HomeMy WebLinkAbout104101952 - Permit (2)Project Address:1139 W Sev enteenth St
Assessor's Parcel 399-072-17 Lot POR 1
Unrt Bldg
Tract BATES
Address Range Suile Range
Zoning ClBlock NA Hrslolc No
, City of Santa Ana 20 Civic center Plaza (lM-19)' Santa Ana, CAg27o2 Building
Permit Counter: (714) 647-5800 lnspection Requests. (7'l'4) 667-2738 lnspector Section (714) 647-5853
Permit #: 1041lJ1952
Pin #: 757$
Building Use Commercial Occupancy: B 1st FL Area: Patro
Job Type Alteration Constr Type V B 2nd FL Area: T I Area
Nature of Work Basement Repairs Code CBC 2016 Other Areas: yards Req.d:
Existing Bldg & Use Commercial/vacant Flood Zone: x-0602320144J carage Area valuation: $S,ooO.OO
Proposed Use # of Stories: 1 ,o,",,
Oescription of Work: Fill-in unpermitted basement & excavation with slurry mix. Replace concrete piers, posts, & floor beams as needed. Return
basement to original condition. Remove HVAC equipment in basement. APPROVED WITH PRESSURE-TREATED POSTS WffHIN
CRAWL SPACE
Plannang Conditions: lhterio-work only. No exterior alterations or modifications.
Owner
Address
Phone
Tenant
Mamo Real Estate, lnc
'1139 W. 17th Street
Santa Ana, CA 92705
(949) 35s-22'16
Conlractor
Address
Owner-Builder
Engineer
Address:
EW-Webb Engineering, lnc
Earl Warren Webb
'1299 Columbia Avenue, E-7
Riversido, CA 92507
(9s1) 788.2050
c37384
Anchor Teflent lmprovement Concept
John Lopez
'125 North Tiana Lane
Anaheim, CA 92806
(714) 351-9809
Phone:
State Lic #:
Lic Type:
Bus Lic #
Workers' Compensation lnsurance
Carrier:
Policy #:
Expiresi
Phone:
License #
Architect /
Deslqner:
Address:
Phone
License #
Plannrng Approval By
Plan Checked By.
Permit lssued By:
NPDES lnsp. Req
PWA lnsp Req'd
Plannrng lnsp Req'd:
Landscaping lnsp Req'd
Gr,ha Jeffery
sultantsS
ski, Teri Date 0l/06/2020 Misc. Receipt
Subject to Field:
Fire lnsp. Req'd No
Potice tnsp. Req'd: No Account#
57607
53 600
57770
57607
5760 7
240 00
5 7612
5 7600
57507
$166.53
$230.87
$23.46
$100.57
$252.69
$1.40
$1.00
$57.20
Dale 10/23/2019 N.4rsc Re( erpt
Date 01/02/2020 l\,4rsc Receipl
01 1 16002
01116002
0M6002
01 '1 16002
08901001
73844
Total
0 77160 02
07776002
077760 0 2
0 71160 02
07776002
08907001
07776002
07776002
07776002
Permit Fee
Plan Check Fee
Microfilm Records
lnvestigalion
Penalty
SIIIP - Category 2
Bldg Stds. Revolving
General Plan Updale
lssuance
No
No
No
No Flood Zone Cert. Req'd. No
Every perm issued shall become hvahd unless lhe work on lhe s/te aulhonzed by
such perml ts commenced wlhn360 days after ls tssuance ot t lhe wotk aulhonzed
on the s e by such perml B suspended ot abandoDed lor a penod of 360 davs aftet
lhe ltme lhe wo* ts commencecl
lnspector MID#: 2019-155337
5'1600
51601
51612
57 770
24000
$22 95
$576 99
$1 00
$23.46
$1.40
$856.67
$230 87
$62 5.80
l\
2c7
Fee Total.
Paid to Date
Balance Due:
.COMMENTSSITE.WORK DATE ID/SIG.
Set Backs I
0@ukForms/Steel/Holdowns Z5//1J/O Nam
Erection Pads
UFER Ground
SLAB Floor
Subf loor/VenVl nsulation
Roof Sheathinq
I ,/)Shear Wall
)J;/eoTt )YfilnA {Y\Framing
lnsulation/Energy tl
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enoineer Final Report
Flood Zone Certif
,{
0aY6FINAL75/ru/O qIilfd)
Certilicate of Occupancy
Notes, Remarks, Etc
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BUILDING- INSPECTOR RECOBD
I
D,t. O\/o 6ee
l.k.nr Nuhhd
I
Planning & Building Agency
Building Safety Division
20 Civic Cenler Plaza
P.O. Box 1988 (M-19)
santa Ana, cA 92702
(714) 647-s800
www.santa-ana.org
APP-I3 CBC 2016
NOTICE TO PROPERW OWNER
Dear Property
An application for a uil rng pe ith
specified at
s been su n your a ngy rS a the builder of the property improvements
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 properly owne r,
obtain the prior approval of the permitting authority.
OWNER'S ACKNOWLEGMENT AN VERIFICATION OF INFORMATON
DTRECflOlVSi Read and initial each statement below to signify you understand or verify this information.
[" c 1 . I understand a frequent practice of unlicensed persons is to have the property owner obtain an 'Owner-Buildel' 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 in.iuries 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 limats of my insurance coverage for injuries to workers on my prop-
erty.
t ,. ( 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.
:E_3 I understand as an "Owner-Builde/ 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 permat filed in his or her name instead of my
own.
0^( 4. I understand Contractors are requlred by law to be licensed and bonded in California and to list their license numbers
on permits and contracts.
u^. 5. 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
"employe/' under state and federal law.
sr,1( 6. 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 com-
pensation of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk.
lL\c 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// 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.
Pt".- 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 finan-
cial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workman-
ship or materials.
I
I
I I
- 9. I understand I ma y obtain more information regarding my obligations as an "employed'from the lnternal Revenue Ser-
e, the United States Small Business Administration, the California Department of Benefit Payments, and the California Divi-
sl n of lnd\strial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 'l -800-
321-CSLB (2752) or www.cslb.ca.qov for more information about licensed contractors
l^a- 10. 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 flnancially responsible for proposed construction activity at the following ad-
dress:
bs-t I I 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.
M'L12. I 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 flnancial 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 flrm 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 propedy licensed and the status of their workers' compensation insurance coverage.
Betore 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 p ermit. /Vote: A copv of the proDeftv owner's driver's license, form notariza-
tion, or other verification acceptable to the aqencv is required to be presented when the permit is rssued to verifv the
Signature of Property Owner Date: O\/o6/?.)
Print name of Owner l.,h+t *--, A-- u
Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize
the followlng 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
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 Owneis Signature Date
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 issued lo verify the property owner's signature.
proDeftv own e r's sis n atu re,
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Name of Authorized Agent:
Print Name of Owner