HomeMy WebLinkAbout102104592 - Permit (2)city of santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA,27O2 Building
Permit Counter (714) 647-5800 lnspection Requestsr (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 102104592
Pin #: 58693
Project Address: 854 E Normandv Pl
Assessor's Parcel 011-223-O'l Lol 55
Unrt Bldg: Address Raflge Suile Range.
Zoningr R1Ellock NA Iftcl 2025 Hislonc No
Building Use: Single Family Dwelling Occupancy: R-3, U ;L Arear Patio.
Job Type: Alteration Constr Type: V B 2nd FL Area. T.l.Area:
Nature of Work: N/V - Reroof/Windows Code: CBC 2019 Other Areast yards Req,d:
Existing Bldg. & Use: SFD w/att Garage Flood Zone X-0602320276J
Garage Area: Valuation: $12,000.00
Proposed Use # of Stones
Tolal:
Description of Work: Legalize reroof and legalize window change outs. Tear otf existing roof material and inslall now comp shingle roof material I
windows to white vinyl. Handout given. Owner-Builder form on file.
Planning Conditions:
Owner:
Address
Phone
Tenant:
Contractor
Address:
Engrneer
Address
Gil Galido/ Frida Moran
834 W. McFadden
Santa Ana, CA 92704
(714) 667-6090
Owner-Builder
Phone:
Slale Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policl #:
Expires:
Phonel
Lrcense f
Archrtect /
Desiqner:
Address:
Planning Approval Byl
Plan Checked Byl
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp Req'dl
Planning lnsp. Req'd:
Landscaping lnsp. Req'd
Aras Fernanda
Chavez. Dave
Date 09108/2020
Date.
Date: 09/08/2020
Subject to Field:
Misc Receipt
Misc Receipt
Misc. Receipt
07776002
0 7 7 76002
0 7 7 76002
0 77 7600 2
017 7 60 02
0 77 76002
0 77 76002
57607
57770
5160 7
57601
516L2
57600
5 7601
$517.92
$4.05
$104.26
$261 .96
$1 .00
$23 79
$s9.30
Fire lnsp. Req'd
Police lnsp Req'd
Flood Zone Cert. Req'd No
Every perm tssued shall become nvahal unless lhe wor& on lhe s/te aulhorEed by
such permt 6 comtuenced wtthn 3@ clays aflet is tssuance.or tf the woa authonzed
on the site by such permtt c suspended ot abandoned lot a penod ol 360 days aftet
lhe time the wo* ts cofimenced
No
No
No
No
NoNo t1"g{H Total
Permit Fee
Microfilm Records
lnvestigation
Penalty
Bldg Stds. Revolving
General Plan Updale
lssuance
lnspector MID#: 2020-161340
01 1 '16002 51600
011'16002 5160'l
01't16002 51612
01116002 57770
$23 79
$943 44
$1 00
$4 05 Fee Total.
Paid lo Dale
Balance Due:
$972 2a
$0 00
$972.28
I
Phonel
License #
BUILDING- INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS oWNER BtIII.D}:R DT,X-CAR TION
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Raluir.d tr(d oa t{<{ifr{.n
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t4
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loor/VenVlnsulation
Roof Sheathino .1
Shear Wall -fi tffi )
Framino v
lnsulationi Energy
Drywall
Ext./lnt. Lath
Brown Coat
l\,4asonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report
Flood Zone Cerlif .
I t I .,
FINAL ItlT -lu DWD a
Cerliricate of Occupancy
Notes, Remarks, Etc.
Rev. 08'07-2015
Iti(l.ar Arl,!'r$
w-
Planning & Building Agency
Building Safety Division
20 Civic Center Plaza
P.O. Box 1988 (irl-l9)
Santa Ana, CA 92702
(714) 647-5800
www.santa-ana.org
APP-13 CBC 20't6
NOTICE TO PROPERTY OWNER
Dear Property Owner:
An applicati
specified at "+"giro^n Ey,:)):r;:f\trffiIyour name listins yourself as the builder of the property improvements
WeareprovidingyouwithantomakeyouaYyareofyour
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 ACKNOWLEG MENT AND VERIFICATION OF INFORMATON
DIRECIIO/VS; Read and initial each statement below to signify you understand or verify this information.
tLLl. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" build-
ing'permit that erroneously implies that the prope(y owner is providing his or her own labor and material personally. l, as an
OwnerBuilder, may be held liable and subject to serious financial risk for any iniuries sustained by an unlicensed person and
his or her employees while working on my property. My homeowne/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 prop-
erty.
2. I understand building permits are not required to be signed by property owners unless they are responsible for the
construction an d are not hiring a licensed Contractor to assume this responsibility.
F-LLI I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect
'myCelf from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my
own.
f/LLo t understand Contractors are required by law to be licensed and bonded in California and to list their license numbers
'on ptsrmits and contracts.
F-LI-|. 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
"employe/ under state and federal law.
{LLU. , understand if I am considered an "employer' under state and Federal law, I must register with the state and federal
jo'vdrnment, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment com-
pensation of each 'employee." I also understand my failure to abide by these laws may subiect me to serious financial risk.
t Ll l. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential
struclures cannot legally build them with the intent to offer them for sale, unless a// work is performed by licensed subcontrac-
tors 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.
(lL, ,understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any finan-
Lial or personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the workman-
ship or materials.
Mn ,understand I may obtain more information regarding my obligations as an "employe/'from the lnternal Revenue Ser-
vice, the United States Small Business Administration, the California Departmgnt of BFneflt Payments, and the Caljfornia Divi-
sion 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.
Fpt rc.I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the
i?y,':rygLT^'i]);y'fry,tl1i':r,g'rty"kuction activitv at the forrowins ad-
[4,'t 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.
[y'l,, 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 ale 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. /Vote.' A coov of the orooertv owner's driver's license, form notariza-
tion. or other verification acceotable to the adencv is reouired to be presented when the permit is issued to verifv the
Drooertv owner's sionature,
Signature of Property Owner i*k/c, ),4irt q-tDate
Print name of Owner h
AUTHORIZATION OF AGENT TO ACT ON PROPERW OWNER'S BEHALF
Excludlng the Notice to Property Owner, the execution of which I understand is my personal responsibllity, I hereby authorize
the following person(s) to act as my agent(s) to apply for, sign, and file the documenls necessary to obtain an Owner-Builder
Permit for my project.
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 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 notari2ation, or other veritication acceptable to the agency is re-
quired to be presented when the permit is rssued to verify the property owner's signature.