HomeMy WebLinkAbout30139665 - Permit (2)City of santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA,27O2 Plumbing
Permit Counter: (714) 647-5800 lnspection Requests: (7141667-2738 lnspector Section: (714t 647-5853
Permit #: 3O139665
Pin #: 73795
Project Address: 2941 N Hesperian Way Unit: B
Block: NA
Bldg: Address Range:
Tract: POTTS, BORDEN &Hlistoric: No
T
AssessoisParcel: OO2-231-2A Lot: POR 17
Owner:
Address:
Thomas Pham
2941 N Hesperian Way
Santa Ana, CA 92706
(714) 890-2250
01116002 51602
0'1116002 51602
01116002 5'1600
011'16002 51602
F6e Type
Water Closet
Sink
General Plan Update
lssuance
Amount
14.22
12.70
22.08
55.04
Qty
2.OO
2.00
1.00
1.00
Phone:
Tenant Name:
Contraclor
Address:
Owner.Builder
Phone
State Lic #:
Lic Type:
Bus Lic #:
Workers' Compensalion lnsurance:
Carrier:
Policy #:
Expires:
totchilff ice
icct+:
7 t9 /2913
lronsi:44ftefl:- 7/9/2fr18Rcpt+ ! 02321:
IronsocI ion
Thohos Phflfi
6€nerol ['l (rr
ot(lI
r,r 11 16110
F'Iuitb in
r"r111600
Updot€
irJ[[t0t:r-
Building Use:
Job Type:
Nature of Work
Commerclal
Alteration
Fire damage repair
Occupancy:
Constr Type
Code:
B, S-1
t B
cPc 2016
ir.'l2u((r
Notes: Plumbing. Olyner-Bullder form on file,
Planning Conditions:
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Chavez, Dave
-*'
Date:
Date:
Date:07 t0912018
Account#
NIisc. Receiptl
Misc. Receipt:
Misc. Receipt:
Total
10195932 $130.96
$0.00
$130.96
Every permit issudd shall becorfie invalid unless the wo* on the site
autlodzed by such pemit is commenced within 1 80 days after its
issuance, or il the worl< authoized on the site by such pemit is susponded
or abandoned for a peiod gf 180 days alter the time the work is
commenced.
lnspector MID#: 2018-141110
01116002 51600
01116002 51602
s22.O8
$108.88
Fee Total:
Paid to Date:
Balance Due:
Suite Range:
Zoning: Al
Fee
$28.44
$25.40
$22.08
$s5.04
I
PLUMBING.INSPECTOR RECORD
APPROVALS DATE tD/stG.COMMENTS
UNDER GHOUND
1,t-4FWaste & Vent lotlt\rB
Water-Under floor
Area./Storm Drain
lnterce orl Clarilier
TOP OUT
Waste & Vent tolSt\t7 u44@)
Water Pi I
Tub/Shower Test
Rou h Water Heater
POOUSPA
P-tra Drain Line
Fill Line/Back Flow
Pool Heater/Gas Line
Gas Service
Water Service
Lawn rinkler
Back Flow Device
Final Gas Test
Meter Release
I I
Notes Remarks, Etc.
FINAL
r)r\ Nt.:R l I I)t.R l)I:L( \R\I.IONI hcrcby llii,m undrr pcnrlrt ol pc,iry rld I fln crc,nnr tnD rhc Coorn.r.n. Liccn\c hq tor rhc rol,,wins us; (S..70:]l 5
Iiusir..s r t ltolts(ion c(xlcr: Any Cir, or CoDnry Nhrh rcqrtc\ n nc nir ro .otr{tucr_ {trcr. irnptuvc, &mni\h or rcprn sn!
nru.lurc, rftr,, its issu.n.c. rl$ rcquncsrhcnmtic. lnr su.hFmir n, filcasi8trcd sar.,hnl lh hco, $. h tircn{d pu6u, .
to rh. pmvi(ions ofrtr (tunr0rxn s Lnu*d lf,s (Chntrr 9, (..mrmncing \rirh Sccrirr 7m0 oi Diyi\io:t otrhc Busin.s\ ann
Pmt$tun\ Codcrorrhar hco..hc ii cx.mp h.r.rronr and rh.iNi\ nn rh.lltcscri.rtrrrrrn AnrviototionorscdionT0.I5byuny
upplicanrrbr l,xrnir sui,jcch l hc oltticd r io scivitpcn xyoinor morcrha firc hutrdr.ddothrsts5rx).
-1,
rs ownd ol rhc p('lrny. r, ml cmploy.rs s irh srXc\ ls I h.n (nc conrpcnsd i(rr. q i[ do thc trori a,xj rtE {turh N fr,rinrcnd or !lI. hd r{r c'L (SL{ 7t{J. Bu\ircs rnd I'ror'.\!ionr (lic 'r'h. C(,hcr,.s Lt.ctr{ uw doc\ n l rtpty ro M ownlr oflh.mrFny Iho noiu!.r invxn$ rhtrun. tukl wtr docs su.h solt hnnscti.r h.uctror rhmush t,, n, r,".."n
"n,pt,,r..,.provdcd rhrr\urh i'ntmvcnrnr\ mld i,rrc Ln oroffcrcd to.s t I h)$crr. rlr hriunj[ or iq,mrcnrnr i\ q,Llsirh,n rc ]rdofconDkri([. t,E owncr Buil&r $ill h1vc rh. hutr,.nofpmvinE rhd h. a, shc did,rn r,ild o; iq,(;vc $c pnrrcny ti]r ttf, N{s* or
L isnwm orrhc pn,r^-rty. mcrchsilclycotrr..iins wirh [.cn\.d conr]cron ro.onjru.r rhc pn+cr (Sc. 70,1. Burrcsxl t bfusi.n C.dc Thc C.nra.loi s Li.cn\c t.]tr (lo$ mr rpply b {n ou6 of prop.rry $ho hurtd\ or inrprovcs rhcr.Dn.rnn $ho.odtucahrsuchpn,lcchwirh!Conrn.bngticctrkdftr u rx)rhc(odtu.r,\t_iccn\uliw).
?o**. X
ai'iirnundfi rcnuhr of pcrjury om oflhc tb,lowirg dc.tuErions
-l
hnre uxl will mintlin a Ccrt iaolc or C6.snr to Scta-tn.!( for mrkB. $mp.nsarion. os lrovidcd tor by Sctio. t70o of rhc
L:bor Codc, for rhc pcrlomErcc oarh. $orLor which th. pemil is isu.d.
-l hNc md will n.inkin wortcn' co'nI.n\atio, insuEnc., ar Erloncd by Serion l7O0 of rlE t hor Codc. tor rhc pcrfordtr or
rh. w6rk for whth rhis Fmi is is$.d. My wortss oqicnsarion insumm. fficr ard rDlicy number @:
WARNING: Failurc r, scur. sorkcs comr..saion corBBc
civ'l linc\ up ro om hundftl thnusantl dottm lSlOO.OoOr, ,n
is untnwf!|, 5nd sh,ll subis an .mplorr ro clniral Ittunis &d
n lo lhc .o{ oa.ompensation, dlelcs as provided for rh.::.rl+t/r :
I hc'ciynlltnrndcr pcMllyofpcrJurr rhnr I rn ti.ctr{it !nrlcr p.visi(r .f Chrprcr g(c.nnNn.ng wirh Scclion 7fiX)) ot Divi\nrn j
.l rhc Bun.c$]trd ltoLssttrNCodc. oi nytf,.n\c i\ ir,ir| ror.c ril.fic.r
CONSTIIII('TION LENDINC ACFNCY
I hcrtylrlimund.r frtultr.f rcrjry rhar rhcrc is a €onsflcri,n lcndins a8crcy ror rhc p.rformrcc orrhc $ork fq *hich rnn t*rmn nis{rd (Sec -1097. Civ C ).
APPLI('ANT I)I'CLAR,{TI0N
I l*rt'y r0lnn utrd.r r.nalrt ofF,jury oR orrhc nnbl,nrS d&tralions
Dcmolirion Pcnnirs Arhcnos Norificliio. FcdcrrtRcpuldn,.\ (Tirlc 40. p!n6)
R.qdied llrlcr of Norifrsriotr
-l
ccniry rhat thc ltdcml r.Fhrioni EBrdine nsb.slos rcmvd r. not uppticlbtc lo rhis pmjEl
I .cfliry fi31 I h!v. rcad this cpllt.rio! atid star. rhor rrE ltow inaormiio. Lr .oir..l. I lgE to 6'irl, eith aI Cny md CoxnryordiE.ccs lnd Srar. bss El,ting ro huilding n.,6c ncrcby lurtsda rq"csnlllivcs oflhh ciryaod Cotnrylo cnr.r upoi rtE,bore m iomd ptupcny fo. insp.clio.
Applic! or !.nlSlsNlu 4r!O
Gas-Underfloor
Building Sewer
Gas Pipinq
Rool Drain
Main Drain/Pool Pipinq
Miscellaneous
Sanitary Sewer/Cap
Rough Plumbinq
.-
lo
I\nicy Nunrh.r:_!xnnc\: _
_l.cnifyrhurinrhcpdfortunccoirhcworforu.hichrhnFnniri\ixsuc.Irhr norcnDloy,p.r$ninanynun.crv, ro b.om shF1 torh.rorkcB compcnsli()n tnw\ot'Crtifoi[ia. nd r8rcclhatit I str)utd hc&m \ubjccl r;rhe.dcr! conucnsiim pmltiatrs olSc.rion.lT0Oofrhc hhr Codc. tsh.[. tunhrirh c..dy wirh rho$ Irovisions..
Li.cn\c Closs Li.dnsc Numh.r
Drl. . Conrmclor
tr.dcfs A.ldrss: _
T?DVryT
I\4AYOR
lvliguel A. Pulido
I\,IAYOR PRO TEI\,1
Michele Martinez
COUNCILMEMBERS
P. David Benevides
Vicente Sarmiento
Jose Solorio
SalTinaiero
Juan Villegas CITY OF SANTA ANA
PLANNINC & BUILDINC AGENCY
20 Civic Center Pleza
P.O. Box I988 . Santa Ana, California 92702
www.santa-ana.org/pba
NOTICE TO 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 ^ I t - o t
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 INFORMATON
DIRECTIONS: Read and initial each statement below to signify you understand or verify this information.
1l' L 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 prope(y. 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.
2. lunderstand buildi ng 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.
T-t-\. 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.
L1_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.
lf 5 I understand if I em ploy 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.
-/)' lI-A. I understand if I am considered an "employea' under state and Federal law, I m ust register with the state and
federal 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.
-.-tt1-!--1. 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
CITY MANAGER
Raul Godinez ll
CITY ATTORNEY
Sonia R. Carvalho
CLERK OF IHE COUNCIL
I\4aria D. Huizar
mpu doaosanla-ana.oro
Mayor P.o Tem, Ward 2
mrma.line2@sanla-ana oro
Vice.te Samienlo
vsamrenlo@sanla€na.oro isolorio@sanla-ana oro dbenavrdes@sanla a.aoro
Dear Property Owner:
Juan villegas Salli.ajero
Wad 5 Ward 6
rvilleoas@sanla-ana.oro slinaieroosanta-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 Contrailor.
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
nancial or personal injuries sustained by any subsequent owne (s) that result from any latent construction defects in the
workmanship or materials.
{t_5. 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 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.qov for more information about licensed contractors.
'T/ rc
G6 p"rtv
address:
I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am
leg all v and financial responsible for sed constr ction a ivity the fo owrng
€,
Tf:t .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.
{flZ. 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.
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 per mit. /Voter A copv of the property owner's driver's license,
form notarization, or other tion acceotable to the aqencv is required to be ted when the Dermit is
issued to the owner's s natu
Signature of Property Owner lt Dale: /c a
Print name of Owner S
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
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 lo the agency is required to
be presented when the permit is issued to yerify the prope,Ty owner's signature.
ir,:-i:: ;:--:Ar r,n:::":,a i..:':.:::"--..-..: --i) :!-."i
SANTA ANA CITY COUNCIL
moul do@santa-ana oro
Mayor Pro Tem Ward 2
mrmanrnezrAsanla-ana.oro
V ce.te Samrento
vsarn e.loosa.la-a na oro EgL9!.s@!e!&:e!e4!s
P Oavid Benavldes
dbenavides@sanla ana.oro ivirleoas@sanla-a.a oro sli.a e.o@saoia ana o.a
Address of Authorized Aoent: