HomeMy WebLinkAbout101102852 - Permit@ city of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA\27O2 Building
Permit Counter: (7'14) 647-5800 lnspection Requests: (7'l4l667-2738 lnspector Sectaon: (714) 647-5853
Permit #: 1011o2852
Pin #: ,tu.t1
Project Address: 421 W NobelAve
Assessor's Parcell 410-10246 Lot: 7
Unit Bldg: Address Range Suite Range:
Zoning: RlTract: 6701 Historic: No
Building Use: Multi-Family (5 or mo.e units) Occupancy: R-1 1 st FL Area Patio:
Job Type: Reroof Constr Type: V B 2nd FL Area T.l.Area:
Nature of Work: Reroof Code: cBc 2019 other Areas: yards Req,d
Existing Bldg. & Use: Apartment Flood Zone: X-0602320278J Garage Area Valuation: S3,000.00
Proposed Use: # of Storiesl Total Bot,:hi:i3886 - 1/14/?t.tlt-t IDt ({:tlEL-L Ai:i
off icer (:TYH 11i115ir ti! 1 ,'i' 1
Dsscription of Work: T/O existing flat roof and reroof flat portion with new torch down to apartment buildingAHdrtt out given. Auth drtle. lLtllrl;11152
R,:ptall:t2g654gg - 1/14,/?r'r?(r 4r?6 r'H
Tronsc.t ion ToLnl t't19.1,l
Pl"nning Condi,ion",
,,,, , nr- -^".,^..," , , .
Engrneer:'Owner: PCI Management LLC Contraclor: Owner-Builder - Generol t'lon Ljpd(te F€e '$?i.-!ii
Address: 421 W Nobel Ave Address: Address: r:tl116utl2- Sl6lruriluil-
- santa Ana, cA e2707 , -
X|iil,lffi i16{l1r:r:r:r .. $3?tr"r6
Phone: (949) 724-9130 Phone: Phone: p,ide s[as RevBlvine 1,1.r.fl1
Tenant State Lic#: License#: r-rl116uu2- 5161?r,[]u-
Lic rype: Architect / Xiii:lill l,??;ffiit' $:i ' "'
I
Bus. Lic#: Desiqner: ii;;- - t,;1ii. L:..
Workers' Compensation lnsurance: Address: (:(:+ i { r r x r} x x x r r -rll.J:j AUt h + : l:lll 1 .1 ,'1.
Carrier:
Policy #: Phone:
Expires: License #:
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp Req'd:
Planning lnsp. Req'd:
Landscaping lnsp. Req'd
Guevara, Jerry
Zuniga, Allissa
Date 0111412020
Date:
Dale: 01114l2O2O
Subject to Field:
Misc. Receipt
Misc. Receipt
Misc. Receipt
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
$333.06
$3.91
$1.00
$22.95
$57.20No
No
No
No
Fire lnsp. Req'd:
Police lnsp. Req'd
No
No Account#Total
Flood Zone Cerl Req'd: No
Every permil issued shall become invalid unless the wo* on lho site authoized by
such pormit is commenced within360 days aftet ils issuance,ot ifthe wotk aulhoizec!
on the site by such perfiit is suspended ot abandoned fora pedod of360 days atlet
the time the work is comfienced .
$22.95
$390.26
$1.00
$3.91 $418.12
$0.00
$418.12
lnspector MID#: 2020-157096
Fee Totat
Paid to Date:
Balance Due
Block: NA
0 77 76002
0 77 7600 2
0 77 76002
0 77 75002
0 7776002
5760 7
57770
57672
57500
5760 7
011 16002 51600
01'1 16002 51601
01 1 't6002 51612
01116002 57770
BUILDING. INSPECTOR RECORD
ID/SIG.COMMENTSSITE-WORK DATE
Set Backs
Forms/Steeli Holdowns
Erection Pads
SLAB Floor
SublloorivenVl nsu lation
l-b4p
'r6,111'
l6t PACr.fi- 3lla<*rr.tr, tan rr-r&,Rool Sheathinq
ec?r-'- ia ,.ya tDShear Wall
.Wr l.o> t-..q-z.Framino
lnsulation/Energy
Drywall
Brown Coat
lr/ason ry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Enqineer Final Report
zM lotFINAL2i6-2D
Certificate of Occu anc
Noles, Remarks Etc
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Bu$n.s a Pdc$n,n Cu,ic): Atry Ciiy or Cotrnry qlrch ,.qukcs I Pcmir kJ .onslruct. alrcr nrrruvc- tjcmolnh or rcBi lnv
sin(tuc, prin h ir\ i\sudrc. ilso rcquifts rh.nNlicrnr lor suchFmir() ilc a sienc,l (,r..rnr lhal hcor sh' is l'ccnsc'l l)ursornr
6 rhc ndvNon( oi llE O,nt.ctn's Li.cn*,i liw (Chllr( 9. Commcrcine wirh S.cxon 7fiIl ot Drvtgbn I ol rh' Busnrs ,nl
Pnnc\sotrs Co,ic)orrl,ar hcorslE isgcmtr rbctclion.nd rhc blsir tu' rhc,llc-!cd cxcnPtron Anvrnnarnnrofselon'0'll5bvrnv
rmlic!fl ti)r a ptfln nrhj.clsrhc amli.anr h a.ivrlEnrlryoinor 'norcnrn irrc hunJtd dDuds 1$500)
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inr.nkl or.ltarcd f;;h rSE-, 7044. Busincs ind r}rna*bff Cdicr Th. Conkr.tn's Liccnsc ljwdocs.or aPFlv lr' 2n owmr of
rh. t)n,Fny wln) tuil&or fi{n,rcs ltFNo. ud whl &n such q)* his\.ll oi hcrrll or lhdgh hr or hcrovtr cq)I)v'cs,
pn,ui[,] fi nBh nupmumnk m tur rtcdol ot oltird lor slc.lt, hourcr. rhe bt'Uhe or r{xurcmnr t $Ll w[hinonc Fr
if complcrion, rh. ownc. Builtlc! v'U hrvc rrr hilcn ol Pmvhs rhrr L or rhe lit B, hudJ olmlorc rhc rqEnv tut rhc IUF * 'r
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-anl Pml6iro C.J.. 'rh. ConrrJuors t trcnsc Lr* Jd( norl0llyn, an ow.cr olpnlpeny*lxt build\ orimp vcr lhcrcon-
uJ *ho conrn$Lr$.hlm,jd\wfha(i! Ertr)(, l(n{J t]ur suxnr ki rhc Contdctn s
tvonKERs cotll'llNsATx)N
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hav..rd will roinrah rCcnficrlcolconsenr ro Sclr-Insurc tuwo 6' conFnsarion $ t'tuvidcd lor hv Sccrnln 170{} or rh'
LdEr Cdd.. Lr lhc pcriomc. or !h. mrk lot vhich rh. p.mir i( L$uc'l
I harc !n,l wru @'nuin sorkcrr .onr.n$rion insurarec, {s tcqurctl bv Ser ion l71D dl rh. Lllu Cod' tor lhc PcrinM' or
rhc w.rk ntr wh(h rhls !.rmil is isfl.n My workqi qrmpcn\arion ,nsuru.c trif .nd noltv num$ct dcl
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$ s r. hcom {hj&l k, ihc wo'kcB con$nsdbn laws ol Cahlomix. and a3rcc rhir 'fI sh.uld h.comc \!
wo.tcn $ rtf,tr\drtrnrpn)vinotr\ol S(rnr l7(X, ot rh. l-rbr G!dc. I shrll. tunhwih complv wirh rhdr
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UFER Ground
Exl./lnt. Lath
Flood Zone Certif .
Li.cnsc C1!$:-l,i.cns. Nnmbcr:
-
.-
Planning & Building Agency
Building Safety Division
20 Civic Center Plaza
P.O. Box '1988 (M-19)
Santa Ana, CA.92702
(714) 647-5800
www.santa-ana.org
aPP-'t3 CBC 2016
NOTICE TO PROPERTY OWNER
Dear Property Owner
An applicatio ra ild in per mt h S d in vour.<>nam listing ourself as builder of the rty improvements
specifie \
We are providing you with an Owner-Builder Acknowledqment and lnformation Veriflcation Form to make you aware of your
responsibilaties 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 unlessyou, the property owner,
obtain the prior approval of the permitting authority.
OWNER'S ACKNOWLEGMENT AN VERIFICATION OF INFORMATON
DIRECTIONS: Read and initial each statement below to signify you understand or verify this information.
\lEI. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Buildel' 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.
hf:.'!42 I understand building permits are not required to be signed by property owners unless they are responsible for the
constructjon and are not hiring a licensed Contractor to assume this responsibility.
\A-, I understand as an "Owner-Builder" I am the responsible pa(y of record on the permit. I understand that I may protect
myself from potential flnancial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my
own.
W-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.
S:14-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
"employer" under state and federal law.
":l'O 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.
U:l4Z I understand under California Contractors' State License Law, an Owner-Builder who builds singleJamily 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 Conkactor.
\;f,p 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.
\nl:..]l_g. 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, th,e Callfornia 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.oov for more information about licensed contractors.
U^'-4-, O. I am aware of and consent to an Owner-Builder building permit applaed for in my name, and understand that I am the
party leg and financiall res onst for con at the fol n s ad-
dress (^r.AL t/
\:-]A1 , I agree that, as the party legally and flnancially responsible for this proposed construction activity, I will abide by all
applicable laws and requirements that govern Owner-Builders as well as employers.
\:b, 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. ivote.' A copv of the propertv owner's driver's license, form notariza-
Signature of Property Owner Date: I oL7 LLC
Print name of Owner p'71+Br lr +FAR 4 d ^nos*-A"^L nr o 4 7.T t4*u "tr"L"*(9 \'
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.
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:
propertv ow ner's sid n atu re.
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 issued to verify the propefty owner's signature.
*,SANTA
NA
PLI\ITiG
&[uDnG
Ifi\CI
Planning & Building Agency Smoke & CO
Alarm Affidavit
20 Civic Center Plaza Ross Annex
P.O. Box 1988 (M-'19)
Santa Ana, CA92702
(714) 647-5800
www.santa-ana.orq
tNSP-02 2013 CRC
This document mdy be found ot...htto://www.san la-ana.orolobal
(Please use a black or blue ink ball-point pen)
Project Address:4zl Alo;,;l A.t
Permit Number:/olloLYSL
Property Owner:
Contractor:Crol rool 49-v>t -z License #: c-37 7l o / /?
State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential
buildings.
California Residential Code (CRC) Section R3l.4.1and R315.2 states in part that existing dwellings be
"retrofitted with smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R314.3.3 define
the requ ired locations.
A eo,h boxes below must be checked:
dC^raonmonoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of
bedrooms and also on each level of the dwelling. Alarms are required in bedrooms with gas-fired
appliances (i.e. hot water heater, cooktop, furnace) or a fireplace.
EKmok" alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping
room, and on each level of the dwelling.
Retrofitted detectors may be battery-operated for buildings where no interior alterations are
performed. Combination Smoke/CO alarms must comply with all applicable standards and be approved
by the State Fire Marshall (SFM). Battery life must be 10 years.
I hereby certify that I am the contractor or the property owner of the above project. I further certify
that smoke alarms and carbon monoxide alarms have been installed in compliance with the governing
Codes and have been tested to be functional. l, also, hereby certify that lwill retest the alarms per the
manufacturer's instructions.
lcheck onel E-.'Licensed Contractor tr Property Owner
NOTE: Ihis sef-certificotion is only used lor projects that ollect the ErTERIOR of the structure. This
process is applicoble ONLY to projects where occess to the interior oI the dwelling by o Sontd And
lnspector is not required.
Signature:Date 2-{'zOE\/ L/
Have this completed form and the job-card readily available on final inspection!