HomeMy WebLinkAbout104101952 - PermitPermit #: 1o41(J1952
Pin #: 7sX{
Proiect Address: 1 139 W Seventeenth St
Assessor's Parcel.399-072-17 Lot: POR I
Unit Bldg
Tract: BATES
Address Ranqe Suile Ranger
Zoning ClBlock NA Hisloric No
Building Use: Commercial Occupancy: B 1st FL Area: Patio:
Job Type: Alteration Constr Typet V B 2nd FL Arear T.l.Area:
Nature of Workr Basement Repairs Code: CBC 20'16 Other Areas: yards Req,d:
Existing Bldg. & Use 66mmslcial/vacant Flood zone: x-o6o232o144J carage Area: valuation: $s,ooo.oo
Proposed Use: # of Storiesr , ,o,u,,
Description of Work: Fill-in unpermitted basement & excavation with slurry mix. Replace concrete piers, posts,.&Lfloel beams,as needed. Return
basement to original condition. Remove HVAC equipment in basement. APPROVEO WITH PRHSSURE-TREATtO POSTS WffHIN
CRAWL SPACE
Planning Conditions: lhterioiwork only. No exterior alterations or modifications
Owner:
Address
Phone r
Tenant
Contraclor
Addressl Address
Mamo Real Estate, lnc
1139 W. 17th Street
Santa Ana, CA 92706
(949) 355-2216
Owner-Builder
EW-Webb Engineering, lnc
Earl Warren Webb
'1299 Columbia Avenue, E-7
Riverside, C,A 92507
(951) 788-2050
c37384
Phone:
License #
Architect /
Desiqner:
Address:
Anchor Tenant lmprovement Concept
John Lopez
125 North Tiana Lane
Anaheim, CA 92806
(714) 351-9809
Planning Approval
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'
By
PWA lnsp. Req'd: No
Planning lnsp. Req'd: No
Frre lnsp Req'd
Police lnsp Req'd
No
No Account#
o
ha , Jeffery
sultants
ski, Teri
Date: 10/2312019
Dale o1l02l2o2o
Date: 01/06/2020
Subject to Field:
L4isc Receipt
l/isc. Receipt
Misc. Receipt
73844
Total
Permit Fee
Plan Check Fee
lvlicrofilm Records
lnvestigation
Penalty
SMIP - Category 2
Bldg. Stds. Revolving
General Plan Update
lssuance
Landscaping lnsp. Req'd: No Flood Zone Cert. Req'd. No
Evety pemit tssued shall become invalid unless the wo* on lhe site aulhoized by
such permit is commenced within360 days after its issoance ot if lhe work aulhorized
on the sle by such permil is suspended or abandoned fot a period of360 davs after
the lme the wotk is commenced
$8s6.67
$230 87
$62s.80
lnspector lVlD#: 20'19-155337
01 1 16002 51600
01 1 16002 51601
01 116002 516'12
01 1 16002 57770
0890100'1 24000
$22.95
$576.99
$1 .00
$23.46
$1.40
Fee Total:
Paid to Date:
Balance Due
., City of Santa Ana 20 Civic Center Plaza (M-'19), Santa Ana, cAg27o2 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Phone;
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Engineer:
P hone:
License #:r_l:rirIr1r:r14:
017760 0 2
0 77760 0 2
0 77760 0 2
0 71160 0 2
0 7116 00 2
08901007
0 777600 2
0 777600 2
07776002
57607
5i 600
57770
576 07
576 01
240 00
57672
51600
57607
$166.53
$230.87
$23.46
$100.57
$2s2.69
$1.40
$1.00
$22.95
$57 .20
BUILDING. INSPECTOR RECORD
SITE.WORK DATE COMMENTS
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loorivenVl nsulation
Shear Wall
allD
Ext./lnt. Lath
Brown Coat
IMasonr
Pool Fence
T-Bar
Handica R
u1D Final Re ort
ineer Final Re ortE
Flood Zone Certif .
FINAL
Certilicate of Occu anc
Notes , Remarks, Etc.
Ol!Nl:R IlUll,l)l:R l)Ul,C/\RA I l()N
I hcrchy,lftrm undcr pctr.lty,rl FrJury lhar I d.rcnpi ti.n rhc conl&clri Liccn* lrl rrtr rhc nnnrqine rasn (S.c ?0:
Btrsincs nnd Pde$bn C{ c): .y ciry or Coutriy whrh rcqtrircs r pcrmir i, cdnnrucr, 2lr.r. iml'lrvc. demolsn or rptrr rny
drucrurc.0norr, s isrurncc. rko Rlun s lhc lppli.ur lbrrd.h n .mi h tilc a vgnc.l srarcEnr rhar hcir dt rs liccn$d Punu.nl
h rhe l'ovr\i,'N of thc Cohtr.l(tr s LNn*d Law (Chrprcr ,. CodmcncinS qih Sccl(rn ,OU) oi Division .l of rh. Buslms ,nd
Pft,fcs$ns C.dc) .r thlr hc or shc i\ crcdpr rhcrc,ion drl ihc brsis ntr thc allcSc,l ckhfln)n A.yvn,btNnotSccri'.ro.ll5byuy
{pplElntlbrrlcrnnrsubjdsrh.,nflsnln)i.ivilp.nallyrlnormorrhslrvchundrcidollar(Ssl()).
-I,I
oqre! oi lhc prupcn y, ,tr ty.npby..lwirhwrPcsasIhctrn)lcuompcD$in)n,wldotlrqGka lhcslrur@i\d'l
inrcnlol o.olLrc'lli,r\rl.(Se7044.Busi,rcssmiPnni$ionsC{rlcTh.Cdnrrd.ktr'sLicc.scljwdocsrorapllyhandqncr.l
rh. pnJIEny wh. huilds or i&T,rci th.d)n. arxl *h) J(cs surh u)r* l,mscllor h.mll or rhtuugh hs or h.r ovr ehlltry.cs.
piov cJrhrr ch impntrrmnt m fr inrcftlctl oioniiql n ab.Il, h)wvcl tlE bu JinS or nryDEmm r$ll*irhmon.wr
of compkrk)n. rlE Oqnu BuUc. *iU haE rhc burdcn o{ pn}vha rhar h. or shc drl mr buill or impn)t d. ln)lxny lor rtE nuqxr€ ol
-I,.sowocrol
rltr pmpcny. darcr.lusivclyconka.rin! s h liccnlc.l c{trlru.br b con{ruc. rh. 8)jccl 1Sc.. 7044. Busocar
aftl Pn,lixsbn Cod.: Th. C. krcttr\ Li.cnsc Law d€s nol apply k' ! own r ot tolc(y who hu itl\ ot ihprovcs thcrcon,
a.d wlD.onk&Flusu.hlr+chwnhrc()htrdvls)li.cn{dpuruarkrrh.Cl,nkr(tr'sL$ntkq)
I rDc\cnfl uklcr S.cr
I h.r.hy rrlt^un'l.r pcnalry orF..rjuryri
LlrlLlrlr r(\
-l
lD!. drl will flimu a Ccnilic{rc ol Conscnr !, ScMn\lrc ntr M)rkdr cor!'cns:xo.,6 F,Yid.d ntr hy Secrion.}7OO olrhc
Lal$r C.Jc. for rhc icdom,ncc ol lhe work nlr rhich rhc pcmir ir issu.d.
I hdv. and will mlirrain work.rr .o mp.os rr tr) n Nursncc..\ rcqutcn 6ySc.ri()n:lTUlotrhc tjhor(i'Jc,lor rhc pcrfonutucot
rhc qork tnr wtu h rhisFcm is i$NJ My wurkc^' Llmpcns htr iNur .cca'cr all Fnrynumhcrdc:
-l
c.d'ty rh.r h rh. J'crl.flnln(e ofrhc wo'k tur wh'rh rhr r.mir r rsrc'1, I shrll nor chlloy rny |1.r.n in any mrnncr
$ Nb t..oN slhFr b rh. Mrkc^ com!.nsrrM hNr ofcalili)mir. anJ rgft rh.r lf I shoul! hc$B thJcd k rhc
wo*c6 comFnerionptuvtrr'nsofSccln,n.!700oirh. Lirr C(x1.,I rhdll tunhw h conply *irh rk)( ntuvisbns
WARNINC: Flrlurc nr $uu,c work *'cont n$ron..vcn3c rs unlxwtul, an'l \h,ll nrhj( arr cnDloycr l,' uimnal Fndhrs Md
n) onc hutr'ld{t rhousdnd dolldrs (ll(x),01ro).
'n
r Jni,)n b rh. co{ .t conrcn\.ru,. Jrmi3c\ rs fr.vtrl.d Lr rhc
Sc.rion 10?6 oirhc Lhtr Colc. trtr.lcsl lnd
,". ot /o 6Ao
I h.'rhyrlh r trtrJ.r I-_Drlryol p.UU'y rhrrI l'(.nrcJ un'lcr F'v'notr olChrplfl , (.inn.kit! snh S.crhr ?O(X)l ol l)'vtru,:l
ol thc BusincslnnJ PbrcisonsCodc. exl nry li.cnsc i\ h tulltnrc. dr,i.flei
.r(ctr.c Numhc'
---
cqlsrBlcuoNrENuBaSgENla
I hc6by ,ftirm uftjcr tEMlty of Frrlry thd rhd is , onirucr irn LtulinS aScmy fq lh. p.rfolmec ol thc wo* tu whah ihr trd !.
isiucd (se. 1097, civ. c ).
tJn,i.,-" Nrm
-
/urIlcAlLPEClABdIlox
I horhy allim unJcr Fnalryol pcrjfiy onc olrhc tulowrnf dccl.ErlnN:
D.tulirr)n P$mirlAshcsros Norili.arion F.'j.Bl R.sulaLdE (Tirlc 40, Pdl6)
_Rcquhd t ttclol Nolili.ali,n
I ccdiryrhar rh. fc'1.ruIrcluhtons rS{nnrS lrh.dosrcfr'vrlrrt nor rmlt$lc r,, rhts Pr+.r
ph(rr(,nr in.!hrr 1h.rlN^. rtrl,rtritkn, rUn..r lx!tu\rJ..trlrv wrrh rllOryr (-,nr Y
rchv u(horiTc rc|t.s.nrxriv.s olrln< Cily rtr! Connry ro ctrrcr trtto r,f,
Ot (od t ? t
IEEITJDaq?m
Set Backs
Zr//S/O
Rool Sheathinq
,/-.)\ttn4Framinqil4/enq
lnsulation/Enerov t l'
I
I+fi1/o/a f.YrufA)w6(
Cr'>^{)
o.t" ol/ o(/zo
t*nJci( AltJrcsr:
-
I
I
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-13 CBC 2016
Dear Property r:
An application for a rng pe ith s been su d n y0ur am S ng rS a the builder of the property improvements
We are providing you with an kn ed ment and lnformation Verifi 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, slgned, and returned this
form to us at our omcial 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 INFO RMATON
DIRECTIONS: Read and initial each statement below to signify you understand or verify this information.
6^a 2. 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.
lr..( 3. I understand as an "Owner-Builde/' l 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.
0-..- 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers
on permits and contracts.
0^( 5. 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.
(v1L 6. 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,.. 7. 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 Contractor.
t^.- a. t 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.
NOTICE TO PROPERTY OWNER
specified at
[t" c t . t 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.
- 9. I understand I ma y obtain more information regarding my obligations as an "employe/'from the lnternal Revenue Ser-
, the Unated States Small Business Administration, the California Department of Beneflt Payments, and the California Divi-
n of lnd,rstrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 'l -800-
2'l -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 legally and financially responsible for proposed construction activity at the following ad-
d.oa"'
hs-l l. 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.
M.cl2. 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.
Signature of Property Owner o\/o6/Date
Print name of Owner Ma+tL.-- &p,
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 flle 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
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 issued to verily the property owner's signature.
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 flrm 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. ,Vote.' A coov of the propertv owner's driver's license. form notariza-
tion. or other veitication acceptable to the adencv is reouired to be presented when the permit is issued to verifv the
propettv owner's sio natu re.
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 fllled out the above
information and certify its accuracy.