof.\\ioi Culc): n, Ciry or Couiry which lcqutcs r Frnrir io .onq cr, rlrcr. i F)rc, d.'n hh .r rpair My nru.rurc. nrnn ro its isnutre. also rcaut r th.,rdicrr f(tr su.h Fr.'ir n' ul. r siS cd idc.rc,r rhr heordr ir licciscd !u^u,nr l. rhc ,hvisioN of rhc Cl.ftn !r's l-i.cn{d L'! (Chrprrr 9. Connn.ncing wnh S.crn r 7l[)0 of t)ivision .] of rhc Bu\i'lrs lnd Pmic$ions Codc ) or rill hcorshc hcxcnfl rhcrcfro$ and rhcbrsi\ for rh. dlhlcd .xc'nprion Atryvt,lDrionotSc.riotrT0ll5hy.ny applicur rbr a Frnril ruhjcct\ lhc lttlicunr lo ucivilncnrlryol trot mrcfion fivc hutrdrcddoll.r iS5($). frl\, a" o*i., ,,r rhr Imriy. or m, cmpk,ydc\ wnh w,s$ a\ rhct vrc co'npcn\rrn,n. sill do rh. $ ork rRl rh. nmrm . d i"rcndct rollcrcd for $k (S(.7O1-4. Au{rcss rtrd Profc$trN Codc Th. (btun ttr s Li.cnrc Lrw docs nor lPplyh o\rftr.f rhc pbp.n! who hrikh or i'npr.ts rhc(r. dd who ,rc\ n'.h sork hinNcll o' hcrcllor lh(n'ai hir or hcr own cmpi)yccs. proviJcd rhlr su.h imnnivcntrh nc rmr i .ftl.d or ollarcd {or sk ll hoMrd. rhc } ildin8 or ntmvc rnr is {,ld wirhir on. $ ol.onDldion. rhc Oqncr Auih$ rill ha\r rh. hr&n of poving rh3r hc or \hc did R trildor ilnl ovc rhc pmlcny ti,r rhc purlr)s of ffi:xx:lrl':u::,;,;H::l'ir;rr:Tli:ilL",:Ifii,,"::::r{:;:;;:'r}'fr"liT#r'fi:'.',,i;,1'f.ftH: rnd *ho conlmch {o! such pmJc.k wir[ icrM.dnnl) lic. \cd I hcrcby rilnn trn .r p.ulryof Frjr'tnm.l rft ftn[Nirr dcclt -l hsvc ondwill mlinrain !Ccnific colconscnrroScli.lnsurcforso crl compctrsotion. as pmvidcdrorhySccrion3?O0ofthc L,bor Codc.Ior lhc p.rfon mc oith. work i.r which rhc p.rnir h isucd IhilcandwillFniniainworlc'! compcnsarinn insunncc. !\ rcqln.d h, Ssiio..i70O narlr Lzt*, Code, f.r rhc p.rformnc..f th. rorl forwhi.hthk p.nnir is issNd Myworkc* .onrpcdqrioi insutunc.ariui rnd l.licynunrb.rr.: Cuicr:- l\'1i.yNtrnrhcr Ertncs:r\ Eit hr rr rnr ,n rtrc rrr.rm{Nr,rl rhc s'trt ,nr lhtrh rhis pcrmir is issucd, I shallnor cnTk)y my pcrson in..y mnncr \l'i7n ha, n c \uhtfl | r, rl. tr.4c'\, rn,|($ariotr |.,tr. oi( trlrf.iinJ.otrd rErcc rhr ri I "hnuld t("m \uhjccr r.r|i. sorlc^ comnrnsari,nn()vi\i,,tr\olSrcri,nr.l?(lO.IrhclilxtrC,d.-l ll. hnhrirh.on,flv rvirI rln'{ Irrvi\i(tr,\ IVARNIN(i |rilur. r, {.tr'c sorkcr'conmcn\rri,r..\.'fu. '\ r lirl- ud \lnll {l,].ct !n cn,rhy.r i, crimnrl t^-.mhis md .tr I lnr\ up k, of. htrnd'cd rhotr\xnd nolh \ r1l(x).(nx)r. iD x(l,l h rh. .on ol .on,lrn\rri,n,. drtrxâ‚¬r\ a\ t)r,vnld ,nr r[r :::::'i";-D'14" I hcrchy rlrtnr undcr pcnihyoip.ryury rhd I rnr licctr{d uMcr taovhior oiCh.i'rcr I of rlr Buenc* d Pturc$n sC.d.. dd.ry li..nsc n in fxll torc. r!]rlfccr l-iccnsc Ch* -Licctr\c Numbcr: - D.l.: Contractor C(INSTRU(:TI(IN I F\DIN(; A(;ENCY I hcrct y irfirnundcr p.nrkyotllâ‚¬rturyrhal thcrc h 0 consrucrhn lcndin8 r8ercy for lnc pcrfommc ollhc *ork tor which rhh lc nir is issucd rSc..1097. Civ. C.) aftrtc NrD[clll[auo! I tEEby irlnn undcr lcnllry ol pcrjury om olrh,lollowirg dcclmrnnN D.nslirrnPcnhirsAsh.{orNorifi.urbn Fcd.ral R.$ldions(Tnb4l), Pd6) R.qurcd lrncrof Norifi.uhon -l..nilyrhar rhc lcdcr rcsuhri{nr rcsndins ast sosrcnnrval.rcnoralplicxt'lcr.rhhpnl.cr H*r 'ly rhn 1 I'x\c 'cxd rh \ rft,li.rr(, r rnd rhar rh. ih,!d irloi,Mrion s conccr I +e lo comply wilh all Cil y and Counly trtiDtr. d hcr$yrurlntrizc rcorcscnlarivcs olrhis cir,0nd Counrylo enrcr up.tr rhc\rfd Sr c ltrtr\s rhrirf r, hrildrtr! trbort Nntoi.d pn,t. y f(n nisFari,nr ,,,,",, iltzt&Appli.ont or A*cnl SiSDrlua: P.nnil.e nanP (pnnl): A /-l1/, a.-- Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Subf loor/Vent/l nsulation Roof Sheathing Shear Wall Framing lnsu lation/Enerqy Drywall Exl./lnt. Lath Brown Coat Ivlasonry Pool Fence T-Bar Handicap Req. De puly Final Report Engineer Final Report FINAL 7-2? -/â‚¬J/e!il ,-(O\ Certificate ol Occupancy Notes Remarks Etc. -{ COMMENTS Set Backs Flood Zone Certif . *" 'E /tz I %r - * *,,^ ^*, ",,,*,,^ ^, MAYOR Miguel A. Pulido IVAYOR PRO TEM Michele Martinez COUNCILMEI,lBERS P. David Benavides Vicente Sarmiento Jose Solorio Sal Tanajero Juan Villegas ACTING CITY MANAGER Gerardo lrouet 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 1988 .santa Ana, California 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 you rself as the builder of the property improvements specified at 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 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. fr\f -U t . t understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Buildefl building permit that erroneously implies that the property owner is providing his or her own labor and material personally. l, as an OwnerBuilder, 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 limits of my insurance coverage for injuries to workers on my property. 1,0 , , understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a Iicensed Contractor to assume this responsibility. [,0 4 ,understand as an "Owner-Buildei' l am the responsible party of record on the permit. I understand that I may plot6ct myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. f,Lo. , understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. [,I t ,understand if lemploy 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. [.Lu. ' understand if I am considered an "employer" under state and Federal law, I must register with the state and lederal government, withhold payroll taxes, provide workers' compensation 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. f ' [) Z f understand undei' California Contractors' State License Law, an Owner-Builder who builds single-family resfdential structures cannot legally build them with the intent to offer them for sale, unless a// work is performed by SANTA ANA C]TY COUNCIL moulido@sanla-ana oro Mayor Pro Tem ward 2 m man .e2@sa.la-ana o.o vi.e.re samienro vsamienlo@sanla-ana oro soloao@sanla-ana oro P Drvld Benavides dbenavides@sanla-ana.oro ivilleoas@sanla-ana.oro sli.aierc@santa-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 contract with a licensed general building Contraq2r. , 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 financial or personal injuries sustained by any su bsequent owner(s) that result from any latent construction defects in the workmanship or materials. E-,\-n , 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 wvvw.cslb.ca.oov for more information about Iicensed contractors. [,\,0 the 0arty address: I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am legall and financiall y responsl le for pro construct activity at f lowi -Eu 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. [ (\,l, ' agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the ihfo/mation 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 jndividual or firm is injured while working on your property, you may be held liable for damages. If 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. 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 propertv owner's driver's license. n anz or ven ation able to the IS ired be ,s issued s,nat re Signature of Property Print name of Owner Owner Date 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 llle 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 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 verify the property owner's signature. i: .f i, ia' a:.r ^:r'i-,,.! r-,::-,-: ;il i r,l:r'. r. p 1;.rlL r': a-r :! ." . SANTA ANA CITY COUNCIL mpulido@sanla ana.oro Mayor Pro Tem, Ward 2 mima.lrnez@santa-ana oro V cente Sarmienro vsamiento@sa.ta-ana.oro isolono@santa ana.ora P Davrd Benavdes dbenavrdeeosanta-ana o.o v eo.s@sz.ta ana oio sl'naie.oaosanta ana oro