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Home My WebLink About30341892 - PermitCity of Santa Ana 20 Civic Center Plaza (M-'19), Santa Ana, CAg27o2 Plumbing Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853 Permit #: 30341892 Pin #: 94652 Proiect Address: 4905 W First St Assessor'sParcel: 108-741-04 Lol NA Unil. Block: NA Btdg: Tract: NA Address Range; Historic: No Suite Range: Zoning: Ml Owner: Address Phone: Tenant Name: Contraclor Address: Thoai Tang '14541 Bushard St Westminster, CA 92683 (714) 936-2803 Discount Spa & Salon Furniture Owner-Builder 011 16002 01116002 0'1 1 16002 01116002 01 1 16002 Amount 't4.78 57.57 22.95 57.20 3.91 51602 51602 51600 5'!602 57770 Fee Typs Water Closet Min Fee Adj General Plan Update lssuance Microfilm Records Qty 1 .00 1 .00 1 .00 '1.00 1.00 Fee $14.78 $57.57 $22.95 $57.20 $3.91 Phone State Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance: Carrier: Policy #l Expires: Botchi:5{20t1 - 2/3/2O2O I03 omoroleslS oftice: CTYH lpsnsi: 78 2 of ?Acct+! Refi! 303{199? Rcpt*:02887095 - 2/3/2920 ll:50 Al1 Tronsdct ion Totol t3l2.g? Thoo i Tons 6enerol Plan l,Jpdote FPe 01 I 16002- 51 6r111110rl- ll icrof i16 & Docurents 011160[2- 57770008- Pluib i ne (t1 1 16002- 51602r1ri0- Cosh Chonse Replace toilet 3?2.9$ $8.91 t129. SS t3?0.00(i7.1S) Planning Conditions: Planning Approval By Plan Checked By Permit lssued By: Subject to Field: Building Permit #: Commercial Alteration Toilet Occupancy: Constr Type Code: B V B, SPK cPc 2019 Noles: Date: Date: Date: lvlisc. Receipt: Misc. Receipt: Misc. Receipt: Total Amsden, Julie Every permit issued shall become invalid unless the wotu on the site authorized by such permit is commencod within 360 days aftet its issuance. or il the wo* authoized on the site by such permit is suspended or abandoned fot e petiod of360 days after the time the wo* is comnenced. o21o3t2020 Account# $156.41 $0.00 $156.41 lnspector ll'/'lD#: 2020-157526 011'16002 51600 01116002 51602 01116002 57770 $22.95 $129.55 $3.91 Fee Total: Paid to Date: Balance Due: Building Use: Job Type: Nature of Work: PLUMBING.INSPECTOR RECORD APPROVALS DATE ID/SIG.COMMENTS OWNET BUILDI]R DII-CA&I'I'ION I ncrcby nlhar undcr t[nrlry {'l ncrjury rhar I onr crcnru riom rhc ()nrmcr{n\ l.iccn\c lf,r' lor rhe r.rbwi'rs rcnqm (se.n).rll5 l,usirc\\ ! PmL$io Codc) Atry Ciry or Counry shi.h ,cquircs {crnir ro $ nrucr. rlrrr. impr.\t, d.frn(h.r El.n my nflctuc, pritrlo ir\ i\\u3trc.. rho rcqlnc\ rh. rnplicrnr tu' \uch Frnrir h lild r si8nc nd.m rh l.. or shc h licctr{J tlnruinr ro lhc [ori\nn$ of lnc Conrlcl,tri l-iccnsd Lr$ (Chrpr.r 9. Connncncin8 *ih scrrnn' 7Ux) .r Dirki{ .r or rhc Busin.ss ,n Pn,t \\ion\ Codc) or rhlr hcor\hc i\ c{cmp' rhcrclronrnd rhc hrsi\ ttr rh.rlhlLlt cxcnrllion AtryvidarionofSsthnT0.ll5hylny rmli.xtrrtu,rnnnnrDijcrhthcrptli.Mrk,r.ivilr.nnkyoftroitrxncrhnlilchundrcddollrrls5m).,a/ '1ff..","* "rt..r'.,y.y i1 n'J ctr.rli4cr\ tr rl-rrpc\J\,h.tr -.h.1{T.n\ir, i $'ll'trrh'tr,r1JJrh.{dNhr,i rhcpn),rny $lm tuilds or n\rn)r\ rh.'srn. r'xl wlx' dr\ {'ch sorl hnn\cll or hcr\.ll or ihn,ufh hk or hcr ow cmlloy.cs. p(,v ci rhri s!.h lnJnnvcnrrr\ .r! rxf i.tcdlc\l or .fla&l n, {b lf. hotr Ns. th. I[rllDg or ir{rovcEnr i\ v'k] wirhir otrc re f.ollrbrirn,rlrOwkrBuiklcreillhrvcrhchtrd$orfiovr*rhrrhcorshcdidtr.rhuik]orinprovcrhcpmncnyli)rrn purF,*of -l- us o*rcr of rhc ronlny- !m crclusivcly conrrur ins *irh li.c"*d conrEcroF r. on(er lli Eoif,r isd. 7044. aB'mdi atu Pmf6sin Codc: Tnc Contrlor's Lic.nsc Law do.s mr ,tply ro of, owncr of rmI.ny who builds .r iftpiots In.rco.. und who conthclr for such rmirrs wnh n Conhcrodl licciicd pu^ua ro thc ConrBcroar Liccn.c ttw). r unld Sdi.. . I & D"te 4z- a) -?Dzd o,M, l)l( I \R \ r l()\ l.rlry ( {xr.. riir lhc l)crhnruEc ol rh. {oni ntr *hi.h 'hc |Emir i\ i\lucd ifu {o'I r,n trhi.hr]rs t)cirniri\ n{dl NIy\o*rrs.odtf,nxriL(i'xn'.frmidIkll].lr.tntrn$errc ri,lir) Ntrtr.hc' F\ ./1-/'fb.ui l) rhdr rhc t{rri{tr\'tr!c i'l rhr *1 1 li1 trhrh hh t{nn F rL'cd. I .l-rl'\.J.1'hq, r.i'hi..rrir5.s l.'\,.'rIl.tru., ' la(. ',i(-'''r nir riJx!'.crhJr nor cn{,loy lny pcMn in any f,uftr ir I should tf,.orE suhrccl lo rhc wo*tr{ .. Drnsd i.n pm!i\io.{ of s.cri.n ]7m of rh. tibr (\dc, I stull. kdh*irh comnlt (irh lhos ,r.vnions I'VARNIN(;j F,ilu,e ro suE tr.k ^ conwnrarion $vcElc k unhuful. .nd stull subFr 3, dnl,lorrt .ivil nn.\ up ro .N hxndrd rhoutud d.lhh (Slfir.fiDr. in iddfin,n h rhc co{ ol conD..\ation. daro8cs S.crn 1076 ofrhr litl, c(dc. inr&c{ and r(ortuv s f..\ . - l -'- Z \r,r,r*-,r, or rltr h,\ircs\ rtr(lPrnc\\iorr\ (i c. d ry li.ensc n if r lnncc rxl.r'lccr Ld.r,l rc8ul k'ns ESarJing asbcsnx r.n,vul trc .or amlk0bk ro lhis pmj.t rcad rhis q,plicrrion ord srarc rhll rlE ovc itrforrornrn n .orcct. I lgN ro oq,ly lnh !I Cnr .nd Cou!'y or rhl\ Ciry !nd (i,nn! n).trrrr nrn, rh. 1],*,,",".,,^.,", *s Ehtim to buildim ronsrrucrion.,nd lErcbyourlmrizc l)rrr UNDER GROUND Waste & Vent Water-Under lloor Gas-Underfloor Building Sewer Area/Storm Drain lnterceptor/ Clarifier TOP OUT Waste & Vent Water Pipino Gas Piping Rool Drain Tub/Shower Test Rough Water Heater P-trap/Drain Line [.4ain Drain/Pool Pipino Fill Line/Back Flow Pool Heater/Gas Line Miscellaneous Gas Service Waler Service Lawn Sprinkler Sanitary Sewer/Cap Back Flow Device Rough Plumbing Final Gas Test Meter Release FINAL 7- lo' zott'{L< tst t e t@t Z? Notes, Remarks, Etc. POOL/SPA I hccty sfirh und6 lcnrlry of ldjory orr or rnc follosing &.kEtiDns Lienrchrr Lietrs Numhci - D.r. _ C@|mrr_ CANSIBI]CIIOI{!EIDINCAGENCI I hcrh, nmrm und* Fnah, o, Friury rh.dhcE ir !.lnarruclion h.dire.!.fty for rlE l.rformkc olrh. $uk for which rhn Frmn is i\\ocd (S< 3097.Civ. C ) L.r.lcr. \omc - t.,n.,'\ AJJ,r.\ AIILICIIILDECLLBAI:IA! I tf,rcht !finr udcr ltrtralry oi pcrjury orc ol r[c rbllowinB ccl rriors: I)cftrIion P$n ] stri.sN.rlr.nrk Fcdcril RcexldtrF(Tirl..{). Prn6) -Rcqutcn Lctlcr of Norilicarion !h.v. mtrrhncd top.ny fttr irsp.clion It,t'licx l r,\xml SiRnnltrF: 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-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 specified at v 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 OWNER'S ACKNOWLEGMENT AND VERIFICATION OF INFORMATON D/RECI/OIVS: Read and initial each statement below to signify you understand or verify this information. !/t I . t 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. 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. /, 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. )l L l understand as an 'Owner-Builde/' I am the responsible party of record on the permit. I understand that I may protect rfryself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. _Ztr_q 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. I understand if lemploy or otherwise engageany 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 "employef' under state and federal law. jZ_6 I understand if I am considered an "employer" under state and Federal law, I must register with the state and federal lovernment, 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. -' /t 7 . I understand under California Contractors' State License Law, an Owner-Builder who builds singleJamily residential dtructures 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. .Jl_8. 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 in.iuries sustained by any subsequent owne(s) that result from any latent construclion defects in the workman- ship or materials. 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 unless you, the property owner, obtain the prior approval of the permitting authority. Jh 9. 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, 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- 32 1-CSLB (2752) or www.cslb.ca.oov for more information about licensed contractors. 4 lO.I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the larty legally and flnancially responsible for proposed construction activity at the following ad- dress: _/Z_11 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. 4-/ lZ. lagree 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 impo(ant 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. property owne r's si qn atu re. Signature of Property Owner Date: 2 -3 -La>D 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. 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 fllled out the above information and certify its accuracy. Property Owner's Signature Date Print Name of Owner Note: A copy of the ownels drivet'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 propetv ownet'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. /Vote.' A coDv of the propertv owner's d ver'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 Print name of Owner la cn, , ,tz-'- - AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF ScopeofConStructionProject(orDescriptionofWork):