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Home My WebLink About20170543 - PermitProiect Address: 1418 S Pacific Ave Assessor's Parcel: 109-263-12 Lot: 62 Unit: Block: NA Bldg: Tract: 1508 Address Range: Historic: No Suite Range: Zoning: Rl City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical PermitCounter. (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-58$6J Permit #:2017o543 Pin #: 13023 Owner: Address: Phone Victor Higareda 1418 S Pacific Ave Santa Ana, CA 927043720 (7141331-2166 01 1 16002 51603 01 1 16002 51603 01 't 16002 51603 01 1 16002 51600 01116002 51603 01116002 57770 Fee Type Amount Qty Fee 125 Volt Receptacle I .5't 29.00 $43.79 Light switches, occ. se 1.64 20.00 $32.80 Light Fixtures 1.09 33.00 $35.97 General Plan Update 22.95 1.00 $22.95 lssuance 57.20 1.00 $57.20 Microfilm Records 3.91 1.00 $3.91 ll,rit,-li,l r 1j,.5 i,',i ',i ;t[ t ,, .,a , 'il.r , .r,. . : .a ...-f,,( tlJl.-l-Lil i,j .: it,;r,t.,lIr,i.llior_i-.i:i.: r.,. .," i . ,,:; If(ll|rlliitl(-'ll lil..i:i . '.'l Tenant Name: Contractor: Address: Owner-Builder Phone State Lic #: Lic Type: Bus. Lic #: Workers' Compensation I nsurance: Carrier: Policy #: Expires: V icton H isrtredn Gener$l P10n Updctt.e Fee tJl I 16ULr2- 516ULrULil:r- Electr i rnl Lrl I 161102- 51 6r:r:ir:rl[i- l'l icrof i Im & Docurrrent l (r1 I 16r_u-r?- 5777LillLrrt- Visct C(.+ : * r***f *x**.r *? g:i2 Auth*:t"tBuilding Use: Job Type: Nature of Work Planning Conditions: Single Family Dwelling Miscellaneous Electrical Occupancy: Constr Type Code: Date: Date: Date: R-3, U VB cEc 2019 Noles: Electrical, outlets, light switches, light fixtures. Owner-Builder form on file. Chavez, Dave?c'01107t2020 Account# Misc. Receipt: Misc. Recelpt: Misc. Receipt: Total Every permit issued shall become invalid unless the work on the site authorized by such permit is commenced within 360 days after its issuance, 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#: 2020-156950 01116002 5'1600 01 1 16002 51603 01116002 57770 $22.95 $169.76 $3.91 Fee Total: Paid to Date: Balance Due: $196.62 $0.00 $196.62 Planning Approval By: Plan Checked By: Permit lssued By: Subject to Field: Building Permit #: 17e.z ->vv)il :DrEttrN-\,{ :(tu!rd) rututr rrlrur.rrd e Zq1 \ r :olBo x:aJntuuAlS lue8y ro luerqddy roJ xuedord pruort@ur o^ulE oql uodn st@ olXlunoJ puB,tlrJ sullJo srrplusrdar ,(tunoJ pue,(tlJ lle ql!^\,{lduoJ ol slip I lDloJ sl JZUOTI ,^qlP aql lurll.luls pw 'tsfod srql ol clq?Jlldde tou lru le^ouor solsls iurpc8rr suortelnia:1uupo3 aqt tuqt,!r;.a: ; uoueJu[oN Jo rolD-l p.rnbru (glpd'0t.llrl) suortelnfoX genpel uo[EJglloN solsqsv-sIUEd uorItou.(] ; suor leel.op flur aolloJ aq I j o eu o {r n lod .; o ,{lle@d rapun uulge ,(F.Eq I m'TfvfPr.J:iifi[flrl-JJv issejppv s..repu.'l raureN s.rapuo'l 1 J ^lJ'160E JaS) prnssr s lurod stqt qrqm ro3 lioa eqlJo elwuoJDd 3ql JoJ ^)Dfe flulpEl uorpruFuor s $ eDql pqt xtntDd Jo Xllsuad lpun uuUle ^qaDq Im :JOIJUJIUO.):al8o ':sselJ osuoJr'l:l{unN esuef,t.l 'lslre p@ cJloJ llnj ur sr asurJrl ^u p@ 'apoJ suolsscJo.rd puu sscutsn8 aql Jo 1 uorsrllq 3o 16661 uorlDs qlu\ SurJuauruoJ) 6 ElduqJJo uorsr^ord Dpon posDlrt uE I tcrll funflrd Jo ^llDuad repun ulge {qaoq ; NOIII7II\1.TMx l9Elul c L )'sal s.,{euotte p@ 'rPo.)eql 910t uo!lDs .ql roJ papr^ord s sfeuep 'uorles.duroJ cql q 1000'00t$) srilop puDsnoql parponq .uo ol dn $uU lr^rl ,slro}\ ems ol oinlE:l :cNlNUvAlpue srlBuad leururo o1 :e,{qduo uu puu uorlusuaduoJ ''suorsrrordosoqlqlrmxlduoJqlaquoj'lleqsl'opoJ.tu]el.qlJooottuollJ.SJosuorsr^olduotlesu.duoJ,sDlioa oqt ot tsfqns aurDeq plnoqs I Jr |uqt ro.rie puD 'uruoJrleJJo satsl uo!psulduor,sDlion Jql ol lsfqns euoJeq ols 6 sr lruied srql qJq.$ ruJ {ro.$ .qtJo.rueuioJDd .ql ur "q, {'*\\ :oqun61 (rqDl .puwu {ue ur uosDd ,(ur {olduo lou lluqs I p.nsst :se:rdx3 :cc uqwnu.{cqod pw Er@f, eJ@rnsur uorpsu.duol .s)lloa,(} l pons$ $ truud $ql q)rqa roJ )troa aqt Jo cJwuoJDd aql loJ 'apoJ rqe'l .qlJo 00tt uorlss xq p.rnbet s 'aJuErnsur uorle$.duo, .sDlroa urElulEu IIA pue .^eq l- 'panss s 1rcd aq1 qtrqa loJ Itoa aqlJo aJWuoJDd aql loJ 'epoJ loqs-l tqtJo 00at uorlr.S,{q roJ prpr^oid s 'uorps.duro, .slroa loJ aJnsl-JIrS ol lE$oJJo.lBJUltDJ B utBtueu llta pw ,^uq I-- :suorlsclop 8uuro11o1 eqlJo euo tuntDdJo,(l;eud opun urJJe ,(qooq I *l;Jxs:N '(ae'l esueJrl s.iolJurluo.) eql ol prsueJrl (s)iopertuo.) e {lr^\ sl$fod q)ns roJ slJuluo) oq^\ pue 'u@Dqlse^orduurosplrnqoqaxurdordJoDU^\oueol,{lddulou$eopae-l .sue)t.Is.rotJeluoJeql-:epoJuu$Juu puB surmg 'rtol FS) lFfod .ql DtulsoJ ol solJuluo. pasueJll qlr^\ iurlJerluoJ ,(le,\rsnlJrr ue '^]Edord aqlJo Du.\\o s I - .(al6 .;o esodrnd eqt:oj {rcdord eqt anordur ro ppnq 1ou prp aqs ro eq rcqt SuhordJo @prnq oqt a^sq lls\ DHrnB DurO cql 'uorplduror3o @,{ .uo urqlA pl6 $ lu@^ordur Jo iurplrq ,ql'D,€,troq Jl q6 rol pasltoJo pcp@lul lou.E sl@up^odurr qrns 1eq1 prpraord 'sxoldue u$o Drl ro srq qino4l roJlasDq roJl.surq )|lo1\ qJns gop oqa pw !@sql srodu :o splrq oq^r ^uedod aqt 3o ouno w ot,,(1dde tou eop au-l .slrl s.ropurluoJ aqf :epoJ suorsJold p@ sursng 'il6/ DS) elw loJ p.JaJJo lo p.pulut '|ou q M,"u$'q'| P@ :; JJffi ,H, ":: ffi _: :,::J;";.ff , ;::,,;,h) Xup trq g l toa uorl$sJo uortslol^ ^uV uord@ra peffells rqt roJ srseq eql pw uogenql lduuro sr eqs:o eq leqt ro (apoJ suor$aJord p@ $aursn8 .ql Jo t uorst^ro Jo 0O0l uorlss qll,$ 8ul)u.uuoJ '6 DldpqJ) ^rE1 posu..rl s.rolrEiluo.) eq1 .;o suorsao:d eql ol twnllnd pesucl s eqs ro eq pql l@@pts peuSrs e alg ol lru!.d qJns roJ luelrldde oql srnb.r osle .Juens$ sy ol loud '.mpruls ,{w nEd.! ro qsrlo@p 'e^ordur 'Dlls'pruNuoJ ot luuad e srnbar qJrq^\ xunoJ !o xllJ ruv :(epoJ uorssJoid pw ssursng S ltof sS) uwol SuholloJ aql JoJ ^\s-l es@Jrl .$olrDruoJ aqt uog lduara @ I pql funfEd Jo ,{1ered rpun uuluB Xq.Dq t NOlrvuvJ't3(l uso.llna utNAto r/)I 'cll'slreuou 'soloN pa L4ftla -lvNH rolay! ocr^Jas qfinoU oseolau Jalol/\l (qOnoy rBg-I) sDurlraC q0nou llJtos I preH)s6urltoC (qDnog) sle1 (lrnpuoC) sileA lrun par^ tuo1ce1 luorudlnbf dol looy sJouorlrpuoc Jrv sloued-qns 0urenbtol sror.uJolsueJl uSln / ourpunore / ourpuog rooll / qels ropun 6urp;rng olqec suorleilunuuoc sJadueo / urelv oJrl o6Ellon ^ o'I/ ^lalBs al!-I (luaunuou) subrs surelunol 'lood 'seds sprepuels lq0rl soseg olod punor0rapun IroM-at!s srNshrWo9 'cts/or flvo S]VNOUddV ouocSu uoJ.cSdsNt-tvctulcf '13 :DIIIDJ H Planning & Building Agency Building Safety Divisiofiif . 20 Civic Center Plaza P.O. Box 1988 (M-19) Santa Ana, CA 92702 (714) 647-s800 www.santa-ana.org a APP-13 CBC 2016 NOTICE TO PROPERTY OWNER Dear Property Owner: An application a buildin g NS.L in your n me listin gyo c" as the builder ofci L?r'1 the property improvementsurself 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 untilyou 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 ACKNOWLEGMENT AND VERIFICATION OF INFORMATON DIRECTIONS; Read and initial each statement below to signify you understand or verify this information. I rJ t* t. 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 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. \ t W 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. llCfa. 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. .. \ -J \t 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. { tt S. 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 "employe/' under state and federal law. -rDCfO. 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. ''l -\t Z. 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 general building Contractor. rtS 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 finan- cial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workman- ship or materials. \' {S g. I understand I may obtain more information regarding my obligltionitrs 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.qov for more information about licensed contractors. $L 10. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party legal and financially ib for co n at the fol d ad-o1L70 J'* ,1. 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. lW2 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 acceptable to the aqencv is required to be presented when the permit is issued to verifv the p ro pertv own er's si q n atu re. Signature of Property Owner Date: \I f,. aL'-> Print name of owner U, t(""e l GA TLEDYF\ AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personalresponsibility, 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) 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 notarization, or other verification acceptable to the agency is re- quired to be presented when the permit is rssued to verify the propefty owner's signature. l^