HomeMy WebLinkAbout30141886 - PermitProiect Address: 25 N Cantera Common
Assessor'sParcel: 100-551-54 Lot: 25
Unit:
Block: NA
Bldg:
Tract: 12386
Address Range: N
Historic: No
Suite Range:
Zoning: SD42
city of Santa Ana 20 Civic Center Plaza (M- 19), SantaAna, CA,27O2 Plumbing
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 30{4{886
Pin #: 434\tr)
Owner:
Address
Phone:
Tenant Name:
Contractor:
Address:
Quang Nguyen
25 CANTERA
Santa Ana, CA 927031200
(949) 310-9247
Owner-Builder
Fee Type Amount
01116002 51602 Wtr Htr (Res up to 50 gr 23.12
011 16002 5'1600 General Plan Update 22.95
011'16002 51602 lssuance 57.2O
0'111600257770 Microfilm Records 3.91
Qty
1.00
1 .00
1 .00
1 .00
Feo
$23.12
$22.95
$57.20
$3.91
Phone
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policy #:
Expires:
Rot{hiri4lgl - 1,131/?[?0 I03 (:CUELLAR
0f, i.e: .:IYH fr'one+r I 1 of IArit+: Fefi: 30141836
ItcpLlrn:gs61tr? - l,/11/?82(r 1r5tr Pn
Tr crr:cr.:t i0r' lotql i1(17.13
Irnns Nguven
Building Use:
Job Type;
Nature of Work
Planning Conditions:
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Single Family Dwelling
Miscellaneous
Water Heater C/O
Occupancy:
Constr Type
Code:Notes Water heater change out in garage.
_ s22.91
g8(r.3?
s3.91
$ 1(r7. 1S
Authi:01?118
Date:
Date:
Date:
vb
01t3'112020
Account#
lvlisc. Receipt:
l\risc. Receipt:
l\4isc. Receipt:
Total
Chavez, Dave
Evety pemit issued shall become invalid unless the work on lhe s,ite
authoized by such pemit is commanced within 360 days after its
issuance, ot ifthe work authoized on the site by such pemit is suspended
ot abandoned lor a period of 360 days after the time the wotu is
commenced.
lnspector MID#: 2020-157515
01116002 51600
01116002 s1602
01116002 57770
$22.95
$80.32
$3.91
Fee Tolal:
Paid lo Date:
Balance Due:
R-3, U
VB
cPc 2019
$107.18
$0.00
$107"18
PLUMBING.INSPECTOR RECORD
DATE ID/SIG.COMMENTS O$NER AUILDI'R DEI-CAlrA'I'ION
! hcrchy xlfinn u d.r NMlry of lijrju.y rhll I u:ctcD|n rn' rhc conlrnckn l-i.ci* Lrw for rhc,ollo$irg rca{r (5r.7(r.115
au\irics\ iRl ltol'c$ion C{ilcr A.y ciry or coutrly shich r.quncl i fnnn ro cotrsrrucr- olrcr' imPdd. dc mlish or EFft rn,
{ndurc. prtu ro ir\ n\urn... rho rcqunc\ thc ryPlic!.r lor luch F nil ro lilc n siSidd iarLmtrr rhd ltr ot xhc is licM\.d Nr{ris
k, rh. F,visnnN ol rlr Co.lr(ld'\ l-i.ctr{d lrw (Choflcr 9. Connn.n.i E *irh Scclior ?(Xl{) ol DivBion .l of rhc llurinc\r and
Pnnasion!C{'dc) orrlDr tu or\hc is cxcryr rhctctomund rhcbr\ir tor rhc rllc8uri crcnfln,n A yvioltrtion.fSccrirnT0ll5byitrt
xrplicrnr Io' a pci,rn suhjcchlhc lpplicn b acivilrcnnhr_olNI nnnc rh{tr lilr huniladdoll.r lsslx))
-1.
us o$rrr ofrfi. pmtl.ny. (tr Dy.mnloycc\ (irh lvr!.\ n( !h.n sob comlEnsarion. $illdo rl* $otk ind rnc dturnrc tr mr
iinridrd or oficr cd irtr s!1. ( Sc{ ?(!.1, Burin.ss nnd Pftlcsrions Cftlc 'I'hc c. krc(r\ l-ien{ lj* doc\ ior trntlv lo xn o{ tur of
dr rNp.ny *l. Itrrikh.r i'lll)(,vcs rncB'n. u Fno de\ \eh q orl h iNclf or h.6cll or rhmuSh hir or hcr o*n cryl.rc.s,
,n,!nkd ihrr strch i'nl('vcnEnF orc n i'rrcmkrd or ollircd ntr $l. ll lxrsvcr. lhc hdiktilS or ililpm$.Enl is 5n $nhnr orc )qr
olconDlcrir.. rhc (hmr aui LY sill hnvc tlE tndcn ol rmvin! rl rh:o'nrlil rk, htill ot i.,{'rovc rh. ntuldv fitr lltr luqre oi
I
0r-/, *,* "*,, '* * *"r. J'n rr.ru\rrly.an,,.'cr ,! wnhli.cnccd corkr.rors to con{n'cr rh. F'jco (se 7Lr14. Busin.\\
-.n lt,ltsDnC",lc lheCunrtucroi( I-trcn.c l-ix dnc\ n.rrppl!t' dotrncrollniip.nysh. huildsor imlrolcr rh$con
,id sh. (nrrocrs lnr \uch lroF.r\ sirh a Co ncb(n li.cnscd IUAur i ro rhc Co.raclr's l-ic.n{ bw).
,,,,. - t /{rrl
I lrcrchr :llnn utrdcr pc rhyol t'cljury onc oI rhe nnk,sinc dftlnrnr
I hrvc d w ill rui lo i Gd iri.ar. ol Cotrrctrl l{, scll lnsurc n,r u.rk.N .omncnsr, ioh- d ln,lidcd i,r bv S$!n'n .17(x) ol rrn'
Utxtr (hdc.lor rhc l)erfon.!rcc.lrh. w.lk lor *hich rhr Fnnil i\ n\!c'l
Ihv..trdwillmrinhh*ukcrr'.onf.n\ari.trirr.utrtrcc.rLrcqni'edhySucrn,nlT00olrhcl-rhorCixlc.ln hcJ,ctlotmlnccol
rhc {o'l f.r whi.hrhis nefl.ir is i\{cd Myworkcrj omptNdirr irr\n rnn.x .nrict d Fnicynnnrh$ r.l
er{...ify rhll in rhc p((ortufr. oflh. *ork ao. which tht li.rnir h issucd.l shall rel crPl'ynn! r.ison in !n, tunnct
$irr,h(.onr\!hl.crrorhctrorkcr(..nrpcn\rri(n'Lxtr\ofCxlrl;irrii.trnnxgr.rl rill!h{,ltt.otrtr\trhjc.rhrlt
{ulc^ o r iurDn I'r,ri\iotr\ olS\.'ri(,n 170rol rhc ljlitr Crtrl..I d ll.lrdhNnh.otDlv $ilhrh.\c |'ovisior\
cilil 6fts trp lo orc hundr.n lhnlsnd d.llds (SIIDJD0I. in irion b rhL.ost ofcodFtrsrion, dr@g.. !s polidcd for rhc
;:J"riFlJm:nror""",E
oi rhc llu\incs rtrd PRnas(i,{N Co(lc. r n,y lic.n\o n i', tulll'r( r&lclfc.r
L.ndcr'\ Add'c$
-
A.PJXIIANLIECIABAITAN
I hrr{y rmtr und.r F.ally ofFrju,y o*.1rhr r.ll,,wing d.cr0..lio.s:
I)crtulirion P.rnn+AstEsk,s Norificalion FcdcrnlR.Srl,ri(,ns (Tillc,10- tfln6)
Rcquncd Lcllcr ol Norifi corion
-l
ccniay rh thc tcdcrul rcSulnrions E-qltding asl*stN rc!revol !r. not arPliclhlc b ihis lmill
Q.#:ili rl'd I hrvcr.nd rhirrpnlicari{,nlft|{rrr h. obow infondrion ir..md I d8G lo odply wirn atl Cny 8nd Counly
s and s{ar. rriws rcl(ins to boildinS .ons nl hcrcby lllnorir rcFc$nldi*{ of thh Cil y d{l Cotr
ltx'vc ftnri'ncd pmp.dy fot in\Fcrioi pnrlbscs.
1Applicsnt or Aaot skn,lure:
t,"-,U"" "".",0n", X ilI ZU
UNDER GROUND
Waste & Vent
Gas-Underfloor
Buildino Sewer
Area/Storm Drain
lnterceptor/ Clarif ier
TOP OUT
Waste & Vent
Water Piping
Gas Pipinq
Rool Drain
Tub/Shower Test
Rough Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Pipinq
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Devrce
Rouqh Plumbinq )-10 22zo tlx- z1
Final Gas Test
Meter Release
>lo-aD P-*sr,'Qr@\ At)
Notes, Remarks, Etc
-+
APPROVALS
Water-Under f loor
FINAL
,r**.F
coNs'rtall(:r'l()N I r.NDIN(; aerN(lv
I ncruhy rmnxd.r pcnrlryofperjrrr rhr rhcc is, orrructi.n lcnJinr r!.k, n" rhc |Erfo aiccofrhcsor*ntr*hicnrhisFnriri\
tsncd rSec 1097. Civ. C.r
GrJr,\ \rn.
-
APP-13 CBC 2016
Dear Property Owner:
on for a building permit has been s bmitted in rna listin yo urself as the buiAn applicati
specified at
er of the roperty improvements
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 ourofficial 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 veify this information.
0U1
'
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 flnancial risk for any injuries sustained by an unlicensed person and
his or her employees while working on my property. lvly 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.
!i L2. 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.
gV 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.
041-0. , understand Contractors are required by law to be licensed and bonded in California and to list their license numbers6-n permits and contracts.
\)triS. 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 flve hundred dollars ($500), including labor and materials, I may be considered an
"employer" under state and federal law.
S-lV-6. f understand if I am considered an "employer" under state and Federal law, I must register with the state and federal
!-overnment, withhold payroll taxes, provide workeri' compensation disability insurance, and c6ntribute to unemployment com-
pensation of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk.
EIU-r. , 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..t
AN./* L l understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any finan-
Eili-6f personal injuries sustained by any subsequent ownerlsj that result from any latent construction defects in the workman-
ship or materials.
Planning & Building Agency
Building Safety Division
20 Civic center Plaza .
P.O. Box 1988 (M-19)
Santa Ana, CA 92702
(714) 647-s800
www,santa-ana.org
NOTICE TO PROPERTY OWNER
We are providing you with an Owner-Builder Acknowledoment 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.
Q\L n , understand I may obtain more information regarding my obligations as an "employef'from the lnternal Revenue Ser-
vice, the United States Small Busjness Administration, the California Departnent.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.
AM10 I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the
tsa'rty reealy and nnanciaily ,QttillE
H,"o"gf.|tsjo,%,131,,r " ,&{",,"1t,ryt }
(iAIf l. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
Epplicable laws and requirements that govern Owner-Builders as well as employers.
(\]t Z. 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 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 againsl unlicensed Contractors may be in civil court. lt rs 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.
Signature of Property Owner .?*-)rD;".-Date
Print name of Owner Qu+Ne e-l
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.
Project Location or Address
v
tl
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 certily its accuracy.
Property Ownels Signature Date
Print Name of Owner
Note: A copy of the owner's driver's ,icense, form notarization, ot other verification acceptable to the agency is re-
quired to be presented when the permit is issued to verify the propefty owner's signature,
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. ,Vofe.' A coov of the propertv owner's driver's license, form notariza-
tion, or other verification acceptable to the adencv is required to be presented when the oermit is issued to verifv the
propertv owner's sion atu re.
2s LO
?
ScopeofConstructionProject(orDeScriptionofWork):
Name of Authorized Agent: