HomeMy WebLinkAbout20166044 - Permit (2)City of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical
I nspection Requests: (7 14) 667 -27 38 I nspector Section. (7 1 4) 647 -5853
Permit #:20166044
Pin #: 93OO7
Proiect Address i 2401 N North Park Blvd Unit.
Block: NA
Btdg:
Tract: 425
Address Range:
Historic: No
Suite Range:
Zoning: R1
q
Assessor's Parcel: 002-063-28 Lot: 152
Owner:
Address:
Garrett James
2401 N North Park Blvd
Santa Ana, CA 927061510
(7',141422-5388
01116002 51603
01116002 51600
01 1 1 6002 51 603
Fee Type
Serv Meter
General Plan Update
lssuance
Amount
51.29
2',125
52.98
Qty
'1.00
1.00
1.00
Fee
$51.29
$21.25
$52.98Phone
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone
Pnt,:h+:441r-rq - 6
0ff ice: (:TYli T
.\--!lrHl-l-L?'
Rcn t *: fl1r287{ i +
Trnnsn':t ion Tot nState Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
nr'rett Jomds
Senenql Plari Urdc';
U1 I l6Ull2- q! 5firlr-rirrr
Ele,:tr irnl
ul 1 16t:r0?- .51 5rl:'rtrl
t/isn
(:(:+: r*r+rll**r*r i.
Building Use:
Job Type:
Nature of Work:
Single Family Dwelling
Miscellaneous
Serv Meter
Occupancy:
Constr Type:
Code:
R-3, U
VB
cEc 2016 Notes: Upgrade/handoutgiven.
Planning Conditions:
Planning Approval By:Date:
Date:
Date:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 180 days after its
lssuance, or if the work authorized on the site by such permit is suspended
or abandoned for a period of 180 days after the time the work is
commenced.
01 1 16002 51600
01 1 16002 51603
$21.25
$104.27
Fee Total:
Paid to Date:
Balance Due:
$125.52
$0.00
$125.52
lnspector MID#: 2O18-143735
E
06t04t2018
Account#
APPROVALS DATE tD/stc.COMMENTS
Site-Work
Pole Bases
Li ht Standards
S FountainsASPool
monumentSins
Lile Salety /Low Voltaqe
Fire Alarm / Dam ers
Communications Cable
sBuildin
Under Slab / Floor
242-/\^Bondin / Groundin / UFER /2fu/D't
Transformers
Sub-Panels
r4t /t9 t
Facto Wired Unit
Ceilin hSHard & Soflit Rou
Ceilin S T-Bar Rou Dbl/rt
Rou h
Servrce [/eter u/v//k z 5ri/1k bt--
Notes, Remarks Etc.
FINAL
OWNER BUIT,DER DELCARATIONI ncrcby amrnr utrd.r pcndlry of Frjury lhat t 0'n er.mpr tmnr lhc Conkr.b^ t_iccnsc Uw ror rh. r.tk,sin8 Easn (Scc 70.115
Borincss a.d Prof.i\ion Codc): Any Ciry nr Count, which rcq ncs B lEmil ro con{ncr. lttcr. inlrovr. d.mthh .r mpoir any
sld.luE. priorlo iIs irsu,ne- also rcquncs dc atplicmr fo! such pcrnrir b tjte e sisncd slalcnEnr rhd hcor she k ticctrkd pursuanr
x, rhc ptuvi\i.n\ ofrhc Conlm.rocs Li.ensed L{w (Chdprcr 'r. Commcncing wnh s..inrn ?OOO ot Divnion I ofrhe Bu\i.e$ otrd
Pmfcsiotrscldd)orthlthcorshch.xcdptthcrciron,ndrhcbnshiorlficrtlcgcdcxcrtrion.AnyliotaliotrofS(lbn70.1t.5hya.t
,ptlicanl ioraFrnh slbjccls rhc 0p0lic, k, u civil txtr,lry of nol mrc rh fivc hn.drcdd6ths (3500)
-l-
0s owncr.athc pmpcny, or mycmplorlcs wirh waScs !s lncn qnc.o.rl).n\dn,i, si d. rhe wmk {Id rrr dmn,rc h sn
nrdnded or ofrcr.d ror salc (Sa 7(x,1. Busincs snd Piof.siors Codc'rhc Codrn rors Li.cnsd lj* docr nol opply k, d.srcrot
rhc tDFny wlF huilds or nnpmB rlimn. !ft *tr dms luch slk hinrcltor hcFelt or thrcu8h hh ur her orncmploycus.
Providcd rhar such imprNtEnk e mi inroxlcd or otrlrcd for sak. I t h.welcr rhc huitdin8 or i,rpr.snrni ir $nd *nfiin o.c ,roroftunl{llcriotr- I hc Owmr Buildq uill hrr rh. hurdcn ol pnvine rhar hc or shc dil mr bdu ni iq,mE tlrc fmtEry fo hc I,!lTn{ ot
-1.
owncr ol rh. ,)tul.ny, ! rxclusircty.onklcring wirh ti..nscd (onrnrlon ro otrjtu r rhc llmF.r ( Scc 7O1-t. BunR\srl llofcssi Conc thcConrra.tofsLi.coscL0sdou\i.rslptyr.ano*mror,rropcrly*hobuitdsorimrrovcsrhcrcorand who conrrrcts ror such f,mrccF wnh r conr"crorlg lircn*d poFum kj rhc Contridor's l_i.cn{ Lrw)
I r crcnrpr undff Sccr
D.lq OpD.r:
won<rns, coupexsarrrrn
DECI 'rn,llloNI hcrcbt arhrmon{jcr !cn0h, or rrjury onc or'rhc nrbwins dstarariotrs
l-nhor co,lc. nr r[( t).rronnrkcolrlr *ol tur shi.h ih. ]r.,trnr a str.d
rh. qork rnr trhi.h !h\ trm rt\ i!s11 lrlrso,[rr\'.,{npcr.rrr]ri,Nr,)D..(,tr1(rntrdlrti.rnunrh.rxr(.
-l
c.nilyrhar in thclttrrormrnccofrhe wort for shth lhh p.rnrn is hsmd,I rhr| nor cmptoy dnypcrs,n in (ny monrcr
vr s to tEcom iuhF.r h thc eon(c,s con{bsarion l.ws orcrtitorn[ and r8rcc rhd itI choutd lllTorrc suh]c.r ro rh.sorkcn conDctrsr'ion pmvtionsolSerion l7O0afrhc tibr C{ c,I shnt. iorihwnh ennpjy $ irn thos fmvhions
IVARNIN(; Fi'lhtrc r, r.urr (ork.n .o[Dctr\rrirnr i)v.r,rg. i{ trrlr$,1t. rnd n t {,h]c.r I cnrtnortr ni cri'ninrl riirrics ,ndcilil fincs u, 16 dm hutrdrcd lk,utrnd dollar (o{ conDensarion, dmEger s\ pmlidcd for rhc
s.criqr 1016.r rhr tnti{ (i!t.
!2l:L!:1.8.!Ur2:
I hctoh) lllflItrnrlc' It rlrroftrrturyI (contrnr c a wirh Secrion TlXIr olI)ivi\i0i.]
ol lhc Btrsi,rN! rtul Pdtsbn\ Codc. ml my licctrsc is in roltftre ai clf(r
I hcrchy rllnr undcr pctrrlly.fpcrlury rhar I n,.ri lc nrg i!cn.r- f{tr r pr orirutrcc ofrh. so for shich rhis pcnnn L\
i$u.d (Scc 109?. civ. c).
L.ndcrs Nnnrc: _
APPI I(]ANT DFCI ARA]'I(IN
I hoE{'y afm !.dcr p€nslry.i trrjury one ot lhe foll.wins drlamrions:
Dcmolirk,n Pcrmils.ash.nos Norifi corion tcdfiat Rcgrlllions (Tirlc 40, paa6)
-Rcquied
Lexcrol Norifi carir
_l ccdilithd rlrc rcdcralrcsul ir rsEsardina0shcslo\rcnxrvularcmr.f0ticrbtchrhi\ptr+cl
-,."0n,u,'f.n. ^,r,n^,nn,'.',,,r(]ndr\n.rlhr L,tr" Rti r," hur,\rnr
FE Fiyr,rm\nN,nn
Applic!nl dr Ag.naSlsnatup
lhc lt.vc inroirn nnr i\ cotrcd I r8rd b.o'nplywirhnllCiryrnd Cuunry
.urhorir. Eprcscnr ivcs ufrhn Ciry od Counryro cnl.. up.n rhc
^'t!9il wa.5
*,.1"/+/LK
ELECTRICAL.INSPECTOR RECORD
Underqround
t _6)
Torqueinq
V>oaAir Conditioners ',6)
Boof Top Equipment
Walls (Conduit)
Walls (Rouqh)
h)
Ivleter Release tt-L-
ACTING CITY I\4ANAGER
Gerardo Mouet
C Y ATTORNEY
Sonia R. Carvalho
CLERK OF THE COUNCIL
l\4aria D. Huizar
CITY OF SANTA ANA
PLANNING & BUILDING AGENCY
20 Civic Center Plaza
P.Hox 1988 . Santa Ana, California 92702
www.santa-ana.orglpba
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
improvements specified at 1 /I.41T) p |arE PJvd
W,
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 ACKN WLED MENT AND VERIFICATION OF INFORMATON
DIRECTIONS: Read and initial each statement below to signify you understand or verify this information.
l'l/> 't I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder"
btilding 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 sustalned 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.
2. I understand building permits are not required to be signed by property owners unless they are responsible for
nstruction and are not hiring a licensed Contractor to assume this responsibility.
W ,. , 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 Coniract,or and having the permit filed an his or her name
instead of my own.
4. I understand Contractors are required by law to be licensed and bonded in California and to list their license
um bers on permits and contracts
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 federal law.
iXAU' 6. I understand if lam considered an "employer" under state and Federal law, I m ust register with the state and
federal government, withhold payroll taxes, provide workers' com pensation disability insurance] and contribute to
unemployment compensatlon of each "employee.' I also understand my failure to abide by these laws may subject me to
ser s financial risk
7. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family
residential slructures cannot legally build them with the intent to offer them for sale, unless a//work is performed by
SANTA ANA CITY COUNCIL
moLr do@sa.ta'a.a.oro
Mayor Pro Tem Ward 2
mimartinez@sanla-ana o.a vsade.lo@santa-anaoro isolonorosantaana.oro dbenavrdes@santaina.oro ivilleoas@sant6-ana.o.o snnaero@sanla-ana oro
I\,4AYOR
N,4iguelA. Pulido
I\,IAYOR PRO TEI\,I
Michele Martinez
COUNCILMEI\,4BERS
P. David Benavides
Vicente Sarmiento
Jose Solorio
SalTinajero
Juan Villegas
licensed subcontractors and the number of structures does not exceed four within any calendar years, or all of the work is
pe med under contract with a licensed general building Contractor.
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 subsequent owne(s) that result from any latent construction defects in the
workmanship or materials.
f.;\V Lg. 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.oov for more information about licensed contractors.
h_A'
l) / rc.I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am
i6e party legally and financially responsible for proposed construction activity at the following
address:
CA 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 OwnerBuilders as well as employers
t<1U J 12. 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 liabte 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 Dropertv owner's driver's license,
ton or other a able to the to be ented when t,
the owner'.
Signature of Property Owner ,^,., bf4llK
Print name of owner 6q(*.h
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
,ollowing 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.
ScopeofConstructionProject(orDeScriptionofWork):
Project Location or Address
Name of Authorized Aqent:
Address 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 req uired to
be presented when the permit is issued to Yerify the properly owner's signature.
SANTA ANA C TY COUNCIL
moulido@sanla-ana oro
Mayor Pro Tem, Ward 2
m marl nez@sa.la-af,a oro vsame.lo@sa.la-ana oro i!98!9@Ed!:?!a,ers
P. David Benaudes
dbenavides@sanla-ana.oro N 1 eoas@sanla-ana.ora srnarero@sanla-a.a oro
Phone Number of Authorized Agent: