HomeMy WebLinkAbout10296528 - PermitE
Project Address: 1214 W Bishop St
Assessor's Parcel 010-281-06 Lot: 36
Bldg: Address Range Suite Range:
Zoning: R'lBlock: NA Tracl: 1470 Historic: No
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building
Permit Counter: (714) 647-5800 lnspection Requests: (7lq 6A7-2738 lnspector Section: (714) 647-5853
Permit#: {0296528
Pin #: 83137
R-3
VB
cBc 2016
x-0602320257J
1st FL Area: 0
2nd FL Area: 0
Other Areas: 0
Garage Area:
Total: 0
Patio:
T.l.Area:
Yards Req'd:
Valuation: $3,000.00
Occupancyr
Constr Type
Code:
Flood Zone:
# of Stories:
D€scription of Work: Replace (6) windows - same size & style
Planning Conditions:
Phone:
Tenant
Contractor
Address:
Owner-Builder
Engineer
Address:
Phone:
License #
Architect /
Desiqner:
Address:
ALBERTO G CAMACHO
1214 W BTSHOP ST
Santa Ana, CA 927034505
(7141676-6322
Eotchi:{3998 - l/2
of0 ice: CTYH lr,1
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policy #:
Expires:
Acct+
RcFt +
TnGns
ALEER
iozzrso:t' - :'::
16''on 'o'tlnnr*o
Phonel
License #P.u i ld
r:tl1 16
r n9
[02- 516(rltr(tr:'-
07776002 57 6d: Peimit Fee $154.26' s93.17
$234.08
$1 .00
$21 .25
$52.98
Planning Approval By Guevara, Jerry
Plan Checked By:
Permit lssued By: ,
NPDES lnsp. Req'd:
PWA lnsp. Req'd:
Amsden, Julie
Planning lnsp. Req'd:
Landscaping lnsp. Req'd Flood Zone Cert. Req'd: No
Every pemit issued shall becofie invalid unless the wotu on the site authotizod by
such pemit is comfienced within180 days aftet its issuance,or if the wotk authotized
on the site by such permit is suspended or abandoned fot a peiod of180 days after
the time the wo* is commenced.
lnspector MID#: 2018-'143518
onrcood
'f59g)AvecllSe{i0o'.
.. ,
07776002 51601 Penalty
07776002 57612 Bldg. Stds. Revolving
07776002 57600 Gene.al Plan Update
07776002 51601 lssuance
Fee Total
Paid to Date:
Balance Due:
Oale 0512212018
Date:
DaIe: 0512212018
Subjecl to Field;No
No
No
No
Fire lnsp. Req'd:
Police lnsp. Req'd
No
No Account#Total
0'1 '1 '1 6002 5'1 600
01 116002 51601
01116002 51612
$21.25
$534.49
$1.00
$556.74
$0.00
$5s6.74
Unit:
Building Use: Single Family Dwelling
Job Type: Alteration
Nature of Work: Windows
Existing Bldg. & Use: Sfd w/att garage
Proposed Use:
Owner:
Address:Tnr F';rlrn I !
Eii?ffiI*l'l!,H['l,tt" "'
[,4isc. Receipt]
lMisc. Receipt
Misc. Receipt
BUILDING- INSPECTOR RECORD
SITE-WORK DATE IDiSIG.COMMENTS OWNER BUILDER DELCAII 'I'ION
I terchy atlto undcr !.n!lly ('i pcrjury rhlr I !m cxcnrlr iron rhc Conlrrro6 l,iccne ljw fo! rhc aollo*ins rcason {sr 70.115
Br\ihc\! and lhfc\si,n Culc) ny Cny or Cotnry whi.h rcquir€s a plrni, ro d)nir cr. ,lrr, inpmvc, dcmlish or rP.ir M,
slru.rur., pritr ro ns issuan.., nls.cquics rhc appli.rnr rt, su.hr.mir ro 6ld a siencd sl,lcnEnl rtu hcorshc ir lianscd ,unulnt
ro lhc Dovhio.s ol Iht Connrlff\ Lictnscd L.* (Chiflcr 9. Com,ncncirs eilh Scclion 70OO of Divisi.n :1 ol lhc Busihds rnd
Pm{.*n,ns C{xlc ) or ihar hcorrhc t .xcmrr rhcrfrom nnd rhc hr\i\ lbrrhc rlhB.d.r.nun,n Ahy vn,hrion ol Sdn)n 701I 5 hya.y
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providcd rhlr such infrovemnh aF mr i.tcndcd o. oficrcrl for nrlc Il h.wcvc( rhc hui(irB or nnporcNd n wU rirhirr om )ta
ol$mplcrbn, $. Ownd Buikld wrll hrvc lhc hndcn ofptuving drd h( or sh. did nor huild or in{role lhc nmldy lirr rhc lDqx'sol .
l.!\owncrofrhcpmpcny.rm.r.lu{volyconr&rifgqnhlicdtr\cd.ornfttrsrr&tr{,x.rrl..rn&.r(scc.7(!4.Du'iic\\
itrd firlLasarflcodc ThcCotrlrrcl,tr s Liccn\c L0* rloc\ nor.nDltr' rnowD( olpronnysho huild\o. imp(,$\rhcrdnr,
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Libor Codc. toi lhc pslortuncc .r rh. work r{tr which rhc pcmir i\ i$ucd
I h.v. rnd *ill nrinrrin wortum .onpctrsalion insurtrmc, as toquncd hy S.crion 3?m of lhe Lltn Code, f$ rh. Fd.rn,tuc or
rhc work lor ehich rhisprnrir is issun. Mywo*c6 comrcns.rion insumncc eric. and policy numhcr a.el
Poli.yNuilb.i ExDtcr
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WARNINC: Flihrc ro scorc worleri.o'np€isarioD colebac is unhwliil. dtul shnll subjc.l m cnll]b)rr xr criDiral pcMllics ond
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COXSIBUCIIONIENI)IXGAAENCI
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tsuc{ (SL{. 1197, Cir. C.)
AITITANLDECIABAIIAN
I tErcbt amnn undcr pcnrhy oipcrjuryotrc ol Ihc followirA dcclomtions:
D.mrIn,n P.rmirs A\b.nos Norificarion Ptdcral Rcgularions (-lirlc 40. P0n6)
Rcqrir.d lx f .f N.riU.didr
lc.nilyrh.rrl[ltdciil,c8ullrions rcsardins ash:(os rcn$ul rrc nor rpli.ahL r, rhir rmiccr
i,D i\ corcd. I l3la r,.onrly sirh all Cntrnd Co!trry
o. Q,
.irhn ( iry,fd Corirr ro Mrcr qxn' ihrf--u. r, ,n, , n*. ,. ,. ,,n. trpp'L r \rxh rhrrr'.:r^.\rtr i,J'
$'iir*W&'n nol ,l-N'/1v
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loor/Vent/lnsulation
Roof Sheathing
Shear Wall
Framing
lnsulation/Enerqy
D rywall
Ext./lnt. Lath
Brown Coat
l\ilaso n ry
T-Bar
Handicap Req.
Deputy Final Report
Engineer Final Report
Flood Zone Certif
FINAL rottE//{filw*'/u'
Certiticate of Occupancy [/,
Notes, Remarks , Etc.
(
Pool Fence
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SANTA ANA CA
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MAYOR
[4iquel A. Pulido
MAYOR PRO TEM
Michele Martinez
COUNCILMEl,rlBERS
P. David Benavides
Vicente Sarmiento
Jose Solorio
SalTinajero
Juan Villegas CITY OF SANTA ANA
PLANNING & BUILDING ACENCY
20 Civic Center Plaza
P.O. 8ox I988 . Santa Ana, California 92702
www.santa-ana.org/ pba
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
improvq,rnents specified,at -1r-/4 W b/sHo Au Sn l.l:-a il"va Q4 qZ+O3
We are providing you with an Owner-Builder Acknowledoment and lnformation 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.
4-h , I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder"
building 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.
A.G 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.
A{:_9. I understand as an "Owner-Builder' 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.
/4:!j_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.
A-LU. 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.
AJZA. 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 compensation of each 'employee." I also understand my failure to abide by these laws may subject me to
serious financial risk.
A {, l. I understand under California Contraclors' State License Law, an Owner-Builder who builds single-family
residential structures cannot legally build them with the intent to offer them for sale, unless a// work is performed by
SANTA ANA CITY COUNCIL
ACTING CITY MANAGER
Gerardo Mouet
CITY ATTORNEY
Sonia R- Carvalho
CLERK OF THE COUNCIL
l\,4aria D. Huizar
moUidolasanla-ana.oro
Mayor Pro Tem. Wa.d 2
mimarlinoz@sanla-ana oro
Vicente Sa.mie.to
vsamienlo@sa.la aoa oro isdqlp@salrqia!!
P Oavrd BeMvrdes
dbe.avrdes@sarla.a.a oro
JLran Villesas Sal Tinsiero
Ward 5 Wsrd 6
iviileiBs@santa+naoro srinaiero@sania€na.oo
A
licensed subcontractors 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.
' Gt 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
financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the
workmanship or materials.
A-C? , I understand I may obtain more information regarding my obligations as an "employer'from the lnternal Revenue
Service, the United States Small Business Administration, the California Department of Benefit Payments, and the
California Division of lndustrial Accadents. I also understand I may contact the California Contraclors' State License Board
(CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.oov for more information about licensed contractors.
Zl - Lr tO. 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
address:
/1. (--, ll.l 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.
A^/\, Ut 12. I agree to notify the issuer of this form immedialely 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. Nole;A coDv of the DroDertv er's license
form notarization, or other verification acceptable to aoencv is reouired to be presented when the permit is
,s ued to the owner's ure.
Signature of Property Owner c t (^Date: O Z-g
,0
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.
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.
Date
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 lo verify the property owner's signature.
SANTA ANA CITY COUNCIL
moulldo@santa-ana.oro
Mayor Pro Te,n. Ward 2
mrmarlr.ez@sanla-ana oro
Vrcente Samrenlo
vsamienlo@sanla ana.oro isolorio(osanla€na oro
P. Oavd Benav des
dbenavids@santa€ns.oro
Print name of Owner
ScopeofconStructionProject(orDeScriptionofWork):
Property Owner's Signature:
Print Name of Owner:
Juan Mllegas SalT,naterc
ward 5 ward 6
villeoas@sa.ta-anao.o stinaie.o@sanla'ana.o.o
SITE| 1214 BISHIP
SANTA ANA CA
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