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Home My WebLink About20170775 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA92702 Permrt Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section. (714) 647-5853 Electrical Permit #:20170775 Pin #:650\\ Proiect Addressi 721 E Second St Assessor'sParcel: 398-482-16 Lot: POR 1 Unit: Block: B Bldg: Address Range: Tract NOAH PALMER Historic: No Suite Range: Zoning: SD84 Owner: Address: Phone Maria G Oregel 721 E 2nd St Santa Ana, CA 927014815 (714) 836-7135 01 1 't6002 51603 01 1 16002 51603 0't 1 16002 5160C 01116002 51603 01116002 5777C Fee Type 125 Volt Receptacle Serv Meter General Plan Update lssuance Microfilm Records Amount 1.51 55.37 22.95 57.20 3.91 Qty 1.00 1.00 '1.00 '1.00 1.00 Fee $1.s1 $55 37 $22.95 $57.20 $3.91 $2?.9:i $114. Lrg $3.?1 $200. nlt ($5?.(16) Tenant Name: Contractor: Address: Owner-Builder Phone Slate Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance: Carrier: Policy #: Expires: BaLch*:54333 - 2/Lt/2tt?tr ID: NGARCIA 0ffice: CTYH Trgns*r 4 1 of 1Acct*: Refi: 2017tr775 Ript+:02891834 - 2/fi/?A2(r 10:22 An Tronsoct ion Totnl il+t1.9+ Single Family Dwelling Miscellaneous Service Meter R-3 VB cEc 2019 Notes: linr i0 G 0resel Genernl PIan Updqte Fee L'l I 16002- 5161:rrllr0tt- F- lectr' icnl 0l I 160112- 5l61130r'lrr- liicrofilm & Documents rJl I l6rrrj?- t777r:ilJ00- (:nsh (:hnnse Hand out guven/Auth on file. Building Use: Job Type: Nature of Work: Planning Conditions: Planning Approval By: Plan Checked By: Permit lssued By: Subject to Field: Building Permit #: AIirrV Occupancy: Constr Type: Code: Date: Date: Date: Misc. Receipt: Misc. Receipt: Misc. Receipt: Total Zuniga,02t1112020 Account# 01 1 16002 51600 01 1 16002 51603 01116002 57770 $22 9s $1 14 08 $3.91 Fee Total Paid to Date: Balance Due: $140.94 $0.00 $140.94 Every permit issued shall become invalid unless the work on the site authorized by such permit is commenced within 360 days after its rssuance, or if the work authorized on the site by such permit ls suspended or abandoned for a period of 360 days after the time the work is commenced. lnspector MID#: 2020-157683 ELECTRICAL.I NSPECTOR RECORD Rev.08-07-2015 APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION I hacby aflirm undq pmalty of psjury that I m ercmpl ftom the Contracto$' Licrue law for the following reNn (Sec.7031.5 Busines axl Profsion Code): Any Cily or County which require a po'rnit to corutruct, alts, improvc, donolish or repair my structue. prior to its issumce, also requircs thc applicut for such pqmit to file a signcd statmot that he or she is licmed pmuat to the provisions of the Contractor's Licensed Law (Chaptfr 9, Commencing with S@tion 7000 of Division 3 of the Bsines ed ProfessionsCodc)orthatheorsheisexemptthsefromadthcb6isfortheallegedexmption. AnyviolalionofSationT03l.5bymy applicantforapemitsubjststhc applicanttoacivilpeMltyofnotmorethmfivehundreddollas($500). -1, o orvno of thc property, or my employm with wage o their rcle compmsation, witl do thc work md the struduc is not inrsded or offsed for sale (Se.7044, Businss md ProfesioN Code: Thc Contrac(or's Licmse Law do6 not apply to an oms of the prcpcny who builds or improvs thq@n, ed who do6 such woIt himsclf or hmclf or through his or ho om employce. provided that such imprcvmmts ac not intadq, or offdql for ele. lf, howwq. the tuilding or imprcvmt is pld within one )w ofcornplaioc the Ouns Buildry will have the btrdfl ofprcving that he or she did not build or improve the prcpety for the purposof sle). -/ / * o** of th. p.p6ly. an exclusively contracting with licffed contracton to construd the prcjqt (Ss. 7044, B6ins/md ProfsionCodc:ThcContractor'sLicenseLawdo6notapplytoilownqofpropetywhobuildsorimprovcsthceon. and who conuacls for such projtrts with a Conlracto(s) lic$cd pumumt to the Contrador's Licme [aw). _l m exelnpt undq B. & P.C. for this r6on. o,t"'rO)- ll' VO DECLARATION I hqcby 8ffim undq poalty of pajury one of the following delaatiorc: _l have md will maintain a Ceflific8te of Coruot to Self-lnsure for work6' compdsation, a povidcd for by Sction 3700 of the Labor Code, for thc pqfomecc of thc work for which lhe pornit is i$ued. _l havc md will mairtain workffi' compcBation iNurilc€, s rcquircd by Setion 3700 of thc Labor Code, for the pqfommce of the work fo( which this pmit is issucd. My work6' composatioo imurilcc tris md policy numbq ae: Cmis: l'olicy Nr Exoirs: _l cfliry that in the psformance of thc rvork for which this pomit is issued. I shall not qnploy any pemn in aoy mmncr e 6 to become subjet lo the work6' compwtion laws of Califomia. and agrs thal if I should becorne subject to the workqs' compcmation provisiom ofSetion .1700 ofthe tabor Codc. I shall. fonhwilh comply with thos prcvisions.. W RNINC: Failure lo scue workers'compmsation covoagc is unlarvful. and shall subject m qnployq to qiminal poaltie md civil fines up lo one hun&ed thousand dollds ($100,000), in addilion lo the cosl ofcompemtion. danages m provited for the S(tion J076 of the Labor Code. inl66t ild attomry's DDCIARATION I hmby aflim undo pcnalty of pqjury that I m licosed udo provision of Chapto 9 (commmcing rvith Sation 7000) of Division 3 of thc Busins ed Prcfsiom Code. md mv licmse is in full force ild effect. License Class:Numbs: CONSTRUCTION LENDING AGENCY I hcreby affim undo penahy of pejury thst th6c is a construction lending agmcy for thc psfommce of thc work for which this pqmil b issucd (Se. 3097. Civ. C.). [Jnd6's Nme: fr tmd6's Addr6: . APPLICANT DECLARATION I herby affm undo poaky ofp€rjury one ofthe following d@ldalions: Demolition P6mits-Asb6tos Notification Fedqal Regulations (Tillc 40. Paa6) -Required Lctts of Notilication _l cqtify that the fedoalregulatiom rcgrdirg abstos removalue not applicable to this prcj{l. -6r*rl have rcad this applicalion ild stale thal the above infomation is corecl. I agre to comply with all City and County 'ordinanccs md State taws rclating to building construction, ad hoeby authorizc rcprGmtativc ofthis City and Coun(y to otq upon thc abovc rnmtioncd propeny for pulpos6. -L/Applicsnl or Agetr( Pernrilcc namc . Or..? el Site-Work Underground Pole Bases Liqht Standards Spas, Pool, Fountains Signs (monument) Life Safety /Low Voltage Fire Alarm / Dampers Communications Cable Building Under Slab / Floor Bonding / Grounding / UFER Transformers Torqueing Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Rouqh) Ceilinqs (Hard & Soffit Rough Ceilings (T-Bar Rough) Meter Release Rouqh l. Service Meter 3/to/zo .?A 4/) 2/FINAL ,X/ eh b'til Notes Remarks Etc o,r",c3'7-lt-VO Planning & Building Agency Building Safety Division 20 Civic Center Plaza P.O. Box 1988 (M-19) Santa Ana, GA 92702 (714) 647-5800 www.santa-ana.org APP-13 CBC 2016 NOTICE TO PROPERW OWNER Dear Property Owner: An a itdi ng pe rmit has subm tn nam ng you rself as the builder of the property improvements specified at We are providing you with an Owner-BuilderAcknowledqment 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 otflcial 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 ACKNOWLEGMENT AND VERIFICATION OF INFORMATON DIRECTIONS; Read and initial each statement below to signify you understand or verify this information. @L l 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 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 prop- erty. It-- O Z. 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. @g I understand as an "Owner-Builde/' 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. Mq I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. ,rl- 0 U I 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. /Ai A. I 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 com- pensation of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. /4 0 ,. I 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 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 generalbuilding Contractor. /4A ,. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any finan- cial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workman- ship or materials. Mg. I 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,Department of Benefit Payments, and the California 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.eLov for more information about licensed contractors. /U210.1 am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party nd financia ble for at followi ng ad- dress: .rjllLl1. 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. ll, - O 12. 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 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. Note: A copv of the propeftv owner's driver's license. form notariza- tion. or other verification acceotable to the aoencv is required to be oresented when the oermit is issued to verifv the propeftv owner's siqnature. Signature of Property Owner Date: r OJ-l/-70 Print name of Or e-€ AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which lunderstand is my personalresponsibility, lhereby 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) Project Location or Address Name of Authorized Agent: Address of Authorized 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 re- quired fo be presented when the permit is issued to verify the propefi owner's signature.