HomeMy WebLinkAbout10296351 - Permit (2)q
Project Address: 314 N Bewley St
Assessor's Parcel 198-18't -07 Lot: 33
Unit Rldg: Address Range
Tract: 546 Historic: No
Permit #: , 029635{
Pin #: 79397
Building Use: Single Family Dwelling Occupancy: R-3, U 1st FL Area: Patio:
Job Type: Alteration Constr Type: V B 2nd FL Area: T.l.Area: 1,142
Nature of Work: Remodel - n/v Code: cBc 2016 Other Areas: yards Req,d:
Existing Bldg. &Use: Sfd Wno garage Flood Zone: X-0602320256J carage Area: Valuation: $45,OOO.OO
Proposed Use: Sfd w/det garage # of Stories: Total: 0
Description of Work: Remove unpermitted work & convert unpermitted duplex back to sfd, add laundry room, relocate bathroom; remove unpermitted
patio cover & unpermitted accessory structure.
Planning Conditions:
Owner:
Address
Phone:
Tenant:
Contractor
Address:
Engineer
Address
Rey Reyes
625 The City Drive South, Suite
lul0nge, CA 92868
(7141 2064048
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
N
Phonel
License #
Architect /
Desiqner:
Address:
Phonei
License #
xavier Oesiqn Group
Xavier Hernandez
4481 Pondmoor Drive
Riverside, CA 92505
(9s1) 830-2018
Planning Approval By
Plan Checked By:
Permit lssued By:
NPDES lnsp Req'd:
Flores, lvan
Ahangian, Kathy
{[ '"'n"nou'' ^utn'
Date; 05/31/2018
Date: 05/30/2018
Date: 05/31/2018
Subject to Field:
l,4isc. Receipt
L4isc. Receipt
l/isc. Receipt
o7776002
07776002
0777600 2
017760 0 2
017760 02
017760 02
011760 0 2
017760 0 2
Permit Fee
Plan Check Fee
Microfilm Records
lnvestigation
Penalty
Bldg. Stds. Revolving
General Plan Update
lssuance
70929
Total
57607
53600
57770
57607
57601
5 7672
57600
57607
$308.52
$427 .72
$32.58
$93.17
$234.08
$2.00
$21.25
$52.98
PWA lnsp. Req'd: No
Planning lnsp. Req'd: No
Fire lnsp. Req'd:
Police lnsp. Req'd
No
No Account#
Landscaping lnsp. Req'd: No Flood Zone Cert. Req'd: No
Every pemit issued shall become invalid unless the wotu on the site authorized by
such pemit is commenced within180 days after its issuance ot if the wotu authorized
on the site by such pemit is suspended or abandoned for a period ofl80 days after
the lime the wo* is commenced
lnspector MID#: 2018-143194
$21 .25
$688.75
$2.00
$32.58 Fee Tolal:
Paid to Date:
Balance Due:
$ 1 ,172.30
$427 .72
$7/14.58
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CAg27o2 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Suite Range:
Zoning: R2Block: NA
I
01 1 16002 51600
011 16002 5't601
011 16002 51612
01116002 57770
BUILDING- INSPECTOH RECORD
SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDER DIiLCARATION
I hcrcby a{ljlnr trndcrycnohy oi pcrjury that I { cxcmpr irorn rhc Contrdrs Liccnsc L!* li,r lhc ioll.winE rc,v,n (sct7o.]l5
Bu\inc$ and ltol!$n,n Cqlc): Any Ciry or CouDr, wnich rcquircs r Frmir b consr .i. alrcr- in ovc, dctrnli.h m rcNn dry
nrudurc, pritr k, ii\ i\suamc, also rcquircsrh. rppli.Mr n' suchFrnrir ro fi|., \i8ftd n.rcnrnr rhar tEor sh. is liccnscd nur$anr
ro rhc lrelnions ofrh. Co.rructn s t-icenscd hw (Chflcr 9. Gnlmrcing *ith Sccrion 7tm.f Divi\ion I of rhc Busincs rnd
Pdtssnrns Codc)orrhrr h.orsh. iscrnDr ih.r.fofra.d rh. hnsi\ fff rhc dl lcecd cx. mpr ion Any violariorolScdion 70:11.5 hyany
qrllic.nt lor r tE,nil subj(k lhc amlicanl lo tr.ivilpcn.[yorno( nbro dm nvc hunded dollrs ($500).
-1.
as o*ncr of rhc prop.ny. (, my en]Pk,rEs silh *ages ar rlEir slc comFtrsDrinn. will d. rlt work nid rtr {u_rm i\ mt
i[c Ii or ollcrcd for slc (Se ?().l-1. Busincss and PrDf.sione C.d.: rh. Contrrctof s Liccrsc tjw docs nor mtly b !. owmr oa
rhc pmr.ny whr hnilds or inpmves rltm( md who d*s skh srk himselfor hcr*lforrhroxlh hi\ or h.r o*n cmtloyrcs.
fioridcd ihar such inrmErnt m mr inrcndcd oroiaEr] for$k l[ howcvcr ihc hildina or inlpmrcmnr i\ c,ld wirhin onc ,cr
olcon{ndion. thc Ow.cr auikln will hNc lhc burdcn ol prorir8 tlur ht or shc did nol lDild or improlc thc pml)ely for lhc puqx,sc of
-1.
$ owmr ol rhc trcpcnr, amcxclusivclyconr&rirg sirh li.cnkd.onracrorsro consrructltE prorst (Scc 701-{.l]ulmss
rpn EDtssi,n Codc:'l hc Conrra.ttr \ I-iceisc Lr* do.s nolutply to !n owncr offlopcdysho buildi or imtRxt\ rhcrcon,
! pho conrrick for such Drrlrls wilh 0 Gnlmcro(, liccn*d ,,usuaflt to rhc Gnbacrofs Lkcnsc Lo* )
I iDrcxcnrpr utrd$ Sccrtu . B. &
slrr\16
I hcrcbtdltlrNutrdcr,r ahyofl.rjuryoncofrhcfolk,*ingdc.lrarn,ns
lhaccarxlwilluinrai'raCcnificar.otCon*nrroScllltrlur.titrqorkc'sconf.n\ati(,n,*ln)vidrdr.rhrSc.rn]7fi)olrhc
litxtr Cnlc- &r lhc pcrn,roncc ot rhc {ork f{n * htch rhe p.rmil is issucd
I hrvc rnd vill nini'nrin wo*cr! .onlrtr\dn in\ur ..c, n\ rcquncd byS.crn lTO0orrhc bh.rCodc.lbrrhc pcrlorrunccol
rhc *ork inr whnh rhis l)c nril is istrd. Mr w.rkc( otrrp.0srri, iNurrncc cnricr nnd tElicy.un$.r sc:
l.cd,fy rhrr in rhc pcifonmndc.i rhc sork for whi.h rhil l)(rmir i\ rsucd. I shnll mr cmplo, ufly pcr$n in atry nEnncr
$ ns lo bc!!,E sul,jcd lo lhc $orkcrl conrren{rion lasr ol'CalilnrniL and osB rnrl ill fi{,rld lEqor suh.r..r ro rh.
wortcn compcn\nrion pmvnionrolSdn,n:l7a{)ofrtc hhtr C.ic.l shnll. tunhwirh.o'nply wirh rho$ lmvisn'ns
WARNTNC: I'iihtrc b scurc workcs' compcnsrlior .ovcroAc is unlnrr'Irl. anl shrll Nbjccr un cNplorcr b dihinrl pcnahi.s trd
civil fitrcs uD Io oN nundrcd Ihousrnd dolhs (Sl(D.ooo), h ddJnh lo rhc..i olconDcns&li{}o- ddDE.\ Ds tio dcd r.' rh.
S.cli{r 1076 oflhc tjbor C'odc, irrcrc( and nllorNy
I hrrch, !finD undc. r.nallyoftEUury lhlr I anr liensd udcr tmvision olCh{prcr 9 (ommnci.8 *i'h S(rbn 7uJ0) olDivhio l
of rh. Auiimssa l Pmfesiors Codc.8nd my lic.n* G in tullld.. url ctLcr
E0NSIBIJCIAIXINDINGTIQDN!.I
I hcrchy ainn undcr Fmllyoirrjury lhd th.rc is a conshclirn bndina rscncy irtr itu pcrtunMncu orrhc work rar Rhich rhk Fflni t
is\ucd lsc. 30r)7, Civ. C )
A"PILICANLIECIABAIION
I H,, afrim undcr p.nahyofpcrjlr, one otrhc a.lr,wins dNlamli.ns:
O.Nni'ion P.rnrirsAstrstos Notific!tion icdcral RcSularions (Tirlc.l0. Pan6,
Rcanircd Lclror ol Norifi .{1tun
-l
ccnify rharthclcdcralrc3rkrions rcgarding lshcnos rcwvul arc norrppli.nhlr tu rhis tmr..t
l..nifyrhxrlhrrcrcddrhirrnpi..rn,nd krc rh.rrhc rtxrc i'itu n oni\conccr Io8rero.onDlyqirhlllCiryandCouniy
.rdmk$ iM Sr c tias rchriDB lo buiklnC cotrsnRrnn\ md hcruby rurhorizc rcfcscnrolirc{ ollhk Cily ond Counr, b enrd rF,n rhc
rbovc nrnrioncJ nn'mdv f in\m iondm*\
noru.-,*n**,."*'* f\Z- /Z
Pem,.?nome(prin,': (q{,-"/"/, /-trr5
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
SublloorivenVl nsulation
Roof Sheathinq
Shear Wall
Framino g'r'(9 .TNP2
lnsulation/Energy {,-7- tx,flJ,A)
Drywall 44-rs l,r.Vl)
ext.linl) Latr $"as, -rg i)rb)
Brown Coat
fr/asonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
FINAL Pluafi,n\he,/
Certificate of Occupancy I U I
Notes, Remarks, Etc
Flood Zone Certif .
C.'E"'
l itr I ro
L.rdeir AdnEls:
-
o*,, s lzt lrc
--------r------
I
MAYOR
lViguelA. Pulido
MAYOR PRO TEM
Michele Martinez
COUNCILMET\,'IBERS
P. David Benavides
Mcente Sarmiento
Jose Solorio
SalTinajero
Juan Villegas
ACTING CITY I\4ANAGER
Gerardo Mouet
CITY ATTORNEY
Sonia R. Carvalho
CLERK OF THE COUNCIL
Maria D. Huizar
CITY OF SANTA ANA
PLANNING & BUILDINC ACENCY
20 Civic Center Plaza
P.O. Box 1988 . Santa Ana, Califotnia 92702
www. santa-ana.orq / 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 jtq u B.t,u l-t+ s I
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.
lau 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. lrly homeowneis 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.
/),
Y' Z. 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,
kL 3. I understand as an "Owner-Builder" Iam 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.
ld/ o , understand Contractors are required by law to be licensed and bonded in California and to list their license
numbers on permits and contracts.
t/ 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.
ZL U. , 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
unemployment compensation of each "employee." I also understand my failure to abide by these laws may sub.iect me to
serious financial risk.
lr' l. 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
mpulrdo@santa-ana.oro
Mayor fto Tem, Ward 2
m manrnez@sa.ta-a.a oro
Vrcenre 53rnienro
wamiento@saola-ana oro bolono@sanla-a.a oro
P. David Benavides
dbenavrd6@sania ana.oro rv eo?s@sanla-ana oro sr naiero@san1a 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.,L//- ' L l understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any
fin-ancial or personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the
workmanship or materials.
ff 9. I 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.
/:l' 10.I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am
responsib le for con5L struction activity at the followingthe party legally and fina
address:
nciall pr
.-v
,//,1. 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.
f // 12.1agree 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 perm it. /Vote; A copv of the property owner's driver's license,
form notarization, or othet verification a cceDtable to the aqencv is reouired to be sented when the Dermit is
issued to veri the owner's n
Signature of Property Owner Date: s f lt I to
Print name of Owner (, n",o Pt,t. z
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 the prope(y owner for the address listed above and I personally filled out the above
information and certif,/ 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 propedy owner's signature.
SANTA ANA CITY COUNCIL
D!qldql@!aflla ana.oro
Mayor Pro Tem Wad 2
mimartinez@san1a-a.a oro
Vrcente Sarmienlo
vsam enlo@sanla-a.a.oro i!g!qi9@$d!:a!3.p!g
P. Davd Benavdes
dbenavides@sanla'ana.oro -.'l'aqe\lara !d !40 q "lldreio6,dnlc.a-a o'