HomeMy WebLinkAbout10291383 - PermitCity of Santa Ana 20 Civic Center Plaza (M-1 9), Santa Ana , CA 92702 Build ing Permit#: 10291383
Permit Counter: (714) 647-5800 Inspection Requests: (714) 667-27 38 Inspe cto r Sectio n: (7 14) 647-585 3 Pin#: 41054
Project Address: 701 E Occidental St Unit: Bldg : Address Range: Suite Rang e:
Assessor's Parce l:
Building Use:
Job Type:
014-213-18 Lot: 23
S ingle Family Dwelling
Alteration
Nature of Work: Demo & Windows
E xisting Bldg. & Use: SFD w/att Garage
Proposed Use:
Blo ck: NA
Occupancy:
C onstr Type:
Code:
Fl ood Zone:
# of Stories:
Tract: 2238
R-3, U
VB
CBC 2013
X-0602320276J
1
Histori c: No
1st FL A rea:
2 nd FL A rea:
Oth er A reas:
Garage A rea:
T otal:
Zoning: R1
Pati o:
Tl.Area:
Ya rds Req 'd:
Val uation: $8,500.00
Description of Work: Demolish pe r mitted patio cover/unpermitted enclosure @ rear of std. Legalize change out of all (13) windows & (1) sliding glass
door. lntall missing cover to attic opening. Repair damaged flooring in living room.
Planning Conditions:AII materials to match existing.
Ow ner: YESENIA ARRIAGA
Address: 701 E OCCIDENTAL ST
Santa Ana, CA 927072333
Phone: (714) 928-3010
Tenant:
Pl anning A pprova l By~. ~sza ilia, Manny
Plan Checked By :
Permit Iss ued By: d i, Teri
NP DES lnsp . Req 'd: N .
Co ntractor: Owner-Builder
Address:
Ph o ne:
State Lie #:
Lie Type:
Bu s. Lie #:
W orkers' Compensati on Insurance:
Ca rri er:
Poli cy#:
Expires:
Date: 11/15/2016
Date:
Date: 11/15/2016
Subj ect to Fi eld:
Misc. Rece ipt:
Mi sc. Rece ipt:
Mi sc. Rece ipt:
PWA ln sp. Re q'd : No Fire lnsp. Req'd:
Planni ng lnsp. Req'd: No Police lnsp. Req'd: No
No
A ccount#
Land sca ping ln sp. Req'd : No Flood Zo ne Cert. Req'd : No
Every permit issued shall become invalid unle ss the work o n the site authorized by
such p ermit i s commenced within 180 d ays after its issuan ce.or if th e work aut horized
on the site by s uch permit is suspended or abandoned for a period of180 days after
the time the work is commenced.
0 111 600 2 5 16 00
0 111 600 2 51 601
0111 600 2 5 161 2
En gin eer:
Address:
Ph one:
Lice nse #:
A rchitect/
DesiQn er:
Address:
Phone:
Li ce nse #:
T ota l
$20 .56
$5 17.12
$1.00
Batch;:s6L4/ -1111~/LUl6 1u: PLu PtL~
Ufi ic\:'.: CTYH 1rcms~: 54 1 of 2
t,cc•:-~: Ref½: 102'i:l333
~CP~~:0 1663905 -11/15/2016 4:26 PN
lrunsaction Total $655.63
Gen~ral Plan UPdate Fee
01116002-51600000-
U1116002-51601000-
~lJ~ St ds Revolving
Utl16002 -51612000-
0 1116002 5 1 6 0 1 Permit Fee
0111 6002 51 6 0 1 Investigati on
01116002 51601 Penalty
0 1116002 5161 2 Bldg. Std s. Revolvi ng
0 111 60 0 2 5 1600 Gene ra l Pla n Update
0 1 116002 51 6 0 1 Issuance
Fee Total:
Paid to Date :
$20.56
$517.12
$1 • (1(1
$149 .25
$90.14
$226.47
$1.00
$20.56
$51.26
Inspector MID#: 2016-132841 NOTICE OF VIOLATION
Balance Due:
$538.68
$0 .00
$538.68
SITE-WORK DATE ID/SIG.
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
SubfloorNent/lnsulation
Roof Sheathinq
Shear Wall
Framinq
Insulation/Energy
Drvwall
Ext.lint. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Engineer Final Report
Flood Zone Cert if.
1 I I-
FINAL "Z..\n \\b ~')9-.~
Certificate of Occupancy . -
Notes , Remarks, Etc.
BUILDING-INSPECTOR RECORD --COMMENTS OWNER BU ILDER DEL CARATI ON
I hereby affmn under penalty of perjury thal I am exempt from th e Contractors' License Law for the fo llowing reac.on (Sec.7031.5
Bus iness and Professio n Code): Any City or County which requires a pcnnit to construct. alter, improve. demolish or repair uny
Slructure, prior to its issuance, also requires the applicant for s uch pennit to file a signed statement that he or she is licensed pursuant
to the provisions of the Contractor's Licensed Law (Chapter 9, Commencing with Section 7000 of Divis ion 3 '51 the Business and
Professions Code) or that he or she is exempt th erefrom and t he basis for the alleged exemption. Any violation of Section 70ll .5 ~>y any
applicant for a pem1it subjects the app licant to a civi l pcaalty of not more than five hundred dollars ($500).
_I. as owner of the property, or my employees with wages as t heir sole compensatio n. will do the work and the suucture is not
intended or offered for sale (Sec, 7044. Business and Professions Code: The Contr actor's License Law does not apply to an owner of
the property who builds or improves thereon. and who doe; such work himself or herself or through his or her own employees.
provided that such improvements are not intended or offered for sale. If. however, the building or improvement is sold within one year
of compk.1ion. the O.vner Builder will have the burden of proving that he or she did not build or improve the propaty for the purpose of
sale).
_I. as owner of the property. am excl us ive ly contracting with lice nsed contractors to construct the project (Sec. 7044. Business
and Profession Code: The Contractor 's License Law does not ap ply to an owner of property who bui lds or imp roves thereon,
and who contracts for such proJccts with a Co ntracto,{s) licensed pursuant to the Contractor's License y
Da t~runexempt undcrScc11on / l '{Bj~c;;;;;t}/A/tiJJI\ ~ •
KllRS' CO~IPll~.T ION C
DECLARATION
I hereby affirm under penalty of perJury vmg declarat1011s
_I have and will mamtam a Certificate o f Consent to Self-lnsure for workers· compensation. as provided for by Section 3700 of the
Labor Code. for the perfonnance o f the wo rk for which th e permit is issued.
_1 have and will maintain wo rkers· compensation insurance, as required by Section 3700 of the Labor Code. for the perfon nance of
the work for which this pcm1it is issued. My wo rkers' compensation insurance carrier and poli cy num ber are;
Carrier: __________________________ _
Policy Number:. _____________________ Expires: __________ _
_I cert ify that in the performa nce of the work for wh ich this pem1it is issued. I shall not employ any person in any manner
so as to become subject lo th e workers' compensation laws of California. and agree that i fl should become subject to the
workers' co mpensation provisi ons of Section 3700 of the Labor Code, I shall. forthwith comply with those provis ions.
WARNING: Failu re to secure workers' compensation coverage is unlawful, and shall subject an emp~oyer 10 c7rirninal penal · and
civil fines up to one hundred thousand dollars ( 00.000), in addi tion to the cost of co mpensation, damages as pro,iid or the
Sectio n 3076 of the Labor Code. interest and atto ey·s f~. A . 1 /2, f
Date:. _____ A icant: / // 11/J.P AYJ l.V'/ /11~ '
'\ •-_LARATI ON
L1 C ll'.NS111 CO NTRA<"TllR ,/j:
I hereby affirm under penalty of perjury that I am liccnsc&der provis ion of Chapter 9 (commenci • ith Sect ion 7000) of Division 3
of the Business and Professions Code, and my license is in full force and effect.
Li ce nse Class.: _______________ License Number: _______________ _
Date .: ____________ Contrac tor: _____________________ _
CONSTRUCTI ON LEN DING AGENCY
I hereby affirm und er penalty of perjury that there is a construction lending agency for the perfonnance of the work for which this permit is
issued (Sec. 3097. Civ. C.).
Lender 's Name: _________________________ _
Lender·s Address: _________________________ _
A PPLICANT D EC L ARATION
I hereby affinn under penalty o f perjury one of the following declarations:
Demolition Permits-Asbestos Notificatio n Federal Regulations (Title 40. Part6)
_Req uired Letter o f Notification
_I certify that the federal regu lat ions regarding asbestos removal are not applicable to this project.
I certify, iat I have read this application and state that the abo ve info nnation is correct:::ZI agree to com ywith all City and County
ordi . nc . nd State Laws rela_ting to,t1ildin constni ction. andjj1er a~t. e representatives o fthi . y and Cou1zty o en ter u n the
a bove nt1oned prope,ty for tns peclt Op f"]" ) /) /Vt( r fi;; ;: I r (I/
Applicnn1 or ~'\gen1Signatur e: '//J.,,Jv" /// , {JI/J Date: / I~ )/{ )
Pcrmitc~n/4rint):_ /\/() \('I) { Ci ( J'TrriC111 /) 1 r)(J1 ';!) _/"---I '-' ~ -// l --
V
MAYOR
Miguel A. Pulido
MAYOR PRO TEM
Vicente Sarmiento
COUNCILMEMBERS
Angelica Amezcua
P. David Benavides
Michele Martinez
Roman Reyna
Sal Tinajero
Dear Property Owner:
An applicatio
improvements spe,,..,·,T,·,=:,-"•
CITY OF SANTA ANA
PLANNING & BUILDING AGENCY
20 Civi c Center Plaza
P.O. Box 1988 • Santa Ana, Ca liforni a 92702
www.santa-ana.org /pba
NOTICE TO PROPERTY OWNER
CITY MANAGER
David Ca v9zos
CITY ATTORNEY
Son ia R. Carvalho
CLERK OF THE COUNCIL
Maria D. Huizar
We are providing you with an Owner-Builder Acknowledgment and Information 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.
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.
OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON
DIRECTIONS: Read and initial each statement below to signify you understand or verify this information.
v:1L. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" ~§I permit that erroneously implies that the property owner is providing his or her own labor and material personally. I,
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 property.
\ ~-I understand building permits are not required to be s igned by property owners unless they are responsible for
~~struction and are not hiring a licensed Contractor to assume this responsibility.
I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may
myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name
of my own.
~ I understand Contractors are required by law to be licensed and bonded in California and to list their license
~~iers on permits and contracts .
...>...Ll.-'--r-· I understand if I employ or otherwise engage any persons, other than California licensed Contractors , and t he
I alue of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an
ployer" under state and federal law.
-=..,_....__~-· I understand if I am considered an "employer" under state and Federal law, I must register with the state and
r I government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to
u mployment compensation of each "employee." I also understand my failu re to abide by these laws may subject me to
serious financial risk .
7. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family
ntial structures cannot legally build them with the intent to offer them for sale, unless a// work is performed by
nsed subcontractors and the number of structures does not exceed four within any calendar years, or all of the work is
performed under contract wi th a licensed general building Contractor.
• Miguel A. Pulido
Mayor
MPulido@santa-ana.org
SANTA ANA CITY COUNCIL
Vicente Sarmiento Michele Martin ez Angelica Amezcua P. David Benavides
Mayor Pro Tern, Ward 1 Ward 2 Ward 3 Ward 4
VSam,iento@santa-ana.org MMartinez@santa-ana.org AAmezcua@sa nta-ana org DBenavides@santa-ana .erg
Roman Reyna
Ward 5
RReyna@santa-ana.org
Sal Tinajero
Ward6
STinajero@santa-ana.org
. I understand as an Owner-Builder if I sell the property for which this permit is issued , I may be held liable for a ny
I or personal injuries sustained by any subsequent owner(s) that result from any latent constru ction defects in the
anst")ip or materials.
9. I_ understand I may obtain more information regarding my obligations as an "em ployer" from the Internal Reven ue
e , the United States Small Business Administration, t he California Department of Benefit Payments , and the
rnia Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Boa r d
(CSLB) at 1-800-321-CSLB (2752) or www.cslb .ca.gov for more information about licensed contractors.
0 . I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am
rty legally and financially responsible for proposed construction activity at the foll owing
s: ___________________________________________ .
1 . I agree that, as the party legally and financially responsible for this proposed co nstruction activity, I wi ll abide by
licable laws and requirements that govern Owner-Builders as well as employers .
. I agree to notify the issuer of th is form immediately of any additions , deletions, or changes to any of the
ation I have provided on this form.
Licensed contractors are regulated by laws designed to protect the public. If 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 ci vil court. It 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 . If you obtain a permit as Owner-Builder and wish to hi re 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 iss · the permi · pertv owner's driver's license,
form notariza ble to the resented when the ermit is
issued to ver, /1 ;· /
Signature of Property Owner __ ~...,,rJ--1,,L'"4.J.-+-iL...S:C--'------+-l---":........,_ __ Date: I l LJ 5'-f tL
LuWo 7
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Excluding the Notice to Property Owner, th e exec ution of which I und e rstand is my personal responsibility , I hereby a uthorize the
following person(s) to act as my agent(s) to apply for, sign , and file the documents necessary to obtain an Owner-B uilder Pe rmit for my
project.
Scope of Construction Proj ect (or Descripti on of Work):. _______________________ _
Project Location or Address:----------------------------------
Name of Authorized Agent:----------------------------------
Address of Authorized Agent:. ________________________________ _
Phone Number of Authorized Agent:-------------------------------
1 declare under penalty of perjury that I am the property own e r for the address listed above and I personall y fill ed out the above
information and certify its accuracy.
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 required to
be presented when the permit is issued to verify the property owner's signature.
PLink:WP51/CounterActivity/AssemblyBills/Notice to Property Form 03-14-2016
Vicente Sarmiento Michele Martinez
SANTA A NA CITY COUNCIL
Angelica Amezcua
Ward3
P. David Benavides
Ward 4
Miguel A. Pulido
Mayor
MPulido@santa-ana.org
Mayor Pro Tern, Ward 1 Ward 2
VSarmiento@santa-ana.org MMartinez@santa-ana.org Mmezcua@santa-ana.org DBenavides@santa-ana.qrg
Roman Reyna
Ward 5
RReyna@santa-ana.org
Sal nn~jero
Ward6
STina fero@santa-ana.org