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Home My WebLink About20170590 - Permit (2)City of Santa Ana 20 civic Center Plaza (M-19), santa Ana, cA 92702 Electrical Permit #: 20{7O59O Permit Counter (714) 647-5800 lnspection Requests: (7141667-2738 lnspector Section: (714) 647-5853 Pin #: 663rtr1 Project Address: 2349 N Siemon St Unit: Block: NA Bldg: Tracl: 3637 Address Range: Historic: No Suite Range: Zoning: RlAssessor'sParcel: 101-042-01 Lot.34 Owner. Address Andy Dang 5712 Ocean Vista Huntington Beach, CA 92648 (714\ 724-0256 011 16002 51603 011 't6002 5't600 011 16002 s1603 01116002 57770 Foo Typo Subpanel General Plan Update lssuance l icrofilm Records Amount 22.95 57.20 3.9'1 Qry 100 1.00 1.00 1.00 Fee $55.37 $22 95 $57.20 $3 91 Phone: Tenant Name Conlraclor Address: Owner-Builder Botchi:53886 - l/11/2020 I0: CCUELT-AR Oftice: CTYH Tronsi: 15 I of 1Acct+: Refi: 2017r-'1590 Rcpti302865404 - ll11/2020 2?11 Pn Tronsoct ion Totol 1139.43 Phone Stale Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance Carrier: Policy f: Expires: Andg Done Generol Plon Lredote Fee rlt116002- 51600000- E Iectr icol 01116002- 51603000- n icrof i lr & oocurents 01116002- 57770000- ICL Check 0011i0 ,22 . ?1 9112.57 !3.91 t139.43 Building Use: Job Type: Nature ol Work Single Family Dwelling Miscellaneous Subpanel Occupancyl Constr Type Code: R-3 VB cEc 2019 Notes: lnstallation of subpanel atmain SFD. Owner-Builder form on file. Planning Condilions Planning Approval By PIan Checked 8y: Permil lssued By: Sublect to Field: Building Permit #: Chavez, DaveY 0111412020 Account# Misc. Receipl: Misc. Receipt: Misc. Receipt: Total Every permil issued shall becone invalid unloss fhe wolk on lhe sila authonzed by such pemit is commenced within 3N days allet ls issuonce, ot t lhe wod, authonzecl on the sie by such peftnit is suspended ot abandoned lot a peiod ol 3& days aftet the tifie lhe wo* is cofifienccd $22 95 $1 12.57 $3 91 $139.43 $0.00 0139.43 lnspector MID#: 2019-149692 01116002 51600 01116002 51603 01116002 57770 Fee Total: Paid to Date: Balance Due: Date Oate Date ELECTRICAL-INSPECTOR RECORD APPROVALS DATE rD/srG.COMMENTS Site-Work Underqround Pole Bases Lioht Standards Spas, Pool, Fountains Signs (monument) Life Safety /Low Voltage Fire Alarm / Dampers Communications Cable Building Under Slab / Floor Bonding / Grounding / UFER Transformers Torqueing Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Rouqh) Ceilings (Hard & Soffit Rough Ceilings (T-Bar Rough) Meler Release I I ./.- Roug h 5 4il,o :6) Service Meter .t )/N..V FINAL I :/,lYilL u <@t/Y Netes, Remarks, Etc. a IV UI I OWIiEI AUILDER DET AATION I haby .rm u.& Fdry olFiury lhd I 6 .i6pt ioa dE Cod.rios tf,oe Lr* for lh. follow,| lgso (Sd 7011.5 Buin6r .d Proldion Co&) An, Cily o, Co@ry whi.h rcqliE . 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Box 1988 (M-19) santa Ana, cA 92702 (714) 647-5800 www.santa-ana.org APP-13 CBC 2016 NOTICE TO PROPERW OWNER Dear Property Owneri An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements sp ecified at 2 1L/ 4 1r *lo r-/ 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 permat 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 ACKNOWLEGMENT AND VERIFICATION OF INFORMATON DTRECflOIVS.' Read and initial each statement below to signify you understand or verify this information. Q-,r -4JIft 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 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 actlng as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my prop- erty. n -Dt, , understand building permits are not required to be signed by propery owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. Itf[S f 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 flled in his or her name instead of my own. -44a , understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. [ ) A u. , understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total v"alue of my constructron is at least flve hundred dollars ($500), including labor and materials, I may be considered an "employe/' under state and federal law. IXLO f understand if I am considered an 'employer" under state and Federal law, I must register with the state and federal g6vernment, 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 sub.iect me to serious flnancial risk. 7. I 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/l 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. ,\ 1\ {lll b. f 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. ,t}.i-g t understand I may obtain more information regarding my obligatrons as an "employe/'from the lnternal Revenue Ser- viae, the United States Small Business Administration, the California Department of Beneflt 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- 321-CSLB (2752) or www.cslb.ca.oov 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 the iig":"ty\Ti*Ti?u;";rjJ:ble for proposed construction activitv at the followins ad- }.W't , I agree that, as the party legally and financially responsible for this proposed construction activity, lwill abide by all applicable laws and requirements that govern Owner-Builders as well as employers. \ fl-fu2.1agree 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 Before a building permit can be issued, this form must be completed and signed by the property ownet and returned to the agency responsible for issuing the permit. ,Vote. A copv ot the propertv owner's driver's license, form notariza- tion oth propertv owne r's siq natu re. Signature of Property Owner Date Print name of Owner At,\,.| D+N/; . 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 pro.iect. Scope of Construction Project (or Description of Work) 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. 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 rssued to verify 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 firm is injured while working on your property, you may be held liable for damages. lf you obtain a permlt 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. o/ ,. - z<)I