HomeMy WebLinkAbout10596542 - Permit (2)q
Proiect Address: 405 W Halesworth St
Assessor's Parcelr 398-54'l -23 Lot: 12
Bldg: Address Range
Tract: HALESWORTH'S ADD
Unit
Historic: No
Suite Range:
Zoningi R2
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714]|667-2738 lnspector Section: (714) 647-5853
Building Use: Multi-Family (5 or more units) Occupancy: R-1 1st FL Area: Patio:
Job Type: Alteration Constr Type: V B 2nd FL Area: T.l.Area:
Nature of Work: Legalize windows/Demo Code: cBc 2016 Other Areas: yards Req,d:
Existing Bldg. & use: Apt Bldg Flood zone: x-0602320163J
Garage Area: Vatuation: $1O,5OO.OO
Proposed Use: # of Stories:
Totat:
Description of Work: Demo unpermitted roof top enclosures on balconies and legalize (20) unpermitted window change outs. Owner authorization on
file.
Planning conditions:
Owner:
Address
Phone:
Tenant:
BRUCE KAO
24048 LODGE POLE RD
Diamond Bar, CA 917653359
t,.h+ r43t6r-l -'.- I -t4/'|t\l'd
i i,:E: {:TYH Ir flns+: 6ii'l*l Fei'+ r
Dt+;c1227(f169 - :; /'14 t 1.{-tlg
qnEo,:t ion Tottt]
Owner-Builder
Engineer
Address:
ID r ail
Phone:
Stale Lic #:
Lic Type:
Bus. Lic #;
Workers' Compensation lnsurance
Carrier:
Policy #;
Expires:
I ! l.d lng
I t 161-u:t2 - 5l6t-lI art :r-.!ilir'(ll P1((n UPdnle
I I 16l]tl2-- 5 l6l"lLll] rll.l-
rde Stds Fievol v ins
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #
1
I
$3
l:rlt:E KA(]
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
Guevara, Jerry
Chavez, Dave < a,
Date: 05/1712018
Date:
Dale: 0512412018
Subject to Field:
l\4isc. Receipt
l\4isc. Receipt
lvlisc. Receipt
$308.52
$1.00
s21 .25
$52.98
07776002' 51607 Permit Fee
07175002' t\672 Btdg. Stds. Revolving
07176002 57600 Genetal Plan Update
07776002 5t60I lssuance
Fire lnsp. Req'd:
Police lnsp. Req'd
Flood zone Cert. Req'd: No
Every permit issued shall become invalid unless the wo* on the site authorized by
such petmitis comnenced wilhin 180 days after ls issuance,or if the work authoized
on the site by such pemit is suspendad or abandoned for a period of 180 daysaftet
lhe time the work iscommenced
lnspector MID#: 2018-143433
No
No Account#Total
01 1 16002 51600
0'1116002 51601
01 1 16002 51612
$21.25
$361 .50
$1.00
Fee Total:
Paid to Date.
Balance Due:
$383.75
$0.00
$383.75
Permit#: {0596542
Pin #: 29(J17
Block. NA
Contractor:
Address:
BUILDING- INSPECTOR RECORD
SITE.WORK DATE tDistG.COMMENTS OWNDR I]IJIt,DER DFJLCAR AI(}N
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CONIIAICUONIENqINII(iENrI
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AIIUIANLD&CI,A.8AI]ON
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Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/Vent/lnsu lation
Roof Sheathi ng
Shear Wall
Framing
lnsu latio n/E nergy
Drywall
Ext./lnt. Lath
Brown Coat
lVlasonry
T-Bar
Handicap Req.
Deputy Final Report
Engineer Final Report
Flood Zone Certil
FINAL I K t9 uf*Ka
Certif icate of Occupancy
Notes, Remarks , EtC.
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Set Backs
Pool Fence
l.iansc Cluss:-License Nunltr:
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MAYOR
MiguelA. Pulido
MAYOR PRO TEM
Michele l\4artinez
COUNCILMEMBERS
P David Benavides
Vicente Sarmiento
Jose Solorio
Sal Tinajero
Juan Villegas CITY OF SANTA ANA
PLANNING & BUILDING ACENCY
20 Civic Center Plaza
P.o. Box I988 . Sanra Ana, California 92702
www. san ta-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
Maria D. Huizar
improvements specified at le>wotl .Son l' ^o
We are providing you with an to make you awa
fr na^re ol
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 INFO RMATON
DIRECTIONS: Read and initial each statement below to signify you understand or verify this information.
0ll\ L 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.
W Z t understand building permits are not required to be signed by property owners unless they are responsible for
the construction and are not hiring a Iicensed Contractor to assume this responsibility.
A1l. 3. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may
piotect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name
instead of my own.
Nr_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.
U41,\ 5 | 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.
At\ o f 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.
W Z. f 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
I
moulido@sanla-ana.oro
Mayor Pro Tem. Wa.d 2
6rmarlinez@santa 6n6 o,o
vicenle sarmienlo
6amrenlo@sanla-ana o.o 60lo.io@sanla ana.oro
P. Oavid 8€navides
dbenardes@santa-ana.oro illeasaOsanta-a.a.oro sl,.a erorosanla ana oro
licensed subcontractors and the number of structures does not exceed fo;r withiri any calendar years, or all of the work is
performed under contract with a licensed general building Contractor.
fW_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 injuries sustained by any subsequent owner(s) that result from any latent construction defects in the
workmanship or materials.
lGf g. I understand I may obtain more information regarding my obligations as an "employer" from the lnternal Revenue
Servrce, 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.
fi't\ to
the party
address:
I am aware of and consent to an Owner-Builder building permit aPplied for in my name,d understand that lam
legally and fina
.J
nciallv5 s ible pro sed constructio ivity e foll rng
\}tVi,-l I .l 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.
Wz. 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 regutated 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 OwnerBuilder 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. /Vote.'A coDv of the DropeIW owner's driver's license,
form notari zati o n, or oth er verification le to the aoencv is uired to be presented whe n the Dermit is
issued to verify the ertv ow ner's sionature.
Signature of Property Owner Date
Print name of owner BR)IE
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.
L !--rr -t{L
k+o
rnftb "qator,Scope of Construction Project (or Description of Work)r0 0 o Y
Project Location or Address
e
Name of Authorized Aqent
Address of Authorized Agent
Phone Number of Authorized
aoL.
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 cedify its accuracy
Property Owner's Signature
Print Name of Owner BRAr-e
Note A copy of the owner's driver's license, form notarization, or other verificalion acceptable to lhe agency is required to
be presented when the permit is issued to verify the propedy owner's signature
SANTA ANA CITY COUNCIL
Mayor Pro Tem, Ward 2
m manrnez@santa'ana oro solonorosa.ta-ana oro ivilleoas@sa.la anaoro strnaleroaasanta ana.oro
\
vsarm'enlo6sanla a.a oro dbe.au des@sa.ra.a.a.ora
I
oate, t'/1-//
moulioo@saola ana.oro