HomeMy WebLinkAbout10195988 - Permit (2)EProject Address: 2111 1/2 S Maple St
Assessor's Parcel: 403-154-04 Lot: POR 2
Bldg: Address Range Suite Range;
Zoning: RlBlock: L l racl 284
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CAT27O2 Building
Permit Counter: (71q A47-5800 lnspection Requests (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 1O195988
Pin #: 93456
Building Use:
Job Typel
Nature of Workl
Existing Bldg. & Use
Proposed Use:
Single Family Dwelling
New
ADU
SFD Watt garage
Description of Work: ADU attached to detatched 2-car garage
Planning Conditions:
1 st FL Area
2nd FL Area
Other Areas:
Garage Area
Total
lncludes (1) bedroom, (1 ) bathroom & kitchen. Auth on file.
Occupancy:
Constr Type:
Code:
Flood Zone:
# of Stories:
R-3, U
VB
cBc 2016
x-0602320276J
1
390
390
Patio:
T.l.Area:
Yards Req'd
Valuation: $42,510.00
Owner:
Address
Phone:
Tenant
Tuan Doan
2111 S Maple Street
Santa Ana, CA 92707
(7141837-2251
Archilect i
Desiqner:
Address:
Midway Arcs Architectural
Toby Nguyen
14832 Monroe Street
Midway City, CA 92655
Contractor
Address.
Owner-Builder
Engineer
Address:
TMC Engi
Tien Chu,
neers
P. E.
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policy #:
Expires:
Phone:
License #:
Phone:
License #:
Services
17 1 4) 251 -2490
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
Fire lnsp. Req'd: No
Police lnsp. Req'd: Yes
Flood Zone Cert. Req'd: No
No
No
No
No
Orozco, lvan
Chehade, Nabil
Zuniga, Allissa
Dale: 0412712018
Dale. 0412612018
Date: 05/11/2018
Subject to Field:
Misc. Receipt
Misc. Receipt
Misc. Receipt
0 7116002
0 71160 0 2
o 717600 2
i 73 7300 2
a 890100 7
47776002
07776002
07776002
Account#
70768
Total
5160-1 Permit Fee
53600 Plan Check Fee
5 7770 l.4icrofilm Records
5799i Res. Dev. Fee - S/E
24o00 SMIP , Category 1
51672 Bld}. Stds. Revolving
57600 Genetal Plan Update
5150I lssuance/New Structu
$450 00
$550.00
$21.72
$3,206.86
$5.53
$2.00
$21.25
$141 32
$4,398.68
$550.00
$3,848.68
Evary petnit issued shall become invalid unless the work o, lhe slte authorized by
such pemil is commenced within 180 days afler ils issuance ot if the wo* au:hoized
on the site by such pefinit is suspended or abandoned fgt a peiod of180 days after
the tine the wotu is commenced
lnspector MID#: 20'18-142058
$21 .25
$591.32
$2.00
$21.72
$5.53
$3,206.86
Fee Totat
Paid to Date
Balance Due:
0'1 1 16002
01 1 '16002
0'1 1 '16002
01 1 16002
ofi901001
31313002
51600
5 160'1
51612
57770
24000
57991
Unit:
Historic: No
lnc ion i
9542 Pacific Ave
Anaheim, CA 92804
(714) 829-s053
72324
BUILDING- INSPECTOR BECORD
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Sublloor/Vent/l nsulation
Roof Sheathing 71plr9 1t0-*9
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Flood Zone Certil
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FINAL t0l tb I t, 7,Dln^qP '?2)
Certif icate of Occupancy I I a ['v
Notes, Remarks , Etc ,A
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COMMENTS
lxnde' \ Addrcs
z. P.t?-r,
MAYOR
MiguelA. Pulido
I,4AYOR PRO TEIV1
Michele Martinez
COUNCIL[/E[/BERS
P. David Benavides
Mcente Sarmiento
Jose Solorio
SalTinajero
Juan Villegas CITY OF SANTA ANA
PLANNING & BUILDING ACENCY
20 Civic Center Plaza
P.O. Box I988 . Santa Ana, California 92702
www.santa-ana.orgl pba
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 2ilt ("A-r,a-c+ q/ 70
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 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.
q-/ 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.
-J--+'U- 2. 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.
-W-3. I understand as an "Owner-Builder' lam 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.
-ffi O I understand Contractors are required by law to be licensed and bonded in California and to list their license
nurnbers on permits and contracts.
,,1
ff-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 ($500), including labor and materials, I may be considered an
"employer" under state and federal law.
LU ,understand if I am considered an "employer" under state and Federal law, I must register with the state and
federal government, withhold payroll taxes, provide workers' compensation disability insurance] and contribute to
unemployment compensation of each "employee." I also understand my failure to abide by these laws may subject me to
serious financial risk.
-r+W 7. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family
residential structures cannot legally build them with the intent to offer them for sale, unless a// work is performed by
SANTA ANA CITY COUNCIL
mou doaosanIa-ana oro
Mayor P.o Tem Ward 2
mimartrnezrasanta ana oro
Vicente Salrn enlo
samEnbaAsanla-an6 oro i!9lqio@$da:a!4q9
P. David Benavides
dbenEv des@santa ana.o.o ivilleoas@sanla-ana oro stinaie.o@santa ana.o.o
ACTING CITY MANAGER
Gerardo Mouet
CITY ATTORNEY
Sonia R. Carvalho
CLERK OF THE COUNCIL
Maria D. Huizar
licensed subcontractors and the number of structures does not exceed four within any calendar years, or all of the work is
perf/ormed under contract with a licensed general building Contractor.
,l--' U: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,--S 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.
10. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am
the party legally and financially responsible for proposed construction activity at the following
address:
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.
fulZ.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'
compensation insurance coverage.
Before a building permit can be issued, this form must be completed and signed by the property o\rvner and
returned to the agency responsible for issuing the p ermit. Note.' A copy of the propertv owner's driver's license,
form notarization, or other verification acceptable to aaencv is reouired to be oresented when the Dermit is
Signature of Property Owner Date: O<.10
Print name of Owner
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 Ille the documents necessary to obtain an Owner-Builder Permit for my
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 propedy owner's signature.
SANTA ANA C{TY COUNCIL
mou do@sa.ra-a.a o.o
Mayor Pro Tem, Ward 2
minarilnez@sanla-ana orq
V,cente Sarmienro
vsarme.ro@sa.la-a.a orq isolorio@sanla-ana.oro
P Oav'd Benavdes
dbenavdes@santa 6...orq iv eoarAsa016-ana.orc stinaiera@sa.ta'ana.ora
issued to verifv the propertv owner's sidnature.