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Home My WebLink About20165932 - Permit (2)City of Santa Ana Permit Counter: (714) 647-5800 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Electrical Permit #: 20165932 Pin #: 814{9 l nspection Requestsr 17 1 4) 667 -27 38 l nspector Section: (7 1 41 647 -5853 Proiect Address: 3020 S Fairview St Unit: B Block: NA Bldg: Address Range: Tract: WILLIAMS Historic: No Suite Range: Zoning: MlAssessor'sParcel: 414-192-03 Lot: POR 4 Owner: Address: David Ly 3020 S. Fairview Street Unit B Santa Ana, CA 92704 (714) 966-6608 Sea Reflection, LLC 01116002 0'l 1 16002 01 1 16002 01 1 16002 01 I 16002 5160: 5160: 51603 5160C 5'160: Fee Type Amount Qty Fee 125 Volt Receplacle 1 .4o 1 .00 $1 .40 Light Fixtures 1 01 '1.00 $1.01 N.4in Fee Adj 68.23 1.00 $68.23 General Plan Update 21.25 1.00 $21 25 lssuance 52.98 1.00 $52 98 Phonel Tenant Name: Contractor: Address: Owner-Builder State Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance Carrier: Policy #: Expires:' uenerol Plon Updste teâ‚¬r_r1116002- 5l60ru(ru_ I lectr ico] '.r1116002- 51603t:r00_ I,.:l_ Check 2tt2l9? Building Use: Job Type: Nature of Work lndustrial Miscellaneous Outlets/Fixtures Occupancy: Constr Type: Code: F-2 V B, SPK cEc 2015 Notes: Receptacle outlets, light fixtures, per occupancy notes Owner-Builder form on file. Planning Conditions Planning Approval By: Plan Checked By: Permit lssued By: Subject to Field: Building Permit #: Chavez, Dave Dale: Date: Date:0512212014 Account# lvlisc. Receipt: Misc. Receipl: Misc. Receipt: Total-yC' Every pemit issuod shall become invalid unless the wo* on lhe sile authoizod by such pemit is commenced withinlS0days aflet its issuance, ot if the wo* authotized on the site by such pefinit is suspended or abandoned fot a period of180 days after the lime the work is cofifienced $144.87 $0.00 s144.87 lnspector MID#: 2018-'143507 0'1'116002 51600 01116002 51603 $21.25 $123.62 Fee Total Paid to Date: Balance Due Phone: APPROVALS DATE ID/SIG.COMMENTS Underground Pole Bases Light Standards Spas, Pool, Fountains Signs (monument) Life Salet y /Low Voltage Fire Alarm / Dampers Communications Cable Building Under Slab / Floor Bondin g/Grounding/UFER gtr)?r? Transformers Torqueinq Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Rough) Ceilings (Hard & Soffit Rouoh Ceilings (T-Bar Rouqh) A Rough e-291y v.vh.d Service Meter FINAL s-29-tV VtLld Notes, Remarks, Etc UU OWNER BUILDI,R DELCAN"{TION I hercby ,rrm uhdcr p.ndry or p.rjury lhd I d cicmrr riom rhc G,nrmcroB Licensc tiw lor rhe tollo*ins Esv,n (ss 7031.5 Btsinc$ snd Pn,fesion Cdc) An) Cily or Coutrry whi.h ..rtuncs a Frnrir Ir) .onstdcr, alt.., nnprorc. {,crclish nr rc03n atry srtucrum, Plbr r. iri nsuatu.. rl{ rcqun s rhc ,rplicant for suh pc.nr ro nle a si8red surcnrcnr rhar h. or shc licen*d pusurnr ro rhe pNvisnrns of thc Contmclor's Liccnscd L.w (Choprcr 9. Conmcn.nrB vith Scclion ?otx) ol Diviion 3 oflhc Busine$ snd Piolcsi(NCod.)orrhdrhcor\h.ndcmprrhcrcnonrondrhclxshforlhculkscdcxcryrion.AnyviohrionofScrionT0ll5byany lppli.rnr roraFmir sxbj.crsrh. rmli.,nr r. acivilpâ‚¬nalrrofnol mrcthan filc hunded dolh. ( $500). *;:;oknDr ofrh. F,!cny. or my cn'floyccs,irh u8cs rs rhct snc $nncNdi,rr. +illdo rh. sort onl rhc (elurc is nol oro,turcd for sL lSN.7U{4, Burin sc dtul Proltssions Cnic -fhc Conra.nn \ I-tcn\c Ir* dr{\ tun ryf,ly rJ an uwNr ol rhc pDncny {tb builds or im,mrcs rhcNr at vho drs rNh kir* hinMlf or hcrsclior lhmuBh hn or hcr owncmplolccs. ,rrovidcd rhrr st.h impmvcmnk m nor inrâ‚¬nLd or olitEd 16r $h. lt hourEr rhc building or inDmvcflrfi h sokl wirhin onc ro of.ofrphrin rhc O*ncr Buildcr *ill hlw llE ttrrdcn of pmving rh{ h. or shc dil mr huit or in{(*r thc l)n)Fny fttr rhc nuqns of l. \otrmr.r'hcpn,I.ny.n .r.lusirtly..ntKii,r! $irh licen\cnconrrxcb^bcoi{tucr rhc p(),ccr (s& 7(}rJ, Bn\inrs uxl lti,icssio, Codc lhcConrrrclolsLiccnscLDwdocsnoraflrlyro osncrorpn)Fnywhohuikkori'ntrovcslhcrcotr. rtrd who co.rrich r(tr s&h pn,jNh wirhrConhrxn(s) licenscdpu^uinr rorhcConrrdor'\ l.iccn\c l-u*) I '<-PTz"Lka DICLABAIII.IN I hcrchyllinmundcr!.nrllyof pcdlryoncofrhcrbllowinSdccl dioN: -l hrtad will minllin a Ccnincatc ol Conr lo Sclf.ln\urc ror wo'kds conqrcnslion.0s nrovidcdlorhySNri.n1700oflhc hbor (ndc. for thc lcrlbrmrmc ofrhc w.rk fo. whi.h rhc p.rmn il issucd I hrrc rnd*illnBintrin *.rkera compcnsarior insurnncc. !s rc{tund hyScdi.n.l?(xrorlhc Lahor Codc. li)r rhe Frf.nmncc ol rh. lork lbr whichrhs pcnnil i\ tsu.d My wortcrr conrt--nsrri({ nsunnrccrris. Fni.y Nnrbs r. PnlryNumbn- trl'rc\ Vccd'b rhd 'n,he ntrli''tuilc "rrhr srrl n{ \hi.h rh's r.m'i n r\ucd. rlharrnorcDrpk,y rny p.Nnr rn rny mncr(:,\if6io ",uhlc.r hrht tr oAc^' c.n'tcn{irr rr L*\. rc.'l,hln'r. un,lrsN rr. rlI.thuk }rc.rm.uhrccr r.rhr wort.s .onrprn{(ionpmvisionsolScdn'n37(xJolrhc LnhnC.dc. I shrll h$irh conrply s,ilI llu\c |nrvi\iox IY,\RNIN(; Iixilurc k, \.curc *orl(l^ (onlrn\]li{n, .olc'rgc i\ trnL\f .lvil tur\ !F n, onc hr drcd lhou\rid zc,!V-noo,, L&MiU!aNTAA(1AA l2[!IdBdrIoN I hcrbr rl1]!, undc. pcnahyolpcrjury rlur I trm licosc(lundcr lmrisi(nr ol'Clnpr.r I ol thc Busiric$a Pr'lc$ions Codc.0nl nry li.c sc is nr fullhrc.nMcllNr Contdtiorl IONIIIBUEI]OIIENI)INI;-AIiIICI I h.rch, lrfirm undcr Fulr, ol pcljury ri rh.rc is a con\trucrirn Icndins lscnc, fu rhc lr.rrolru.c. .l rh. *ok r.r shih rhis l.rnir is issucd (Scc -1017. Ci! C ). AfIUCANLDECI.AXAIIIJN I ho$, anim udcr pcnalty oI rdr ry oe 6r rhc lbllo*ins d(hrut ions Dcmlirn,. Pcrnih'Asbcsros Nolilicllion lcdcrol RcBuhlions Ont 40, PanO) -R.q!iEn bttcr of Norifrarin -l ccnilrrhir rhc icdcral rc8ullri{n'\ r.ludin8 a\h.{o\ rcmrvrlxrc nor rnfll.rl,lc k) ihi\ nnjrcr mli..:ll*l I tuvrtu,l rhnrtlnli.rri(,r i\comd I rgre ro.onrly with 6ll Cityand County ,cF.*nrnriws otrhis Cnyand Counrt lo cnrs ulrn ur Jk,vc nEnli(,ncd pmpcny Applicnnt nr Aeent Sigtrstrm r"*iI* ,"*" rpa'o,K G\/ J t *,"'@elk' ELECTRICAL.INSPECTOR RECORD Site-Work lvleter Release Lrnd.l' Addrcs - MAYOR Miguel A. Pulido MAYOR PRO TEM Michele Martinez COUNCILMEMBERS P. David Benavldes Vicente Sarmiento Jose Solorio SalTinajero Juan Villegas INTERIIV] CITY MANAGER Cynthia J. Kurtz CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar CIry OF SANTA ANA PLANNING & BUILDINC AGENCY 20 Civic Center Plaza P.O. Box I988 . Santa Ana, Californla 92702 www. santa-ana. orq,/ 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 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. U--,1 , understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" building fermit 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 llnancial 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 forthose 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. V , , 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. U 1- S t understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect myself ffom potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. \)-o I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on Permits and contracts. 5. lunderstand if lemploy or otheMise engage any persons, other than California licensed Contractors, and the total valueof my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. D{ U ' understand if I am considered an "employer" under state and Federal law, I must register with the state and federal gbvernment, 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. D\/ Ul-7 . I undersland under California Contractors' State License Law, an Owner-Builder who builds single-family residential sfutfures cannot legally build them with the intent to offer them for sale, unless a// 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. C\/jl!+. t 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 owner(s) that result from any latent construction defects in the workmanship or materials. SANTA ANA CITY COUNCIL moulldo@sanraâ‚¬na oro Mayo. Pro -rem. Ward 2 mimarlinez@sanla ana.oro Eorono@santa an6 oro P Davrd Benavides dbenav des@santa-ana oro villeoaslosa.la-ana o.o stinaiero@sanl,a ana orovs.m enra6sania-ai..ro I \_,0 le0ally an address: I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party d financ ly responsible for proRo sed construction a at the followi ng Z o -LlappICa 1. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all ble Iaws and requirements that govem Owner-Builders as well as employers. X 12. t 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 Ilnancial loss you may sustain as a result of a com plaint. Youronly 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 flrm is injured while working on your property, you may be 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 Iicensed 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 pe te: A copy of the property owner's driver's license, LofrlD notarization. or other Yerification able to the ,s siqnature.r/r-^/ur-Signature of Property Owner Date /7 PERTY NER'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 pmject. 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 pe4ury that I am the property owner for the address listed above and I personally frlled 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 ink:'!'V P51 i CounterAct vllylAssernblyB illsr Nolice to Properly Form SANTA ANA CITY COUNC]L moulrdo@sanla-ana oro M3yor fto Tem. Wad 2 mrmarline.@sanla-ana oro Vicenle Sarmienb vsam e.lo6sanla-ana.oro isgLqls@$-d4slElrg dbenavidesrosanla-anaoro v eoasrosanla'anaoro slr.aero@sanla-araoro \]-g. f understand lmay obtain more information regarding my obligation's as an "employer" from the lnternal Revenue Service, the lyn'iied States Small Business Administration, the California Department of Beneflt Payments, and the Califomia 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. Print name of Owner I