HomeMy WebLinkAbout10195932 - Permit (2)rProject Address: 2941 N Hesperian Way
Assessor's Parcel: 002-231-28 Lot: POR 17
Unit: B Bldg: Address Range:
Tract: POTTS, BORDEN & SIDWBlockr NA Historic: No
Suile Range:
Zoning: A1
city of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA\27O2 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667 -2735 lnspector Section: (7'14) 647-5853
Permit #: {O195932
Pin #: E1346
Buildlng Use: Commercial Occupancy: B, S-1 1st FL Area: Patio:
Job Type: Alteration Constr Type: lll B 2nd FL Area: T.l.Area: 5OO
Nature of Work: Fire damage repair Code: CBC 2016 other Areas: yards Req,d: O@O
Existing Bldg. & Use: Retail Salas Flood zone: x-oao232o144J Garage Area: valuation: $25o,ooo.oo
Proposed Use: # of Stories:
Totat:
Description of Work: Repairs due to fire damage - .econstruct bathroom, create new office, new roof structure over unit B only with new class A bur.
One new rooftop unit.
Planning Conditions:
Owner;
Address:
Phone:
Tenant:
Thomas Pham
2941 N Hesperian Way
Santa Ana, CA 92706
(714) 890-2250
Contraclor
Address:
Phone:
Stale Lic #;
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policy #:
Expires:
Engineer:VP Home
Ben Phan
r r s+r erirhrdth'$treet
c.raen dioL6i cr,lr i$!'ti '
tt'rtlzrli,{li' I r' ri' rr
57550 l,riiir,, r r; i, ri,
VP HOme'. nrtf.:,L Ftnrj ir,.11,,,
Ben Phaq,t 1 ia r-!ri r ,:,1i1,ri1,r
11541 Elilð Street
Garden G,bVCJ-GA42t4O, rl r.ri ,i,,
l7'l4l 2s't,4jgf 11 f. llir ' ',rl 1,,:,-rr '|::r 1rrrir'
Owner-Builder
IOI I-ROSALES1of 2r l!-rl?:i932l? il' i,t2 AII$!l!,4J
Address
Phone:
License #
Architect /
Designer:
Address:
Phone:
License #
*11.i.7 a
t 1ir. i-fl-r
Planning Approval By Pezeshkpour, Ali Date: 06/26/2018 Misc. Receipt
Dale: 06/26/2018 lvlisc. Receipt
Date: O6/2Gl20i8 l\4isc. Receipt
Subject to Field:
Noyes Account#
iri i i 4r,rir 7 t:t,} i ri \tIt
077760A,6, F7'607 Pdrmit Fee
07776ofrP?tfrTtw- Edf Lctrcokf ee
otlzatibS Stzzo Microfitm Recordsi', 1! +++u?a+r++r+
08907007 24004 SMIP - Calegory 2
Fee Total:
Paid to Date:
Balance Due:
g46l{9 r.rl
-$427 .72
$lqP0"' '
s70.00
70747
Total
Plan Checked By:
Permit lssued Byl
NPDES lnsp. Req'd
PWA lnsp. Req'd:
Planning lnsp. Req'd
Mazarji, Zac
Amsden, Julie
o 07776002 sl5'12 Bldg. Stds. Revolvinq
07776002 51600 General Plan Update
07776002 51501 lssuance
$ 10.00
$21.25
$52.98
$1.080.93
$427.72
$653.21
No
No
Fire lnsp. Req'd:
Police lnsp. Req'd
Landscaping lnsp. Req'd: No Flood Zone Cerl. Req'd: No
Every permit issued sha become invalid unless the work on tho sito authorizod by
such Dormit is commenced wilhin 180 days aftet its issuance,ot il the v,/o* authoized
on the site by such pefinit is suspended or abandoned fot a period of180 days after
the lime the wo* is cofinenced.
lnspector MID#: 2018-141110
01116002 51600
01116002 51601
01116002 51612
o1116002 s7770
08901001 24000
$21.25
$s15.76
$10.00
$36.20
$70.00
BUILDING- INSPECTOR RECORD
SITE-WOBK DATE ID/SIG.COMMENTS OWNI'R BUII-DDR DI]I,CAR{TloN
I hcrcby rfltr undcr pcnahy ot ntrjury rh l aD cxemfl nom rhc ti,nh.rolr l,iccnsc li, ,or rh. f(nhrir8 rcrYrr lsc.701l5
llusi..sr lnd l\ofssn,n Codc) Any Cily or Cornr! Rhi.h rcqunc\ s lEn.ir h .on{tu r. 0hcr. inrProvc. dcnnrl,(h ttr rcnrt r)-
{tu.rur.. prd b ns i\\u!mc.,l\. r.quncslh. rmlicrn b, such lcmrirt,lilc. siSncd slalcnrcnl rhrrh.orshc is liccnscd IUAUfiT'
ro rhc provntN ofrh. contrrclofr Liansed li{ (chnfl.r 9. commcrcins qirh s.crion Tuxl of Divnion I orrh' Ilu\ints ur!
Pn,L$n,n\ C6dc) or rhrrtr or sie h crcmfl rhcr.ft,mnnd th. b$is lor lhc lllcs.d.nnrflion Anyri,n,bnolScclionT{)ll5 hr triv'
,tpli.,nrrora,rcanisuhjalsrhcrppli.r ki.ivilNtrilryolnolfrrcrhMivchundrcddollus($5ff)).
Las osnc.olrherr)!cny.or ry cnPk)yccs *ith \rrs.s r\ lhcir {,h coil|{nsd bn. u ill do rhc solt ud lhc \rdlun i( n'r
iorcndcd o.o,lcrcd ntr \rlc lsc.?(ll,l. Busincs and ttolt\.i{n'\ (ixlc lhcO'nrrrckn\Licchs.hwdocrnortrmlyrortrrwtrcrol
rhc pmrrny Ehn huilG or irlll,ruvcs rhcron ord wh. der qEh u) hn!*lror hcrscltor rhnuah hi\ or h.r osn cmllovcc\.
rdridc(lihar ru.[ irnpnrrcmnsm nor i'ncnk or offcrcd fdsrL ll hoscvcr. rhc tuildi'r8 or inPovcm is sold $irhin oqcdr
ot.onpLrn{ rlE Ouncr Auitlcr sillhrlc rh. hur'lcn.fp(riu rl hc.!$cdid'xnSuil.lorin K)vc rhc nDdy irrh( Ptrqs{of
.1.*,**,,'*r.*r,.d,r\!lu.trrry\n,rx!rtr'pwirhliccnscdconh.ttrsi.a)nirucrrl'dprt,l..r(scc.7(!r.r.Bu\in.\\
I,il h"ti.'i,.C*1"'rhr('ontr.ror\LNctr.cIrtrJ,,c\trorllplyt, nowtrcror'!tr)ndywhobu,lasnrimlrra\rhctuon.
rtrd who conrm.F for such pnrjcch lnh , c(lrh.tun s) li.ctrs.d puruMr t' rhcconrncl.is Liccns. Lw)
;'"'wqil/.2 "-*.,
I'IICIAIAIIAN
I hcrcby rllirm u Ddcr n rltr ul ltrjry onc .l r hc li,ll.* inE dcc lrrrriun:
I-.lLllB\c aftl trillnEn aiiJC.drllcirc.rCon.cdhsclrlnsurcr(rwortcn conlPcnsali{]n. rs ndvidci for hvSsrioi r70o orrlr
Lrtx/C.1. lft rl'c prnhnrtrtrc.frltr No.k lhr (hich rlrc lcnn r i\ is\uc
-l
hrk rnd sillnuinrrirl qorkcr' comFn\ar i('n insurnncc. r! rcquitcd hySc.rion.lT(X)ofrhc lihqCodc. for rhc ,xnorninc. .i
rhc work r(rwhichihi\ p.rnir is tnrcn. My*ukcri.. rrcis.rion imur0Ne catrid and Flic, numh.r arc
P,ni(t Nu rhcr:-
-l
c.nily lhrr in rhcErr. nrkcolrh.$rrk,irshichrhi\ncnnil n is\ucd.l \hr!l ntr cnll,ov nnv l(r$n ii,nynr.nncr
n, r! b h..oM \ubF.r to rh. !ltr(c^ .onltcn\arii)n hs{ ofC lilirnii. rnd tr8toc rhdl rfl slnnrld hccort sDbjc.l ro ihc
*ork.n ro rr.n\.rn lnvi\ionsnfScdion.lT(Dofrhc Lil!,((xlc.l dull nflhRith.onrtly sit h rho{ Pr,li\nnN
1IARNINC lilurc k, $.trrc workcr' cont|arslriotr covcftsc i\ !trli*ltl rni shrll su$]c.r I'r .nrdo]cr lo oininsl Fntlric\ nnd
t' onc hutulrcd rhouvnd dollus (!l00.Un). in ddiri(lr h rhc co( ol ommns n'n. damucs nrovidcd f.r lnt
Sc.rim:lo76olrh. L'lxi Cndc. inlcr.{ rtr{ldoriry \ l.rt
6/zy'zotr
NF(I ARATION
I hcrcby rmrin undcr Fnrlry olpcrjury rhnl I an lienrd undcr Pnrvili.n ofChrPIcr', (connftftnr8 wirh Sctrbd ?(x)0) 'rDiuhion:l
of rhc axsincs rnd Pdtsn,ns Codc. n d
'y
1tr..s is iI iull l.rcc md crr..r
-l,iccn\c
N!.rh.r:
-
CONS'IRUC'IIIJN I NNDINC CT'N(]Y
Ihcrchyarfiirtruid.rFfilryoip.rjuryrhrrhcrcisr.ontu.ri(, lcrdirsrs.my lorrhcl).rformrrc orrhtwotk for whith(hi\ Jrnr i{
isrucd lScc. lO9?.Ci!. C.).
tfnJc.-c Nrmc
-
AE&TEANLI)ECIIBAIIO!
I lrn$y rmnn und.r !.mlty oifcrjury oic orrh. lnlbwinS dcclarution\:
Dcnnniri(,n Pcirnirs Asb.{o\ Nolificrrn,n FcdcElRrsul"rt,n (Tillc 40. Pana,r
_Rcqlncd hncrof Nolific ion
I.drrl.vIlrll lMIcdcrulrcsul ois rctdiliu rshcslos rcnrvrlrrc mr rflll.rhl.lo rhn nmFd
V4 l.cnilyrhd I lhvc rcrdrlh q'nlic0rion unl darc rhdrh.rh)it rtrf{muli(nr iscorc.i I aEr..bconrPly{irhrllCIv.trd Coufrv
0..\ d Srric Ln$s rcldill! r,6ull(lin!rnn,.rndI'crcb!.urhori7.r.t)'c\r r!r.\ol rhil(lr) rn,la,,uri)lt.nlcrnJ,.f rl{
ak,vcnicnrionlpnpcdyturi'r\tx.rlotr
,\Dpli.nnl or /lAenl Si8nnlrre
< :Ztutl ^'.t/zt/z"S
Set Backs
Forms/Steel/Holdowns (,t8 =FLt vrt tadl
Erection Pads
UFER Ground
SLAB Floor
Subf loor/VenVlnsulation
Roof Sheathinq *tu/*tO--..
Framino
lnsulation/Enerqy
Drywall l.L1,*t ;a,r*/
Ext./lnt. Lath
Brown Coat
It/asonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
FINAL tl4ltq v /xuffil_z>)
Certilicate ol Occupancy U\
Notes, Remarks, Etc.
Shear Wall
v
r-------T------
T
MAYOR
MiguelA. Pulido
MAYOR PRO TEM
l\.4ichele Martinez
COUNCILME|\,llBERS
P. David Benavides
Vicente Sarmiento
Jose Solorio
SalTanajero
Juan Villegas CITY OF SANTA ANA
PLANNING & BUILDINC AGENCY
20 Civic Center Plaza
P.O. Box 1988 . Santa Ana, California 92702
www.santa-ana.org/pba
NOTIGE TO PROPERW OWNER
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements spe cified at
ACTING C'TY MANAGER
Gerardo l\,4ouet
CITY ATTORNEY
Sonia R. Carvalho
CLERK OF THE COUNCIL
Maria D. Huizer
0
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 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 INF ORMATON
DIRECIONS: Read and initial each statement below to signify you understand or verify this information.4V | 1 . 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. 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..4
V I ' ?. I understand building perm its 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.
-/nv ){ s. t 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 Conkactor and having the permit filed in his or her name
instead of my own.
-V-[!0. , understand Contractors are required by law to be licensed and bonded in California and to list their license
numbers on permits and contracts.
-ny1!6 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.
-nh. , 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.
, /rnV I I 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 a// work is performed by
SANTA ANA CITY COUNCIL
mou do@sa.ta-a.a orc
Mayor Pro Tem Ward 2
m marl nez@sanla'ana oro
M.e.te Samienlo
vsamienlorAsanla ana.oro so ono@sanla-ana oro dbenavrdeslOsanla a.a oro v leoas@sanla-ana oro slinaiero@saola-ana.oro
Dear Property Owner:
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.
--{2Vl18. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any
fin-arrcial or personal injuries sustained by any subsequent owne(s) that resutt from any latent construction defects in the
workmanship or materials.
L!!g. t 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 lndustrlal Accidents. I also understand I may contact the California Contractors' State License Board
(CSLB) at 1-800-32'l -CSLB (2752) or www.cslb.ca.oov for more information about licensed contractors.
- /')
W hO. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am
tn6 party legally and financially responsible for proposed construclion activity at the following
..l.l.oc c
the ow ner's re
Signature of Property Owner Date
Print name of Owner
AUTHORIZATION OF AGENT TO ACT ON PROPERW OWNER'S BEHALF
Excluding the Notice to Property Owner, the execulion 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 ior my
project.
Scope of Construction Project (or Description of Work)
POect 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 prope,Ty owner's signature.
,r i,,,.ia -..iAr ., i.,;i-.ri.. .:...ir! 1-,).- i,';_'-.
SANTA ANA CITY COUNCIL
houlido@sa.la-ana.oro
Mayor Pro Tern Ward 2
mLmarlrnez@sanla-ana o.o vsarm'entorOsanla-a.a oro isolorio@sarta 3na oro dbe.avrdes@sa.ta ana oro ivilleoas@sanla-ana.oro st.a ero@sa.ta-ana.oro
-o/l I tt .l 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,/ I 4Z t agree to notrfy 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; A copv of the prooertv owner's driver's license.
form notarization, or other verification acceptable to the aqencv is required to be presented when the oermit is