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Home My WebLink About10194881 - Permit (2)q Project Address: 2806 W Brook St Assessor's Parcel:'to9-7 41-22 Lot: 130 Unit:Bldg: Address Range:Suite Range: Zoning; RlBlock: NA Tract: 4025 Historic: No city of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CAI27O2 Building Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853 Permit #: 1Ot94881 Pin #: 26777 Building Use: Single Family Dwelling Occupancy: R-3, U 1st FL Area: Job Type: Reroof Constr Type: V B 2nd FL Area: Nature of Work: Reroof Code: CBC 2016 Other Areas: Existing Bldg. & Use: SFD w/att Garage Flood Zone: X-0602320256J Garage Area: Proposed Use: # of Stories: Total: Description of Work: Tear off existing roof material and install new comp shingle roof material. Owner-Builder form on file Planning Conditions: Repair any damaged, eaves, rafters, fascia prior to final approval. Patio: T.l.Area: Yards Req'd: Valuation: $5,000.00 Handout given Phone: Tenant Contractor Address: Owner-Builder Engineer Address Jose Enriquez 2806 W BROOK ST Santa Ana, CA 927041508 Phone: Slate Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance Carrier: Policy #: Expires: Phone: License # Architect / Designer: Address: Phone: License # 9:161.5t1 $1,ttLr Planning Approval By: Plan Checked By: Permit lssued By; NPDES lnsp. Req'd: No PWA lnsp. Req'd: No Planning lnsp. Req'd: No Landscaping lnsp. Req'd: No Orozco, lvan Dale:1112012017 Date: Dale:1112112017 Subject to Field: N,4isc. Receipt NIisc. Receipt l\,4isc. Receipt 07776002 51601 Permit Fee 01776002 s7672 Bldg. Stds. Revolving 01776002 51500 General Plan Update 07775002 51501 lssuance $1.00 $21 .25 $52.98Chavez, Dave ?,?, Fire lnsp. Req'd: Police lnsp. Req'd No No Account#Total Flood Zone Cert. Req'd; No Every pernit issued shal becone invalid unlessthe work on the sile authorized by such pemit is commenced within 180 days aftet its issuance,ot if lhe work aulhoized on the site by such petmit is suspended ot abandoned for a period of 180 days after the time the work is commenced . lnspector Fee Tolal Paid to Date: Balance Due: $383.75 $0.00 $383.7s 01116002 51600 01116002 51601 01'116002 51612 $21.2s $361.s0 $1.00 Owner: Address; 11,/jt,rjrili I Tiorr!-+ ! 3li LRNsALES 1 (if II I irl $308.52 MID#: 2017-140066 BUILDING. INSPECTOR RECORD SITE-WORK DATE ID/SIG.COMMENTS O\I|'NER BUILDER DELCARATION I hdeby amm md6 Fnahy of prjury lhal I m .r.mpt ftom lhc Co ra.ro6 Li.d3. Llw ao. lt followins rc$n (5(.7031 5 Busin*s and Prolsion Codâ‚¬): Any City or Counly which r.qutrB a Fnil ro .onslruct. 0h6. imprcve drnolBfi or (pat .n, srrucrue prior to ils issus... also r<un6 rhc arplican' for sch Fmh to filc a signcd statmdt lhal h. or 3h. b licscd ptrBtranl ro rh. FovGions oarh. Conkacior's Liccnkd Lsw (Chapl6 9. Codncn inE Nnh sdiion 7000 of Division I of lhc Busin6 and Protsioos Cod.) or Ihar hc or sh. is crcmpr thd.6om dd rh. b4G aor th. all.B.t ermplion Afly violation o f Sdion 7011.5 by 8nt ,rrlic!.r ror , p.mi slbjc8 rh. applicmr lo a civ il p6.hy o anor more tha fivc fiu.di.d dolla ($500) }}tl "qns "hhc Fopdr). or ny .hplo)G *hh *t86 s rnct sk ompâ‚¬@lioo, *ill do lhc \6rt nd rn inrlE b nol imddcd orolId.d lor eL (Sd 704,1. Busins d Prof6sions Code Th. Contactors Li.as. t wdoBnotapplyloano*ndol rher,lFny reho bilds or ihFsrB rho6( ed wno dG Mh a,l hins.lr or h6dr or rhmuSh his or ha opn .mploy6. prolid.d rhsr sr.h inpmldnflls m aol inlqr&j or oilEed ror elc. ll rave6, fi. hrilding or imprevoc, is $ld *ilhin on. yw or conpunn. the OMo Blildd will Mw th. hrl&n ofFoving lhd h. or shc did rel buiu or idFov. fi. F.Fly aot lhc BrFs of L s oNnd oarhc propcry. m â‚¬rclusiv.ly co racrinB snh Ucd!.d .oita.'o6 'o coNrud Ihâ‚¬ prej(l {Se 704.1. Bams and Pllusion Code: The Contr.ctois Liccffc Law do* not apply lo an oNnr 6lprop.n, *ho builds or implov6 rhs.on, ,nd Nho conImds lor such p.ojdrsvirh. Co rad.(s) Iicas.d puGodi lorh. Co raclois l-ic.e lai) I m crcng und6 Sdion "s',I l-zl-10r?,,-.".-A ) DECI,AAAUO! I h6cby a,lim urds poalry of paju.y .n. ofrh. follo{ in8 d{ltrarioB ! h.v. md will n.inrair r Câ‚¬nrficarc of Const lo S.lf'lnsue lor tr$rlm- .ompd$tion. 6 previded tor by Sdrion 1700 o f lh. Lrhrr Codâ‚¬, aor $e pdfomance of lh. woi( tor vhich lhc p6nil G issucd. I havcand rvill mainraia workdt co'ntc.sarion insuranc.. ar r.quircd bySeclio..1700ofthc Labor cod., for rhc pdfom.nce of Ihc vorl for *hich rhG rierhir is ilsucd My work6 conp.Bdion iBurmc. carir and Flicy numbd dc: Policy Numbq --- Eryircsl \ 4"Liry rl'd i" rh. p.6,-anc. orrlE work ror which rhis pmir is isued.l shallnor nplo, any p6sn m.ny ndns $ 6ro bc.omc subjcr ro rhc Nrt6'cohp.n aio. laws of califomir. Md aer lhal ifI should bdom. subid to ih. Norkm' conpastion pNvi.ions of serion 1700 oarh. khor Code, I shall. fonhwilh comply wiih lho$ lrovisioos WARNINC: F6ilorc io Kur. wtrt6 .onp.nsalion covdlg. is unl,stul. d shall subid d oploF ro nninal Fnahi6 and cilil fin.s up to onc hund,Ed thoGud douad (5100,000). in rddnion lo lhc cosl olcompsslion. daBa86 as pro\id.d lor rhc Srrion 1076 ollhâ‚¬ khor (bdc, inr6.d ed diom.y\ fc l)-Lt-1oq x ,t-, L^.1 !,rcErsELcoNraaclla DECI,ASAI.IaN I h.ftby aLm undd tftall, of pdjury lnal I m licas.d undâ‚¬. pr.vi.rioo ofc.naprd 9 (comacing with Scclirn ?0o0) ol Dirision l ol Ihc Busin* dd Pof*iom cod.. ed my licâ‚¬e is in full forcc d cfi*l CONS'I'RUCTION LENDING ACENCl I I'cEby amm undcr p.nally o I pdjury lhd lh6c is r connrucl iof, lcndins asocy for lh. pdfomm.. of Ihc $ork fo. Nhich rnis ldmir is iss!.d (56.109?, Civ C.) a.tt1.tcaxlD[ctdf,alla! I ho4 aftn uidn p.nalry of pdjury on. ot in. followir8 d.cl&atio.s Dcmolilion Pmils-Asb6los Nolilica(ioh Fcddal R+u lal iom (Tnlc 40. Pan6) Requn.d lirr6 of Noifi @ion I .dify rhrt $. f.ddal r.gulalions Esardins 6b6tos roov.l Ec nol alpli.abl. lo this pmjd ) Aairr ua I r, " .-a rr,is aprlicarion and srarc rhar rhâ‚¬ atovc inrom.rion n coft.d I agr* ro conply vnh au city .nd cormy ordin.ncs.nd Sht. ries rcLrins ro buildinE co.sttuclion. ed hr.by althortc rcpredtotivB ofthis Cny a.d Counlylo di6 upon dE aho\ e menrion.il prclrny lN applicrtrr or Asenr Stniru..L\.r I I -2t'1ot1 os e-ir.J 4. { -,k) Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Subfloor/VenVl nsulation IL Roof Sheathing ul\r A 's Shear Wall ul Framing lnsulation/Enerqy Drywall Ext./lnt, Lath Brown Coat Masonry Pool Fence T-Bar Handicap Req. Deputy Final Report Engineer Final Report I I b@ B Certificate of Occupancy Notes, Remarks, Etc _, nfll A Flood Zone Certif. FINAL Licmc \ats Co r..lor _ t-+- dc-34- I\,IAYOR MiguelA. Pulido I\4AYOR PRO TEI\.4 Michele Martinez COUNCILT,4EMBERS P. David Benavides Vicente Sarmiento Jose Solorio SalTinajero Juan Villegas INTERIIVI CITY N,4ANAGER Cynthia J. Kurtz CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar CITY OF SANTA ANA PLANNING & BUILDING AGENCY 20 Civic Center Plaza P.O. Box 1988 . Santa Ana, California 92702 www. santa-ana. oro / oba 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 ZbO6 t tJ - B noon c_l_ 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. J{ 1. lunderstand a frequent practice of unlicensed persons isto have the property owner obtain an "Owner-Builder' building permit that erroneously impliesthatthe property owner is providing his orherown laborand 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 ljmits of my insurance coverage for injuries to workers on my property. ) ' a 2. I u nderstand bu ilding permits are not req u ired to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. J"Lg. f understand as an 'Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential flnancial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. J-'f C. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. J3I S. funderstand if I employ or otheMase engage any persons, otherthan California licensed Contractors, and thetotal valueof my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employei'under state and federal law. J-4-U. , understand if I am considered an "employef' under state and Federal law, t must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation of each "employee." lalso understand my failure to abide by these laws may subject me to serious financial risk. J tt- l. t understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential -skuctures cannot legally build them with the intent to offer them for sale, unless a/i work is performed by 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. ) :"-A. I understa nd 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 owner(s) that result from any latent construction defects in the workmanship or materials. SANTA ANA C1TY COUNCIL nourido@sanla a.a oro Mayor Pro Te.n Ward 2 m marti.ez@sanla-a.a orc vicente Samienro vsamrento@sanra-ana oro solorio@santa-ana oro iv{e9es@sad!:a!aa!9 slinaiero.Asanla-ana.oro P Dav d Benavrdes dbe.avides@santa-aoa.o.o J_.L g. t understand I may oblain more information regarding my obligations as an "employer" from the lnternal Revenue Service, the United States Small Business Administration, the California Department of BenDflt Paynrents, and the Calilornia Division of lndustrial Accidents. lalso understand lmaycontactthe California Contractors' State License Board (CSLB) at 1-800-32'1-CSLB (2752) or www.cslb.ca.qov for more information about licensed contractors. lâ‚¬, O. , 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 followingaddress: 7.QO6 w. lSnogk e -J-' J ., 1 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. JLl2.lagreetonotifytheissuerofthisformimmediatelyofanyadditions,deletions,orchangestoanyoftheinformationlhave provided on this form. Licensed contractors are regulated by laws designed to protect the public. lfyou contract with someonewhodoes 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. Youronly remedy against unlicensed Contractors may be in civil court. ltisalso important for you to understand thatif an unlicensed Contractor or employee ofthat individual orfirm is injured while working on your property, you maybe held liable for damag es. 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 responsibfe for issuing the permit. Nole: A copv of the propeftv owner's driver's license, form notarization. or other verification acceptable to the aqency is recuired to be presented when the permit is issued to verify the propeftv owner's sianature. Signature of Property Owner \')Date il-2-l-'Lat7 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 Location or Address Name of Authorized Agent I declare under penalty of perjury that I am the property owner for the address listed above and I personally lllled 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 property owner's signature. PL in k:\i, P5l iCcunterAclivilylAssemblyB iils:l'lctice ic Prcseily Fcrm SANTA ANA CITY COUNCIL moul do6sa.ta 'ana oro Mayor Pro Tem, Ward 2 mi6an nez@santa ana.oro Mcenle Samieno vsarmrenbras6nla ana.oro 6olorio@santa-ana.oro P. Oav d Benavides dbenaudes@sanla-ana oro vrlleoaslasanla'ana oro sl naero@sanla-ana oro Print name of Owne, \Ose Zxf-rtl,rEZ ScopeofConStruCtionProjeCt(orDeScriptionofWork):- Address of Authorized Agent: Phone Number of Authorized Agent: _