HomeMy WebLinkAbout102102832 - Permit (2)Project Address: 940 W Eighteenth St Unrl Bldg Address Range Suite Range.
Zoning: RlAssessor's Parcel 399-053- l l Lot 6 Block NA Tract 9451 Histoflc No
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CAq27O2 Building
Permit Counter. (714) 647-5800 lnspection Requests (714) 667-2738 Inspector Sectionr (714) 647-5853
Permit #: 1O21O2A32
Pin #: 12726
\N
Building Use:
Job Type:
Nature of Work:
Existing Bldg & Use
Proposed Use
Single Family Dwelling
Alteration
N/V - Orywall
SFO w/det Garage
Occupancy
Consk Type
Code:
Flood Zone
# of Stories
R-3, U
VB
cBc 2019
x-0602320144J
1st FL Area:
2nd FL Area:
Other Areas:
Patio:
T.l Area:
Yards Req'd
Garag
Total:
e Area:
tlolr h : :'i.i',r l,l
Valuation:s1,000.00
0
Description of Work: Legalize drywall on garage walls ticp t i ! u?966t-l5tl -
Trflnsocl i on Ioto I
1 lr: I r.r
46,
R i eoberto Pere;
Owner
Address
Phone:
Tenant
Cont.actor
Address.
Engineer
Addressl
Architect /
Desiqner:
Address
Phone:
License #
Rigoberto Perez
940 W. Eighteenth Street
santa Ana, cA 92706
(714) 206-0016
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policy #:
Expires:
6errerol PInn Ljpdote Fee
u1 I I6r-lrJ2- i16tftlr,I:lU.-
P.u i 1d ineIl I16t:rD2- r l6r:r1(n]['l -Ilde Stds Revolv ins
(r1l 160r:r2- 51612r:rur.r
n icrof ilB I Do{:uientg
lrl l l6f lrl? - i777iu[[t..
Vrgo
(:C+: *rrrrxrr rxrr I971
$
Planning Approval By
Plan Checked By
Permit lssued By:
NPDES lnsp Req'd.
PWA lnsp. Req'd:
Planning Insp Req'd
Landscaping lnsp. Req'd
Graham, Jeffery
Chavez, Dav -vt
Dale 0111512020
Date
Dale 01115l2O2O
Subject to Field
Misc. Receipt
Misc. Receipt
Misc Receipt
No
No
No
No
Account#Total
0 77760 0 2
07776002
07775002
0 77 7600 2
07776002
0 77 7600 2
0 77 7600 2
57607
57770
57607
57607
57672
5 7600
57607
$166.53
$3 91
$100 s7
$252 69
$1 00
$22.95
$57.20
Permit Fee
Microfilm Records
lnvestigation
Penalty
Bldg Stds Revolving
General Plan Update
lssuance
Fire lnsp. Req'd No
Police lnsp. Req'd No
Flood Zone Cert Req'd: No
Every peml tssuod shallbecome tnvalid unloss lhe wod< on the sle authonzed by
such permit iscommenced wtthin 360 days alter ls issuance.or tl the work authonzed
on the sle by such perml ts suspendecl ot abandonec! lor a peiod of 360 daysafiot
the timo the wotk ts cgmmenced.
lnspector t\AlD# 2O2O-157O54
01 1 16002 51600
01 1 't6002 5'1601
011't6002 51612
01116002 57770
$22 95
$576.99
$1.00
$3.91 Fee Total
Paid to Date
Balance Due:
$604.85
$0 00
$604.8s
Planning Conditions:
Phone.
License #
I
BUILDING- INSPECTOR RECORD
SITE-WORK DATE ID/SIG,COMMENTS OWNER BUIT,DER DELCARATION
I h.r.hy dlltrm udcr lrnslry,, Friury rhrr I m.r.dlr hm lh. O,trrrtn'F' Lietnr. uw fir rhc tullrqo8 rcos'n (semll t
Bulrcs( .Bl Pntir\x{ (-dlc): A.y Cry or C(Mty wh*h r.1uue r Frh nr .1rn!Nr' !lrc( r'{n'v.. d.m L'h " rcF! 't.nlB-rm, Ftr t' [. hr!.F!. .lq, rquri rh. {'il.er fq rhh IEmr I' lik . 1l3Li (dr*d rh, h( or ax ( hcn*] I'{r{d'
1,, rtx Fi'rrrnr of IL Conrrtnn-s l-..n*d tlw ((]upts 9. Conh.mr8 *nh Saron 7(m of Drvr[n .] ot rh' Busrm( r'l
PNlcsions(i c)orlMr lrorrh. r.rcml'r rhcrctn,turnl rh. hrn( n, th. allcScd.rem , n Anvvirhrrn tS..lDtr 70115 byrny
dfiirc.nr lnr rltmn slbFh lh. tml{{r t':.,v'1,'.n,lrvotnn orc rh:n nv. huB]Gi tlollB (l5rn)
44aL {*ffi ,,r'hc pn,rny. d my.q'bFs w h vrs.r I th.r q . coqrnqr.n. * l'.tr rl! *d,n th. {urE ! B'
mr.nt{ or ollini nn trk (SN rur4, Buucs,nd PDfcsDnr C,rlc: Th. Ci,nrrldni l,r.n{ tlw ttf,r n.r q'tlv b M nwncro,
rh. l'otrdy wh, huildt.r uqmEr rlEFn. ul *hr Ltrr rRh srt hrfrscll or hcrelfor rhnrqh hit or rEr dqcmpl('v.'r,
n vrlol rh4 !u!h r{nrtffii c Bn del.n (*oflfrl nf, sL ll.lr,kld.lh.lr lD3({ qnH..t ! w,U, to(EFr
ol unt*lra llE Ovrr 8u&r w'I h.E rlE h!i.n ol F v$! thr h.,x3r !r! r h t'rlqmEtlElt{6vfmrh.FlFrol
l, .< dlEi ol rht rn,Fn t, d c$lulwly conrtro! * h lr.nr.l $d,rr'n n' .on{o.r rh. In,j.$ (Sd ?04t. Busm<'
r l Pr,lia(n(ixL: Th.ConrBroat l-(.nF L.s LtE. mr +tilt k! so*N.l lioFny uhr burld! or urll)mrcr rh.r.{n,
rnJ sh) Lonterrktr ulh nn'F(r\* h a c,,nlkkin licny\l Pu^ulnr nr rlt (nn(rttr'\ lrcn!-ljr I
I amc\cn$r uni.r S(rr)tr
ao
DEIIJSAUAN
I lrch, dlun uto .r FMlryolFjuryoE oft& lt)l!,*tr! lehdrx,trs:
-l
hrk d *nl E6tu . C.n'f.rr. ol Coenr lo S.lf'tBur li* *rrt6 .r,r{inqrrn .r FoYrtql nt by Sdrrr l7m ol rlE
l,hr Gn., tu rlr Frroll:l&. of lh. *,t ror whkh rrE Fmn ! s .J
-lh:k
d wrll trrtrn *orl.^ (mFN.rir tnrurrr.. Erlwql by Sarrun l7{$ or rlE f.htr (irL for!tundo'lrr:I'ul
rh. k)rt lt, whrh rhl Fmi B ssl My qf,l6 Nn{hsrir nrurrM !u.r d Fnrv nuds E
l4f[.rr,oo,,n,r'.n"d"-,Rc"r,h.*urth,rhtrh,htrF,n(r(.r.I\hrllnor.n9[,vanvFBunhanvlukrq' $ tu h-ur subrcd k' rlt mrk n' ontp.netx)n hw! ot ai ,'mu. u'l rtN lhar if I rh,ulJ b€lom tuhF k, rh.
k,l(qa .omltnsrin ,n,vshnr ol SR rin 17x) .l rh. l:h{ (iri., I sh.ll, l,!nh* h roqily wdh lh). pn,vLrun!
WAnN|NG l'rturc t, a\u. ult.r' u't{nsri,n (trtEF. tt u.hslul. ii rh.ll d1F(r ! qr{ lFr rr trul Fn.lrF tnl
lNd llkr trt' t) oN htrrrlnJ rh{NnJ &nlu\ rlllx)($(r), h r.l,l i tldrD8.r a! FU\rl.'l i'tr rh.
S..u.tr llrT6or rh. lrlxn (iilc ni.r.nrRlrrkrrt'.i.c'
tJ- 2.o )<.-.,
L!r_ll:-Llt ! !\ r8 r!-r.98
lElLd8arIa!
I h.Eby rlhrm unttcr p( nrlry ol pcrjry rld I am lMns.{ xn.t.r Fsvrit,n ol'Chnfl.r q (!.nrmk'ng wdh S.clDn 7(x).) ol D'!vtrkn' I
oi rh. Btrrm$.nJ Pn,f.sx,trr C,ik. ,rl my lr.n{ tr n iullh(t lrl clldr
l-trctrr ('li$
CONSTRTICTION I ENDING (|ENCY
I h.Ehy rtltm uoJcr Fhrryof p.riury itu rh.rc x l Nnrtd.r$n Ln lin3 r!.n v tir lh. Fnarl]rfr. of rh. *ork t)i rhf,h rhri IEturr !
Fs!.rl rso trJT.Crv ( r
l. d'tNrtu _
ATILICATLIEII.A8AIIO!!
I trrtry rlli n, u 'rl.r !.nrlry ol P.rr!ry.n. ol rh. n)l!)s1n3 del.[r!,ns:
lrrnrnnr,n l'.rnrk-Alh.dds NoLlr.rrr |.Jcful Rqolrr( 1lI dlc 40. Pi6)
R.qur.,l l.nd ol tlidi.c'n
l..n'iyrh[ th.l.dcr{l reNlsr(rs rc8drlin3 {\h.dos,1]lmvilrrc Nl ltfl(trh|. t,lhn I'n*!r
44fd,rv rh! I htrc rc.,]rh,. rmlrdrrn gi !r.r. rhri rh. rh,n ml!)mrir r.odd I .3N b !1,qiv $rh.ll crv r cou.rv
,cJDr.r rnJ Srrr. b*\ ELrry I' hu'l]hr r.rrtur I r,I\ d rrrh! rurh r/tlrr(snrri r.\ {l rhhOr} lri Counrv nr mrd uF nilr
Jh,s. mn'!,r.J nn,Fn! ri{ ,.il\t'n4/ /L* ,/-/
^ca\*t * ^.^tsv,-t"*.@.ht'J:
t (' 1 o
?,,,,1*-*,,n"1,.L. (t6o6e AfO C. /aAtz-
Set Backs
Erection Pads
UFER Ground
SLAB Floor
Subf loor/VenVl nsulation
Roof Sheathing
Shear Wall
Framinq
lnsulation/Enerqy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Enqineer Final Report
Flood Zone Certil
FINAL r /Z{/ )az.Fl:fz/rrJ
Certit6te dabccuparrcy
Notes, Remarks, Etc
-t,
l).k
-
Conlalo. -
Forms/Steel/Holdowns
APP UVEL
PLANN G DIVISION
.4As'ERr o )olo l57lJD
zo,* ltl
DATE
ED BY D^I'E
,LANT'iING INSPECT
FiN
ETATN pr..A \,S FOR F URE REV!S{ONS
UBJECT TO ITEN:S C
ELOlV
REOU IRED
ruorutX
lin t/ J alatn'""/
7
INTIRIOP TI OI{L
NC aX iE ilo.r .\L E llAT r oN s/t,1 0 0l F tcATt o'J,
,CH EXISTING
i:NlN,; REO IREIJ
lUEl',flT LANDST:E PI ANS
;p LA
]LANNER
,.RANSEE
iOUGH
rAt,tE
3
\(,J
J
-l
(6nt Yrzla
s(frcL0( f'r)
e
E <:-'
L*l srPG
3t r:e uL
Pnr.,t'uY
R-f,-; ts[-trLft'
.-9s\-
c(
TF
5
tt
L
t_
{
\^I
l-
SD
o
:t--s-
(714) _ - _$-1 rrro.u..
I-\l\<
LJ.t}(,Pr-
G n,taGv
--)
2L Cr
tQ 1I+ 3A
, T.Ni:
-7 r.,
t
il
t
t
s
e
J{.]
B
.!}
:tl
CKED AND CONDITION
l!:
I
'l
I t. _
I
t------.r
T
Planning & Building Agency
Building Safety Division
20 Civic Center Plaza
P.O. Box 1988 (M-19)
Santa Ana, CA 92702
(714) 647-5800
www.santa-ana.org
APP,13 CBC 2016
An application for a bgilding permit has been submitted in your name listing yourself as the builder of the property improvements
specified at q{o L). /gr4 sT S a ^4.L ANA ca 911 oL
NOTICE TO PROPERTY OWNER
Dear Property Owner:
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 atour 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
DIRECTIONS: Read and initial each statement below to signify you understand or verify this information.
Dcl L t understand a frequent practice of unlicensed persons istohavethe 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 seraous flnancial 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 prop-
erty
llcl Z. 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.
Ltj Z. t 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.
E4-0. , understand Contractors are required by law to be licensed and bonded in California and to list their license numbers
on permits and contracts.
k4 S. t understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total
value of my construction is at least flve hundred dollars ($500), including labor and materials, I may be considered an
'employer" under state and federal law.
-/,4U t 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.
8t-? l. I understand under California Contractors' State License Law, an Owner-Builder who builds singlejamily 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.
Rcl 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 owne(s) that result from any latent construction defects in the workman-
ship or materials.
A.
!U-5. I understand I may obtain more information regarding my obligations as an "employe/'from the lnternal Revenue Ser-
vice, the United States Small Business Administration, the California Department of Benefit Payments, and the California DivF
sion of lnduskial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1 -800-
3?1-CSLB (2752) or www.cslb.ca.oov for more information about licensed contra'ctors.
[Lc? n.l 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 respgnsible for propose
dressr q40 D./efli d construction activity at the following ad-ST 5 al-trA ArJA c* 9L1 ob
2c? 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.
P<?p. 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 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 properly licensed and the status of their workers' compensation insurance coverage.
tion. or other verification aecgpla$e to the agency is required to be presented when the permit is issued to verifv the
prope rtv ow ner's s ion atu re.
Signature of Property Owner Dater / - lf- 2oL0
Print name of Owner /, Goot-t,.c fzsLz-
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.
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
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 to verify the propefty owner's signature.
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. /Vote; A copv of the propeftv owner's d ver's license, form notariza-
Print Name of Owner