HomeMy WebLinkAbout101102883 - PermitProject Address: 1418 W Elder Ave
Assessor's Parcell 109-276-08 Lot 7 4
Unit Bldg: Address Range Suite Range:
Zoning: RlBlockr NA Tracl 1574 Historic. No
i City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA,27O2 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714\ 647-5853
Permit #: { O{ { O28E3
Pin #: 56Ki\
Building Use:
Job Type:
Nature of Work:
Existing Bldg. & Use
Proposed Use:
Single Family Dwelling
Alteration
Pool demo
Sfd w/att garage
Occupancy:
Constr Type
Code:
Flood Zone:
# of Stories:
R_3, U 1st FL Area: patio:
V B 2nd FLArea: T.lArea:
cBc 2019 Other Areas: Yards Req'd:
x-o602320257 J
Garage Area: Valuation: $3,000.00
Total:
*-PERMIT SHALL NOT BE FINALED UNTIL ALL N/V PERMITS HAVE BEENDescription of Work: Demo pool & backfill. Pool demo handout given.
FINALED""
Planning Conditions:P,(rtEh+:5315? - tl17/21't2l) ID: C(:UELLAf
Owner:
Address
Phone:
Tenant
Andy Dang
5712 Ocean Vista
Huntington Beach, CA 92648
(714't 724-0256
Contractor:
Address:
Owner-Builder
E ng ineer
Address.
Rrr't:ru?9671?6
Trqnsttct ion Tot(t1
$iel+: 1011r:r:i8s3
1/ 17 /2tr2tt 4119 ln
$4S6. u9
{
P hone
License #
Phone:
License #
AndY 0(rnePhone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policy #:
Expires:
6ener0I Flon Updote Fee
r:r1 I I 6r:t02- il 6t l0r:u-
llu i Id ins
r-r1 1 l6r-ul2- 5l6r:11[rjr-r-
P,1d s Stds Fevolv ine
nl t l6url?- ll16 1?r-I:I,r-
ll ii.r'ol i 1fi & Do,;uilenl,E
r:11 1 l6|]r]?- 5777ur-rtll]-
Architect /
Desiqnerl
Address:
Planning Approval By
Plan Checked By
Permit lssued Byl
NPDES lnsp Req'd
PWA lnsp. Req'd:
Planninq lnsp. Req'd:
Landscaping lnsp. Req'd
Amsden. Julie
Dale:1012512019
Date:
Dale O1l17l2O2O
Subject to Field.
Misc. Receipl
Misc. Receipt
Misc. Receipt
o n t e o [I) +6 i66f #Eihlit F63+, 1]
07776002 57770 Microfilm Records
$166 s3
07776002 57672 Bldg. Stds. Revolving
07776002 51600 General Plan Update
07776002 51501 lssuance
$3.91
$1.00
$22 95
$57.20
$251.59
$0.00
$251.s9
No
No
No
No
Fire lnsp. Req'd:
Police lnsp. Req'd
No
No Account#Total
Flood Zone Cert. Req'dr No
Every pemit issued shall become invaltd unless lhe work on ,he sile authotized by
such permil is commenced wilhin360 days aftet its issuance,or il lhe work authorized
on the site by such pemit is suspended ot abandoned fot a peiiod of360 days after
the time the wo* is commenced
lnspector MID#: 20'19-155420
01116002 51600
011 16002 51601
0'11 16002 516'12
01116002 57770 Fee Iotal.
Paid to Dale
Balance Due:
Orozco, lvan
$22.95
$223.73
$1.00
$3.91
BUILDING- INSPECTOR RECORD
DATE ID/SIG.
Set Backs
Forms/Steeli Holdowns
Erection Pads
UFER Ground
SLAB Floor
Roof Sheathino
Shear Wall
Framing
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
Ivlasonry
Pool Fence
Handicap Req.
Deputy Final Beport
Engineer Final Report
Flood Zone Certif
I
FINAL ualrL)PN \rv vx61
Certificate ot Occu pancy r l TI
Note Rem rks, Etc
Z 14 ,L 7 - -ltI
--7
o\rNl,R It It_Dt_R t ,:t,( \R,t t loN
I hcfthy aflirn und.r n nihy of perjury ih.r I m.x.ml,r tmm rh. CDdracMs Li..nk Law f(n rh. f.lhsin8 r.asi (s.c.7oll5
Buin.s afll Psr.sion Coa.): Any Cny.r Cou.ry whi.h rcqui$ i p..mii ro co.nrucr. !lr.i inpmv., dcmltt o, r.Fi, oy
itucrur.. lrhrh irs isiuanc..ds r.+n.s rh. lftli.r t,such |]. mtr, fi|. a \ign.d (d.mnr rh?r h.orsh. k licen*d puiiuanr
r. rh. pmvi\ions olih c,'ntrxrois t-t.n\d l-au (Chfl.r 9. C 'nm.fti.g wirh se.rion Tlx olDivki.I olrh. Bu{n.s ?nd
/tn,f.sinnsCnd.)nrrh ,Ior\h.k.\.mflrh.,.frnmindrh.hnsnfo h.all.B.d.x.mlion tryliolati'nofSdionTi)1l.5by y
l,!n1.,ntr.n1.",'nr.,6,.,,.,* inplhi L' xciv'.nenilr).'rnor ma.'tun rnc hund'.Jd nI6'lr'x,,,\4-
'a.J/flrr' otrncr or'h. DhEnr. or myemnl,,ve.\ *nh */Er ar rh.n e,le Nnp.n!.rioi. uilldo rhc Nork and ih. ntuuE is norYliJ.a -,,raa r," *r ri- roir. a^ii.* *,r n.r!*o* c * dD.\ n.i anrry r' !n wn..o.
rh.r'oFny wh hralds.r iq'hv.srlrB)n, rid !h) d'h n'ch {nk himr.lfor h.rr.lfor rhn,u8hhn or h.r oM cmrhy?.r.
povklcd rhlr such imlrcwnr e un i.rcnd.d or oftErt fitr Mk ll krw.nr. rlE horuiry or irq'nv.md is sU r ihir nn. )tr
ot mr'Illction. lh. Owne, Buil]s will haE th. tuftlei oarDviu d h.or$.dt d t{ill or impnnr fic pop.ny forr,t l[qneor
-1,
aso$n.roirh. pr.I.ny. !o.rclusively.onr.din8 siih !i.en\.J c.ntricr.^ h c.n!rucr rh. f'mler? rh)tssnn Cod.: Th.Conkrcrn s I ic.n\.1-.r dc( ndI npplyh an Bnn frop.ny*r$ huildr
rnd who contr.r\ ILtr n'.hpnr.ct\ sirhr s)liLrn\.tlJru( (,ih.{n m.rn \ l-icci
** at
Ih.chy rffifln under rcn!hy.ln rjury n..rrh.n,lLi$inEd(lrn i')il
lhdvcrndsillminirinaC.niff,{.ofCon*ntt,Selaln\u..tuHnk.^('mFns i,n.asF.vid.tlf.rbyS..rion:l7lx)otrh.
l.ahn Cod.. for th. p.rlormE. .f rhc w.rk aor vhrh rh. O.mir i1 ksu.d.
_l ll3v. aid will mrinrain pork.i( comD.trsuri'd in{r.nc., rs eqtriE hy Se.r ion l?rrr of lh. l rh.r Cd.. fo. i,. p€rfome. of
rh. Mrk for *hi.hrhn O.rmI n irs.d MyrDrt.n mhl'.nsr tr insuian& canh and F,lay numh.r ar.:
hb.r'-l
{olk.rs mmp.n\arit)nnn,vnionsofS.dion]7urofIh.
wARNINO F.ihrc t' *.ure *orken c.FFnMrn,n.'
(ird.. I shal. ftrnhwirh..mpl' rnh rho
i 0.lnqi[|. and \hall \rhiecr !n e
civil ,ines up h oi. hundred rhnusrnd dolh^ ($lrx).(
l;;'fi;0/?4)o
IJ,STAAION
I h.Eht ilirm undcr t .ilryofrErjury rhd I !m,ien*J uid.J pruvniun DfChrfl* 9lc.rmn.in3 wirh Scdi.n 7Ox)) ofDivisn,n l
.i (h. Busik$.n,t Ptufrrsbn\Cod., lntt my lic.n* n ii frrlllon-.. and.fi.cr.
cgxslxuclloNrliullNc-Acl;Ncf
I h.Ehy alfirm und., Fnilry.i p.rjury thd rh.E t aconqrudi,n lndin3ag.ncy nn rfi. F fomam. of lh. *ork tin whih rhirp.rm n
issu.d (sf 1097.civ. c ).
A"TTLICANfDIiCL'.BAIIA!
I lfttry nlUm undd n nrlry.lli.4uryon.ofrh.lollorrng ..l nr)ns:
l)en.l,ri.tr l,..mirvA(h.(.s Norilt{ior F.dcnl Retulit.i\ {Til|c,10. Pfi 6)
R.oun.d liucr of Nonlf, di0n
Ll !.n1 rh'r rh. f.J.'rl drlldi,a( FrarJinp a\h.v,^'.m\al
f^L4-*'o *n, r*..r,n^ rrnr*rtr,n dir {r,.,hd ,h.4h\. ,n Dn i\ cotr..r I rlr&. rn.o f lt $ih rll ( ny xnd Counr!
o 'nrn(rsrrrlStrre Lrs\ r.ldins ri
rhrr. mdioncd nrrFnyntr
mliu l.rArrntSiBnnrtrr(v':,;Til;L
Ilcv. 0B-07 2015
SITE.WORK COMMENTS
Subf loor/VenVl nsulation
T-Bar
zo
l.'..i\. Cltr\ l.i..n!.Nun,l)s
(onrru.n'r
q
t4\S v,/,
.e L zv1?-7,/\2<
E Yrc;;4 iA-<, Dt ^42
t l-t +''
r ;;O L
s
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L'+nlt',e
B\.ie'ze t-'*"1
APPROVEDplrNHrcDtvtstoN
,I'AgTER I.D.-lSELl?/)
LLHTL Axr/'4 ?sa P1
frD),lfriNR
TRAMIFERRED IY DATE
PLAI{NII{G I
ROUOH
R&UIRED
1
(714)----
RETAIN PI.A'IS FOfi FUTURE REVI s{o SSUBJECT TO
tr trrERrcn I oityO No EXTERtoa aTERATONsA,!ODrEtcA r ^\!U ALL I ATERIALS TO MiTCH EXISTINT-C ScREEN]NG REoUIRED
-r "LlBltltt Llt'tDsclpp pr er.,s'lhouM,ta
ONE
N4
Planning & Building Agency
Building Safety Division
20 Civic Genter Plaza
P.O. Box 1988 (M-19)
Santa Ana, CA 92702
(714) 647-s800
www.santa-ana.org
APP-I3 CBC 2016
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 improvements
soecified et /LttU. t.r. tr-/ >lA
We are providing you with an Owner-Builder Acknowledqment and lnformation Veriflcation 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, initraled your understanding of each provision, signed, and returned this
form to usatourofflcial address indicated. An agent of the owner cannot execute this notice unlessyou, 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 infomation.
/-'M-r. t understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" build-
ii6 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.
\.
ilLZ 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.
d,{-a f understand as an "Owner-Buildef' 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.
. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers
o permits and contracts
M I understand if lemploy 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
"employef under state and federal law.
-IWS. I understand if I am considered an "employer' under state and Federal law, I must register with the state and federal
g6Vernment, 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.
. I understand under California Contractors' State License Law, an Owner-Builder who builds singleJamily residential
S ctu res 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.
. 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 owne(s) that result from any latent construction defects in the workman-
ship or materials.
I
#;",
sion of lnd
32'1-CSLB
understand I may obtain more information regarding my obligations as an "employe/'from the lnternal Revenue Ser-
nited States Small Business Administration, the California Department of Benefit Payments, and the California Divi:
ustrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1 -800-
(2752) or www.cslb.ca.oov for more information about licensed contractors.
,\t
^1l lll-.- 10. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the
pdrty legally and financially responsible for proposed construction activity at the following ad-
d ress
,{)L,',. 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.
C\"
l)*:'tr.l agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I'iZie provioio 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 flnancial 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 completed and signed by the property owner and returned
to the agency responsible for issuing the permit. /Vo
proDertv ow n er's s i q n atu re.
Sig nature of Property Owner Date
Print name of Owner
AUTHORIZATION OF AGENT TO ACT ON PROPERry 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.
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 Ownef s Signature Date
Print Name of Owner:
Note: A copy of the owner's driver's license, form notarization, ot other verification acceptable to the agency is re-
quired to be presented when the permit is issued to verity the propefty owner's signature.
GEOTEGHNIGAL INTERNATIONAL
LAN & ASSOCIATES
Civil . Structure . Geotechnical . Topographic Survey
13139 Harbor Boulevard, Garden Grove, CA 92843
l'el: (714) 414-9215. Fax: (714) 537 -7974.Email : I-anpham9la)hotmail.com
Project no. : SA-0 l -01 -20-03-SW
Permit No. I 0l I 02883
January 26,2020
fuchard Osorio
(714) 760 - 8098
Richar_20 I 9@yahoo.com
c.o. Wendy
(714) 747 - 7244
Subject:Geotechnical Engineer's Certification Of Demolition And Backfilling Of
Pre-Existing Swimming Pool For Abandoning Purpose Located at l4l8
W. Elder Avenue, Santa Ana, Califomia 927 04.
Dear Mr. Osorio:
In accordance with the requirements of the City and per your request and authorization,
this certification has been prepared for the demolition and backfilling of the pre-existing
swimming pool located at the subject site.
We understand that creation of drainage holes along the bottom of the swimming pool
by puncturing,&reaking-out the pool shell bottom has been approved by the City
inspector prior to backfilling the swimming pool.
2. Removal of the coping, bond beam, and upper portions of the swimming pool shell
side walls has also been performed and approved by the City Inspector.
3. All utility lines serving the swimming pool including electric, gas, and water lines
were terminated/disconnected./removed and plugged/capped in an approved manner,
and approved by the City lnspector.
4. Some concrete pieces of demolished pool shell side walls, coping and pond beam
were placed along the bottom of the swimming pool.
5. The regular soil fill materials generally consisted of mixture of yellowish brown and
grey/dark grey silty fine sand and clay, were placed in thin lifts, added water by using
a water hose, and compacted by using a Bobcat.
Conclusion: The demolition and backfilling ol the pre-existing swimming pool is
considered geotechnically acceptable and suitable for the intended use for landscaping
purposes.
Note: If a structual object such as a room addition/ADU is to be constructed at or near
the swimming pool backfill area in the future, a qualified geotechnical engineer should be
consulted for provision ol geotechnical recommendations for foundation design.
If you have any questions or required clarification, please contact this office. This
opportunity to be of service is sincerely appreciated.
Very truly yours,
Lan N. Pham, P.E.
Chief Geotechnical Engineer
RGE 686, exp.03131l21
?
&
0F CALIi