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Home My WebLink About10193944 - Permit (2)Cify 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: (7141647-5853 Permit#: lO{93944 Pin #: 125lJ1 Project Address: 1921 E Garneqie Ave Assessor's Parcel: 430-222-12 Lot: NA Unit: G Bldg Address Range: 1901-1921. Historic: No Suite Range: Zonang: MlBlockr NA Tract: NA Building Use: Job Type: Nature of Work: Existing Bldg. & Use: Planning Conditions: Commercial Addition Addn/Tl/Roof Mtd Equipment lndustrial/Offices Occupancy: B, S-1 Consk Type: V B Code: CBC 2016 FloodZone: X-0602320279J 1st FL Area: Patio: 2nd FL Area: 1083 T.l.Area: 3374 Other Areas: Yards Req'd: Garage Area: Valuation: $159,000.00 Proposed Use: # of Stories: Total: logg Description of Work: Add 2nd floor mezzaninerstairs with offices, storage, & 1-restroom (1 ,083 sf). Tl to comblne Suite(s) G & l,l. Nely interior part create offices & 1-restroom on 1st floor (3,374 sf). SAUSD #3904. F(cpt+; l]2.15', Trqn5q,.L i r'rn I 4: 1 PBr-; i Owner: Addressi Owner-Builder Engineer Add ress lvy Geng 1921 E Carnegie Santa Ana, CA 92705 (949) 445-2435 UM Media Phone: State Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance; Carrier: Policy #: Expires: AQX Engineering Qiang Xiao 1520 Brookhollow, S45 Santa Ana, CA 92705 (714) 562{510 5289 AQX Enginâ‚¬erinq Qiang Xiao 1520 Brookhollow, #45 santa Anai cA s2705 (714) 662-0510 $J r151.,/q $7. r:rr Phone: License # Architect / Desiqner: Address: Phone: License # Planning Approval By: Plan Checked By Permit lssued By: NPDES lnsp PWA lnsp. Req'd ezeshkp , Ati 07176002 07116002 07776002 0 890100 7 07776002 07776002 07776002 $1 ,210.47 $2,576.72 $36.20 $44.52 $7.00 $21.25 $141 32 $4,O37.48 $2,576.72 $1,460.76 o Date: 1011312017 Misc. Receipt; 7016'1 Oalet 0112412018 Misc. Receipt: Date: 05/07/2018 Misc. Receipt: Subject to Field: Account#Total 51601 Permit Fee si600 Plan Check Fee 57770 Microfllm Records 24000 SMIP - Category 2 57672 Bldg. Stds. Revolving 51600 General Plan Updale 51501 lssuance/New Structu n B ki, Teri No NoPlanning lnsp. Re Landscaping lnsp. Req'd: No Flood Zone Cert. Req'd: No Every pennit issued shall become invalid unless the wo* on the site authotized by 6uch pemit is cofinenced wilhin 180 days after its tssuance,ot if the work authorized on the site by such pormit is suspended ot abandoned lot a peiod of180 days aftet the time the wotu is commenced. lnspector MtD#. 2017-138228 01 1 16002 51600 01 I 16002 5160'1 01116002 51612 o1116002 57770 08901001 24000 $21 .25 $1,351.79 $7.00 $36.20 $44.52 Fee Total: Paid to Date: Balance Due: Phonel Tenant: Contractor: Address: Fire lnsp. Req'd: No Police lnsp. Req'd: No BUILDING. INSPECTOR RECORD SITE-WOBK DATE IDiSIG. Forms/Steel/Holdowns VMErection Pads ,/a UFER Ground t- I t u? SLAB Floor Roof Sheathinq ^?4ry",{Shear Wall (l>11[E lr ll ,t I IA.,L.iFramingtl)YIrB T ,Y t(.raf d^^uitl ',-"I{lnsulation/Energy I \)l utapblt)Drywall I ?, Ext./lnt. Lath /t L Brown Coat Masonry Pool Fence av4<,4-T-Bar r$I .)/ Handicap Req uv Deputy Final Report Engineer Final Report Flood Zone Certif '^tqer'J,FINAL t6ltq 1i ?9./ Certific ate of Occupancy yl Notes, Remarks, Etc (,WNER ITUILDER I)EI,('ARA'IIoN I hcrch, rrirm und.r Fnrlry uf pcrjury rhar I d crcnDr fronr ihc Conrmha Li...\c Lnw fur rhc nrbwirg !cr$n (Scc 7031 5 Ru\nhs md Pmf.\siun (-.dd) Any Ciry or Coufry which !.quircr r tknn[ h .onsln.r. rlrcr. nn[otr. dcnrnhh or rcIan un, slrucrurc. lmrlo i* (surrcc, rho rcquiic\ thc rffli.rnr r(r\u.h lf inil t,lilc. siSrrd starcnrnl lhrr lror shc is liccn{d Phuxnr n, rhL p'ovi\nrnr ofrh. Conkrkn\ l-ic.n{d Ixs l('hr0rr 9. Coarnrncin! *nh Sc.rion 7(XXr of Oivision:1 .ilhc Busin.* !.d PmfcsronsCoc)orrhrrhco.shclscx.mJ'rrh.rcrronmdrhcl!\i(ltrlhc0llclcdcxcnrplion Anyvi.llrionofScciii,nT0ll.5hydiy trpplicrnr l'or a pcmit suhjecls lhc !npliconr ro acivilpcnnnyoinor mrcrhin rirc huidrcddolhN (55(x)) l. $ osi$ or rhc phlEd!. or nry cnDlo,rcs n'i'h $n8cl r\ rh.i. vnc cotrlnctrslrirnr. will no rtu {ork uxl rh. dtuiur. i\ ioi i'ncRl.ll ororitrcdhr$lc(Ss7(lilt.Buli'rcl!xndl}lncsiqNGxlc:lh.(innrncttr\l.i.c$t.rwdocsnoramlrlornowrErof rhcpnrFrry wlfu hu ilds or nnlf.h\ rlEfrnr. .kl qho dNl \u.h ur hirn\cli.rhc^cllorrhroughhkorhcro*n.h!hy.c\. nrovidcd I hrr such i.,r,mwnrnh rrc Rn inrcndcd or.lT.ftl lnr $h ll h.r cv.r. rhc hiHinâ‚¬ or imIn)vcnf,nr i\ q'kl wirhir , tr'c ) cir olmnrflclion.lhc Owncr aurldc. sillh{rc lh. hunlcn ol !tuvirS rlDl }r or shc did m'l [nik or improvc rhc p'orcny fitr rhc PtrrFJ*uf -l..sown.rol rh.Fopc,ry.0mcrcnrilcly.onrricrir8 sirh li.ctr\cn.onrrrcrocro.on{tuci rhe pnjc.r (sd 7(ll,r. Btrnncs\ rirl Pnfc$ rCodc Th.Cntrta.tr'il-i.cnsc I-r{ dor\ ior qrplrh rtr.w cr ol rn,F.dyBho htrilds or imlrovcs rhcrcon. rnd sho conr is for suchl)rojccrsw(h0Conrracktrls) licctr*d nlNulnrrorhe(onr,acroi! l-iccn\c li*) 7r/7 I hft.hy 3f,ir undrr n(nrlrrof D[rt x{ua! I-ihr Ci)dc. fir rlcNrliinn rcollM$ork Lrshihrh. ncnnir i\ i{uci rhc *ork ,nr which rhi\ n ,nir ir n\uL{ ^1ts.rkrs-r. rfoi\ rtrnr iNurdn.c.mis n F,licy trtruh.r irc l.cnili rhrr h rhc p$nnnnn.c ofrhc tro!k hr wh'.h rlns 1rrtr!ir is t{rc(1. I sIrll nor cflnloy rny p.^otr n, dny nrtrkr $ tr 6 t'cconE n,hrc.l lo llrw.rkcis conulnsllion h*\ol (alili,nritr. nd lgcc rhnr if I \hould hccorft \ubj..l n) rh. norkch comnctrsrrionpnrkions.,Sccri.nlT(x)ofrhclnhorCoc.lsl ll, n,nhsirhconrplr $ihrk,t Pn,visions I(Xr.(lXr, h dilidr h lhc ..\r ofconrncn\rrin. drnHrc\ as fn'rid.d fo' rhc:::r[#(3 Ihcr.bytrfirflutrdcrpcn0llyoarcrjuylhllIrnrliccntnundcrFnvhionofChaprd9(.onrkitr!wirhsc.tion?un).il)ivhiool of rhc Bu(in.$ Md Pdasior$Codc. aM rnylicctr\r is in tull lorcc.nd cfllcl CA!fl8I]qT9!I,ENUINC.AGINI:I I h.toby affir'n trnd$ p.nalryorl.rjury rhd rhurc n r.on{ructi,,n hndirg r8cft, for rlrc p.rlofluncc olrhe sork f(n which rhk Frmir i\ tsucd rsec 109?. Ci! C ) AITUCINLIEIIIIBAUqN I hcrc{ry llinn undcr rcnslry ofpcrj'ny nrc ol ihc ldlk,winr dcckrdrn,ns: Dcnmlirion PcrnrirsAstE(os Notificorion [cdc(l Rcsulurions (rirlc 40. Plna,r -Rcquncn l.ttcr ol Nolilic.rion l.ral i.Suhrion! rcB&din8 ishc{or rctrxx.l rrc nor ryplico6l. rhnrpplicirionlxl(arcrharrhc.novcinr'onBrion hcoro cl0riry to huildiu cotr{rucrioo. rrd hcrcnynurhorizc rcrcw .r lrgri! r).on,tl! (nh xll( ir rirn.\ olrhn ( ir! rnd ( o!trr\ .>.w COMMENTS Set Backs Sublloor/VenVl nsulation Lc crs Addcs -121rc -T------ MAYOR MiguelA. Pulido MAYOR PRO TEM Michele Martinez COUNCILMEI\4BERS P. David Benavides Vicente Sarmiento Jose Solorio SalTinajero Juan \4llegas CITY OF SANTA ANA PLANNING & BUILDING AGENCY 20 Civic Center Plaza P.O. Box 1 988 . Santa Ana, Califo-nia 92702 www.santa-ana.org /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 ACTING CITY MANAGER Gerardo Mouet CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL l\,4aria D. Huizar improvements specified ^, l(Zt â‚¬2 ,s 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. - 4 I I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" builifing 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. 442 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. 71q5. I 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 Contractor and having the permit filed in his or her name instead of my own. ZAC. I understand Contractors are required by law to be licensed and bonded in California and to list their license numUers on permits and contracts. 71lS I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total \ialue 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. 1/l/-q 6. I understand if I am considered an "employer" under state and Federal law, I must register with the state and fedetal 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. f47 . I understand under California Contractors' State License Law, an Owner-Builder who builds single-family residbntial structures cannot legally build them with the intent to offer them for sale, unless a// work is performed by SANTA ANA CITY COUNCIL mouirdo@sa.ta-ana.oro Mayo. Pro Tem, Ward 2 mimarlinez@santa ana.oro vcenle Samiento vsamienlo@sanla-ana.oro isolonc@sa.la.ana or0 dbenavrds@santa ana.ora ivilleoas@sanla-ana.oro slinaiero@sanla-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 Contractor. Z fi na ncta . I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any I or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the f/t /z.rr workmanship or materials. / LrB. I understand lmayobtain more information regarding myobligations as an "employer'' from the Internal Revenue S6rVide, 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 informalion about licensed contractors. ),GlO 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: 2 {^ll I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all apblicable laws and requirements that govern Owner-Builders as well as employers. =hlZ.l agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the ii-forniation 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 owner and returned to the agency responsible for issuing the permit. Nofe.' A copv of the propertv owner's driver's license. notarization or other verification table to the en ts when the it is th owner's natu Signature of Property Print name of Owner ,,h c:Lt t 6â‚¬4^4 Owner Date -JAUTHORIZATION 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) POect 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 ,illed out the above information and certify its accuracy. Property Owner's Signature Date Print Name of Owner: Note: A copy of the owner's driyer's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the propeiy owner's signature. . i-,r,!: t,-i:i :1-, ly !.:j.,:.: _i:: .. r.-. -. i. rr :r',_ | . - : :' ;..' a SANTA ANA CITY COUNCIL moulido@sants-ana oro Mayor Prc Teh. ward 2 mimarlrnez@santa-a.a o.o V cente Sam ento vsam ento@santa aoa.oro isoloriolosanta-ana.oro P. DBvrd Be.avides dbe.avides@sanla ana oro srnarero@sa.la-ana orovrl eoasiasa.la-ana oro Address of Authorized Agent: