HomeMy WebLinkAbout10195340 - PermitCity of Santa Ana
Permit Counter. (714], 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building
l nspectron Requests: (7 1 4) 667 -27 38 lnspector Section: (7 1 41 647 -5853
Permit #: {Ot95340
Pin #: 71252
Proiect Address: 2902W Borchard Ave
Lot: 2
unit:Bldg: Address Rangel Suite Range:
Zoning: RlT racl 3627 Historic: No
Building Use:
Job Type:
Nature of Work:
Existing Bldg. & Use
Proposed Use:
Single Family owelling
Addition
Addition
Sfd w/att garage
R-3, U
VB
cBc 2016
x-0602320256J
'l st FL Area: 4'12
2nd FL Area:
Other AreaE: ,
Garage Area: .
Total: 4'12ilr :L I
i'rt"
,/ .i, i(,!
Valuation: $4O,O0O.OO
Description of Work: Add 412 sq ft to enlarge living room and bedroom. Add '18 sq ft porch
lorLll
nr! uDdote f
'i I Airi 'lrii-Planning Conditions:
Owner:
Address
Phone:
Tenant:
Engineer
Address
Chuc Nguye
Chuc Nquye
7540 Katella
Stanton, CA
t6u 1r:lr:ll:l-
:v31,/ ing
iti1Il-{r'll:l-
Do.rrnenllE
Thuc Nguyen
2902 W Borchard Ave
Santa Ana, CA 927043005
(714) 675-8606
h,PE
n
90680
(714) 893-0609
38556
ABC Art Desiqn Development Group
12550 Brookhurst Street, Suite F
Garden Grove, cA 92840
(714) 499{798
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policy #;
Expires:
Phone:
License #
Architect /
Desiqner:
Address:
Phone:
License #
ner-Builder
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'
PWA lnsp. Req'd:
Planning lnsp. Req'd
Guevara, Jerry
So, Anson
Amsden, Julie
07716002
07716002
01776002
0 890100 7
0 77 76002
07776002
0 77 7600 2
Permit Fee
Plan Check Fee
Microfilm Records
SMIP - Category 1
Bldg. Stds. Revolving
General Plan Update
lssuance
Date: 01/18/2018 Misc. Receiptr 70506
Date: 05/30/2018 Misc. Receiptl
Date: 05/30/2018 Misc. Receipt:
Subject to Field:
Total
5760 7
53 600
577?0
240 00
5 7672
57600
57607
$578.48
$610.60
$43.44
$5.20
$2.00
$21.25
$52.98
$1 ,313.95
$610.60
$703.35
No
No
No
Fire lnsp. Req'd:
Police lnsp. Req'd
No
No Account#
Landscaping lnsp. Req'd: No Flood Zone Cert. Req'd: No
Every peflnit issued shall become invalid unless the work on lhe site authorized by
such pemit is comnenced within 180 days after tts issuance.ot il the wo* aulhorized
on the site by such permit is suspended ot abandoned for a petiod ofl80 days aftet
lhe time the wotk is commenced.
01 1 16002
01 1'16002
01 1'16002
0'1 116002
0890'1001
$21 .2s
$63'1.46
$2 00
$43 44
$5.20
MtD#. 2017-138714
51600
51601
51612
57770
24000
Fee Total:
Paid to Date:
Balance Due:
Assessor's Parcet 4O7 -041-28 Block. NA
Occupancy:
Constr Type:
Code:
Flood Zone:
# of Stories:
Patio:
T.l.Area:
Yards Req'd: ' ,
Contractor:
Addressl
lnspector
BUILDING. INSPECTOR RECORD
SITE.WORK DATE COMMENTS OWNER AUILDTJR DELCARA'TION
I h.rcby rrtr uMcr p€nalry ol p.rjxry
'hd
I mr cx.n1fl lmn rhc ContacroB Liccns ti{ inr the hllowinE @son (Scc.703l 5
ausnrss and Pbrdsion c.dc) Any Cny or Counly *hi.h rcquncs a pcirnn lo onnru.l. ahcr. inrprolc. dcnnnh or Eirn uy
srdclurc, riffro nr issuaNc. also rcquncs lhc np,'licant lor such l)cfln ro nbasisned ilarcmnr rhd hcorsh. is li.c.scd tuBxr.r
lo rhc pmvii,ns of rhc Conrn.roi s Liccnrd L,w (Chapr.r 9. C.nnncncrg wirh Scction 7U)0 oi Division I otrh. BusirrcN rnd
Pofe$ions Codc) or rhat tr or shc h cxempl lhcrcrionrand rhc b.sn for lnc lllcscd c$mrrion An, vn,hrionorserionToll5 by a,ry
rptl.!qrr'nrrflrnir\uh|.cr.rl. rnrhtrnrl,rti!ilpcnrlry rrormn.,liltrrhd rJd.llrF'1rUU,,fN
,"-+. as owncr ol rhc poFny. or my empbyces *ith wases r( lhcn $t onrFnsalii'n, willd() rhc *mt a,rl rh str(m,s mr
inrcftlc or olTcrcd ntr sb (56 7l}ll.1, Bu:inc$ rtrd Pr.rcs\i,n* C(xlc: Thc Conlricror'\ Li.cnsc L.w docs nor oplly ro ano{ncrof
rh. l,otEny who t{ilds or irym6 rhcFr- and *ho des suh $ort himscllnr h.rtltor rlYouSh ht or hcr.wn cmPloyccs.
pmlidcd rhar s&h impmlctunk m nor inrcndcd oi offcrcd ru slc Il lwcwr. lhc hoildinS or impmvcm i\ y,ld wirhin .m Fd
olcorqrlction. r1r Owm. auikhr rillltrrc Ihc hrdcn ol pmving rhal l.c or shc dil ml buikr or inpoft rhc tn)rdy ror 0r lu.lFs ol
_1.r\.sncrorrtunm|rny.anrcrrlu\irclyconki.ring*irIlicc\cd.ofir.nn!h.onsru.rrhcln)jcd(SLr7(].lt-Burncs
rndI'nii:\\hiCodcThcCotrrmnn\l-i.ctr\cLr*doc\notrnrlybrnosrcrotnropcnyshobuild\ornpn,(csrh.rcor.
nJ *ho.onrrcr\rn{'chl,n,jccr\wirhrC.ntact,r\)lic.n\cdnursunDrhrhecoDrdolsLl.cn$L.s)
-l
nmc\ctrv undcrs(rio
d,",.5lihl_LK X"t!4]!xD[ti:11[urr5 -l!a!DrcLlXAl!!)!
I hrrrh'Jil nnunJrrI[tr,'l(!olItrrlurto crlrhcl,rl({!i'rgtlr.hrrri,nr\
-l
hrvc 0ndwill nrinrain aCedilrarcofConscnr ro Seltlnsure lorsorlcn c.mp.nsdn,n.as pmvidcd lor byS..lion 3100 ol'lhc
tjtxtr Codc, lor rh. p.rfrnEncc ol rhe work ld which ihc rrmil n nlucd.
Ihrvcrnd\ill,mi'riiworkc.r..nip.tr\nri{,nin\urnt,r\rcqutdhyScdn:l?Ur.lrhct-rhor(ir.larrhlFrlornri..ol
rhc{orklar{hthrhnplrnririsi\sucd.Mtaolkc^..rr^-isit. ruflmc .rtricr ml Ix) li.y nunrh.r e:
.it',..",fyrhrn,rrp.rlni,mtucotrhc$oikfdwlrRhrhi!Jrnir is rssucd. I sIrll nor cmpk'y rtry ncrotr ir atry mrtrncr
h s ro bcdnm n$lccr ro rhc wortcF con{c \arion laws orcrlilnrnix.,nd n8m rhd ill should tEcoaE ub]cd ro lhc
*or[c6 co.nncnsalion pmvnbm olSmri,,n.]70Oolrh. tihr Cel..l shnll. fonhwirh conrDly wiln rhoc Imvision\
WAlrNIN(;: Fdlurc b sccurt workcrs .onwnsain,n covcrusc h !nk*lil. itrd rhlll suhjc.t ,tr c ploycr lo criminrlp.nulris lnd
civil lincs up ro otrc hundr.d rhousrnd dolhr\ lsllx).(x)). i! rddirion b rlt..i of..nrP.trrdi.n, d.nEscs !s lrolidcd ror rhc
rhc t]txtr (n.1.. inrcr.{ xnd itrmltl
DECI,AN{IDN
I hcrc6y alliru undcr l{rrlly of pcrjtrrr rhnr I r'n tutd\ti uid.r nn,vnion ol('h.nlct I (comrmncin8 sirh Scri'n ?(XD) ofDivisn l
ol lhc susinc$ d PDIi$ion\Co{lc, d 'nyliccn{ n in iuu tor.c anlcalccr.
cl)x tru(:Ill)NrlNDtNli-dtrlcr
Ihcrctryalitnrundcrpcnrlryoltrrju'lrhdrhcrci\rco.{rucri,,nkiinerBcncylnrrlEncrlotnunccofrhcworklirwhi.hrhisFrnriris
rsu.d (Sc. 1097. Civ C.).
ATIIICANLDECT.AEAIJON
I lrr$y altnnr undcr ncnrlry ol lcrjury orc ofrhc tollowina dccluriotr\:
lxmolirionPcrnirlAsb.nos Nolinc iooFcdcral Rc8ularions(lnti{)-l'rn6)
Rcqun.d b(cr olNolifi calion
__tl .ailyrhr'rhclc,ic'rlrgulr'nn\r.Gfld'ngJ\h.rn.r.nmvrln r.rJnrltrJhhr.r\rnroi(r
{U.d'ryrhd Itukr.drrhnr {rri.n ad iarc rhar rhc unovc inromurn'n is corer IaEer,.oq)lyRilhallcn,rndcounry
Unr8..nslrucridr, rtrl ftrcby urhri/d rcprr\.darirc\ of rhi\o'diria ..s dd Srdr. l-dss rld irE
a ilNw
CiryMd cornlylo cnlcr utotrlhc
" >l 7'l!3
Set Backs ioQ rL1,!/ u'\- ,|2
Erection Pads
UFER Ground \
SLAB Floor
Subf loor/Vent/l nsu lation
Roof Sheathing 7lLlt9 1/4{/i/
Shear Wall llri'lrz 17,1€r)
Framinq ittl lB vdm
lnsulation/Enerqy '7lzsl N.
'vtvy
Drywall I
Ext./lnt. Lath fldrP' i QszrtA-/01-
Brown Coat 9ltbl-ft 'iLtt-v,,t '>1)
lr/asonry t U !
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report \
Flood Zone Certif .
FINAL :4NrQ -ttV*r,zlt t,2rh )
Certificate ol Occupancy u'l
NotQs, Remarks, Etc.
6ltt,lr aQ..t
l1 T'l
)
ID/SIG.
Forms/Steel/Holdowns
txnd./! Addrcs
-
arL- Alol,.t'
----+---
MAYOR
MiguelA. Pulido
MAYOR PRO TEM
Michele Martinez
COUNCILT,lET,{BERS
P. David Benavides
Vicente Sarmiento
Jose Solorio
SalTinajero
Juan Villegas
ACIING CIIY MANAGER
Gerardo Mouet
CITY ATTORNEY
Sonia R. Carvalho
CLERK OF THE COUNCIL
Maria D. Huizar
CITY OF SANTA ANA
PLANNING & BUILDING AGENCY
20 Civic Center Plaza
P.O. Box 1988 . 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
improvements specified atantlr- Wr*€d ,QcttL W ?>rct^qrr/
yourself as the builder of the property
/wt A,fr4 or,-a afr E L'7"\
We are providing you with an Owner-Builder Acknowledqment 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.
.rtJ 1 . 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. 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 property.
TtJ 2. I understand building permrts 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.
<J g. f understand as an "Owner-Buitder" I am the responsible party of record on the permit. I understand that I may
protect myself from potential fanancial risk by hiring a licensed Contractor and having the permit filed in his or her name
instead of my own.
+-d-+. t understand Contractors are required by law to be licensed and bonded in California and to list their license
numbers on permits and contracts.
fl 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.
-fJ O. tunderstand if Iam considered an "employer" under state and Federal law, I must register with the state and
federal government, withhold payroll taxes, provide workers' com pensation disability insurance, and contribute to
unemploymentcompensationofeach"employee.'Ialsounderstandmyfailuretoabidebytheselawsmaysubjectmeto
serious financial risk.
-[J , , understand under California Contractors' 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
SANIA ANA C]IY COUNCIL
moulido@sanE-ana.oro
Vicenle Samienio
vsam ento@sanla-ana oro
P David Benav des
dbenav des@sa.la-ana oro NilleoasaOsanla-ana oro slrnaie.orAsaola ana.o.o
M3yor Pro Tem, Ward 2
n ma.t nez@sanla-ana oro solor o@sa.ta-ana oro
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.
rN 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
financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the
workmanship or materials.
1.Fl 9. 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 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.
fd rO. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am
the party I
address:
egally a nd fi ncial res onsible for sed construction at the followi ng
u
activitvcfr'c
<P 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.
<(J lZ. t 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'
com pensation 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 pe rmit. /Votei A copv of the propertv owner's driver's license,
form notarization, or other verification a cceDtable to the aqencv is reouired to be ted when the Dermit is
,ssued to verify the owner's siqnature,
Signature of Property Owner r
Print name of Owner
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
rl
Name 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 Owner's Signature Date
Print Name of Owner:
Note: A copy of the owner's driyer'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.
SANTA ANA C TY COUNCIL
moulido@santa ana.oro
Mayor Pro Ten, Ward 2
h marlr.ez@sanla-ana ora
v cente sam ento
vsam'ento@sanla ana oro soono@sanla-ana oro dbenavrdes,Osantaana.oro rv eaasrAsa.la-a.aoro stinaiero@sanla-ana oro
Address of Authorized Agent: