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Home My WebLink About20165921 - Permit (2)City of Santa Ana Permit Counter: (714) 647-5800 \ 20 Civic Center Plaza (M-fp), Santa Ana. CA92702 Electrical Permit #: 2lJ165921 Pin #: 76536lnspection Requests: (714\ 667-2738 lnspector Section: (714) 647-5853 Project Address: 2105 W Flora St Unit: Block: NA Bldg: Tract: 3679 Address Range: Historic: No Suite Range: Zoning: Rl q Assessor'sParcel: 412-397-04 Lot: 2 Owner: Address Ramon Ramirez 2105 W Flora St Santa Ana, CA 92704 (714t 317-1425 01116002 51603 01 116002 51600 01116002 51503 Fee Type Serv lvleier General Plan Update lssuance Amount 5'l .29 21 .25 52.98 Qty 1 .00 1 .00 1 .00 Fee $51 .29 $21.25 $52.98Phone: Tenant Name Contractor Address: Owner-Builder Phone Building Use: Job Type: Nature of Work Single Family Dwelling Miscellaneous Service Meter Occupancy: Constr Type Code: R-3, U VB cEc 2015 Gâ‚¬nerol Pl(rn Updof,e ttl 1 16U02- 916u1-[-lur]- Electr icol t'-rl 1 l6L"ru2- 5 l6lr.liuu- naster C(rd (:t+ : **xrrx*r**rr /8 te t-t Notes: handout given Planning Conditions: Planning Approval By: Plan Checked By: Permit lssued By: Subject to Field: Building Permat #: Hernandez, Kathy Date Date Date 05t2112018 Account# Misc. Receipt: Misc. Receipt: Misc. Receipt: Total Every permit issued shall become invalid unless the wo* on the site authorized by such permit is commancod within180 days affet its issuance, ot if the wo* authonzed on the site by such pemit is suspended or abahdoned fot a peiod of 180 days after the tine the wofu is commenced. $21 .25 $104.27 $125.52 $0.00 $125.52 lnspector 01 1 '16002 5'1600 01 1'16002 5'1603 State Lic #: Lic Type: Bus. Lic #: Workers' Compensalion lnsurance: Carrier: Policy #: Expires: 8rrt,:ht:43981 Llff i,:e: (.1Yl Ar,:ti: Rcpt.iItrr;6ij: Trqfisort l0n - \/ tI/ lt lttj fr(tns+l lJ fiiei + t:1 . :.,1'i! i?tl lotq I Ro or R$fi rlez Fee Total: Paid to Date: Balance Due: MID#: 2018-143480 ELECTRI IINSPECTOR RECORD APPROVALS DATE ID/SIG.COMMENTS , Site-Work Underground Pole Bases Lioht Standards Spas, Pool, Fountains Siqns (monument) Life Safety /Low Voltaqe Fire Alarm / Dampers Communications Cable Building Under Slab / Floor ra Bonding / Grounding / UFER 6- il-ttr Transformers Torqueinq Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Rouqh) Ceilings (Hard & Soffit Rouoh Ceilings (T-Bar Rouoh) ,FAl\ileter Release 6-lz-ttr 7-\j Rough ,A Service lvleter (o:-tt"IY FINAL ClLzltg _ Notes, Remarks, Etc OWNDIT AUILDER DELCARATION I hcrcby 0fllrm under pcnalty of Frjury rhal I mcxcm nom rhc ConrrrroF Liccn$ Law ror rh. follosin8 E$otr (S(.?o-tl.J Busincs lnd Pmfcssio. Codc): Any Ciry or Count, shich rcqliE\ a tcdir b cun(rucr. .xu, inprovc. dcnrelish .r rcnut Jtry srrucrurc. riorro irs tsulncc- !l$ requt \ rhc arplicrnr rdr su.h lErmir b fiL a siBk{ narcnrnr thal hc o, châ‚¬ is lid,hcJ lu*umr r Io lhc ,)mvnions or lhc ConlEctois Li.ersd Law (Cndttcr e. Comntnci'ls wirh s.ction 7(xx) of Divhion 3 oflhc lrusincss ond Prolcssiotrs Code)or rhlr t(or shc kcrcdfl rhcefon.&l rhcba\is ror rhc.llct.ncxc'ryrirn. Any violllionol Ssri,n Ttill t hy trny applicrnrturaFrnrir subh.rs ihc appli.ddl ro a.ivilpcndltyornor mrcrhin livc hundrcddolloG ($500). -1. as owncrofrhc nrolEny. or my cmnln)es * h {!3.\ al rlrr sk ompfn{Lon, wrt do rh. *""," t* *.a* t. *, inredeJ or ottcrcd lor slc (Sft.7o!,4. AusiBs nnd Prclcsions Codc Thc Contnckr's l-i.cn\e l,,e do.s..r amly ro.n uqrcrof lhc pmpcny wh, huiids or iDrl,n'ks rlrEln. and ulb d(E srch u)rk him\clfo. h.nclfor rhmlCh iris ot hcr ow.cnPloy.c\. tovidcd rh0r su.h impmEmnls aE mr inrcnd.n ff oaar.t ,or sh lt hotrcw, rhc hoildinS or imlmvcm is {'rd wirhitr o.c )lu ol coqihrt,n. dc Ower Auiuci *ill h0!. 'tr huni.. or p Jving rhd tE or shc dil mt hoiu or iqrot lhc pDp.dy ror rrr N4B* ol _l-!\ownerotrhcpopcnr.dmdrclu\ircly(ntacringwirhlic.n\cd..itrr.!ntocoonruclrhcrojc.l(S..7Or4,Btr.ir(s .fi1 Phfdli Codcr ThcContacror'( Liccis. Low do4 mr.,rplyro rnorncr.lri{,p. ywho build.or im,rrorcs rhclmo- s.d *ho conrructntr \u.h tniccB wnh , c(,rn.tn( s) liccnkd puhu4n rorhlConlrocroi\ l.i..n\c l-rw). I rmcrc inr u drr S..ridr ( Irr.(I.i-utMu I hcrehy rllirm undcr ptnrlr!otI}.rloryonc ofrh. r(,1k,$nig d.clrrtrrtr \ Ihivcondwill'mnnainrCcnirtolcoaC.n*nlroSelllnsulcnrworkcB conr!.nsdion. !s Pmvidcd f(rhrs..rion1700olrhc tjtitr crxlc. ror rhc FJroiiMmc of rh. uoik for uhich rh. pcrmil is issued _l havc alldsillnuinrrin *orkcn .onrFnsdrbn insurrn..,,a tuqutcdbySccrion.lT(x)ollhclihorConc.rorrhcFtr.rmrktot rhc ,ork tor which rhis ponir ir il\u.d My wortdr' conlrns.rb. iNUn rc cmicr and policy nrhbd ml lccnirrrhar rh. Fr,nrmrn.cofrh. qo* fo whi.hihh pcflni is nsucd- I fiull norcmploy anrrc*on in.try.rrifr{ $ m to tE$nr subrrl ro lhc w()rls\' con{i.nslrion lnw\ofcditurnia, and r8cc rhd rrl thou}d hccorrc uhJccr h rlt sorkcn conpcnslrion pmvisn,n\ofSecrion l7m ofrhc lrhr C(xlc.I rhlll.lonhqirh conPly wirh rh){ Pmltnnr.. WARNINC: ltilurc lo surc *orker( .onqf,n\rrn,h (,v.rasc ir unlnNtul. nnd shall subi.{l m cmplortr b .rn$nnl FMhas md (ivll filc\ W ri ,rc [trn,lr.,l rhotrsrnd,lollrrs i11(X).01r)r. i', {lJiri ] nr I r{a1Nrlkr,. ,rnrgc\ r\ t ri(lr'l li! rhr Scction 3076 ol thc tiho. Codc. inrer.n od a ormy \ r.{s DoLr Appliatrt: D[CI.ABAII!'! Ihcrcbyutfi nundcrrEnllry.fFrjuryrh0r I a li..nr\l xndcr pmvkion otChtrllq 9{conrtuncine wirh sâ‚¬!ion ?000) otDilision.l or rh. Busincs md Pml'csions C!dc, ond my licen{ is in tull roG ail .fic.I. CONIIBITCIXINIENIIIG.AGENCI I h.rcby am,n u.d.r Fndyorpcluryrhd rhs. h 0..n{dcrion lcndi,E asency ror rhc lJ.rrom.cc orrhc *ork for wiici rht Frn r i\ nsucd (Scc.1007. Ci! C ) AIIUIANLDECI,I8AIITN I hodry aEin unds Fnllty of F.ju!, oN or rh. rollowing derd,! n .s: D.mlition Permir$Ashcstos Norificariotr Fcncral Rc8ulort,ns (Tirlc 40, Pan6) -Requtcd Lerrcr ol fiorirurir Iodifyrhnrrhcf.dcr lrc8ulirio.s rcE3rdins ishcn.s renFvrl arc norrpplicftlc k, rhillnrF.r l.e(ilv rh.r I lne rcrdrhi\ iftli.xrn a nir. rhxr vc iDrarnhriotr is.oncd l rAreroconrplywirhall ciryr d (tu ty onlrfrn.c\ rtr(lsr c L:rtr\ rc]!lir! r) builtli',9 aJd hcrcby axrhorizc rcpescnrn'ivcs ollhis Cny and C.unryt, ctrrct u,rin'h. rbrvc n{Drnnrd FioFn! ntr nlt)ccr ,\rplir nl or \a$lsixn k'rt ""*U*,,.",rn.,,, P4If 4a- i4xwr(Eâ‚¬?*..,#!' Vlu.t) E.r4tt) .</4(fr, Canir I (cn\c ( lr\s: Lnrf\r Ntrnrl{r lhr( L(Flci. Nrmc tt INTE RI I\,1 CITY I\,4ANAGER Cynthia J. KurE 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. san ta-an a.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 atL\o5il.vt-oQt>51 SotI(DA+-ra c-r>, 9L1Oe{ We are providing you with an Owner-Builder Acknowledament 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. Q49 l. t understand a frequent practice of unlicensed persons is to have the property owner obtain an "OwnerBuilder" 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. O)U(Lr. , 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. fuv'&3 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. @Q+ I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. fuVfu5. t 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 ($500), including labor and materials, I may be considered an "employer" under state and federal law. t@0. f understand if I am considered an "employer" under state and Federal law, I must register with the state and federal government, withhold payrolltaxes, provide workers' compensation disability insurance, and contribute to unemployment compensation ofeach "employee." lalso understand my failure to abide by these laws may subject me to serious financial risk. Q#kr. ,understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless a// work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar years, or all of the work is performed under contract with a licensed general building Contractor. QIW A. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal inluries sustained by any subsequent owne(s) that r;sult from any latent construction defects in the workmanship or materials. SANTA ANA CITY COUNCIL mpu dorAsania-ana oro Mayor Pro Tem, Ward 2 mima.linezrosa.la-aoa oro vsarm enlo6)sania a.a oro ls!&!ie@s!!!a:a!!g P. Oavid Benavides dben6vidsrOs.nta ana.o.o i!l1le9?s@$da:a@ slinaiero@sanla-ana.oro MAYOR [,4iguelA. Pulido I\4AYOR PRO TEM Michele [rartinez COUNCILMEMBERS P. David Benavides Vacente Sarmiento Jose Solorio SalTinajero Juan Villegas Dear Property Owner: t?-ivVl- O. f 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 Calilornia Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.oov for more information about licensed contractors. pN4O.l 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 to5 vJ . HoU> Sf - @',.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. QWf-tZ.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 com plaint. 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 llrm 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 verirying 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 p ermit. Nole,- A copy of the propefty owner's driver's license, form notarization, or other verificalion acceotable to the aqencv is reouired lo be oresen ted when the permlt is issued to verify the property owner's siqnature.k)Signature of Property Owner Date: 5 L\t0 print name or owne, a"l{ffi - ur^rao---- 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) POect 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 property owner's signature, PLink:WP51,'Cc!nterActivily Assen'rblyB I s.Nolice 1c Properiy Fcrm SANTA ANA CITY COUNCIL mou do@santa-a.a oro Mayor Pro Tem. Ward 2 m harl nezosanta ana oro Vce.te Sarmre.to vsarmrentor@sanla ana.o.o i!9Ls!ia@s@Eie!a P Oavid Benavrdes dbenavldesAsa.la-ana oro villeoasdsanta-ana oro sl na ero@sanla ana oro *,,$ANIA A]{A,ffi Planning & Building Agency 20 Civic Center Plaza Ross Annex P.O. Box '1988 (M-19) Santa Ana. CA 92702 (714) 647-s800 Yf,r/./r/, s a n ta -a r't 3. or?, 7 rNSP-02 2!1t CRa This document mqy be found ot...h tlp:/r',,,.,,i,,,i sa nta -a ne. oro,loba/ (P/ease use a black or blue ink ball-point pen) Project Ad dress:4o5 h,. F{o?}:,r ?pbAnLr Qb,rncs.. lq. tZ>r,,nQt;7; Contractor:License #: Permit N umber: Property Owner: State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential b u il.dings. California Residential Code (CRC) Section R314.1and R315.2 states in part that existing dwellings be "retrofitted with smoke alarms and carbon monoxide aiarms. CRC Sect,on R314.3 and R314.3.3 define the requ ired loca tions. f\ aotlr boxes betow must be checked: ECarbon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of bedroorns and also on each level of the dwelling. Alarms are required in bedrooms with gas-fired appliances (i.e. hot water heater, cooktop, furnace) or a fireplace. ELSmot e alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeprng room, and on each level of the dwelling. Retrofitted detectors may be battery-operated for buildings where no interior alterations are performed. Combination Smoke/CO alarms must comply with all applicable standards and be approved by the State Fire Marshall (SFM). Battery life must be 10 years. I hereby certify that I am the contractor or the property owner of the above project. I further certify that smoke alarms and carbon monoxide alarms have been installed in compliance with the governing Codes and have been tested e functional. l, also, hereby certify that I will retest the alarms per the ma n ufactu rer's stru ctio Licensed Contractor ope Owner NQfE: This self-certificdtion is only used lor projects thot aflect the EXTERIOR ol the structure. This process is applicable ONLY to projects where occess to the interior ol the dwelling by a Santa Ana lnspector is not tequired. Have this completed form and the job-card readily available on final inspection! Signoture:ootr' lr6f IO Smoke & CO Alarm Affidavit I (check one)E