HomeMy WebLinkAbout101102760 - Permit (2)Project Address: 1923 W Jan Way Unil Bldg: Address Range Suite Ranger
Zoning: RlLot 49 Block NA Tracl 3355 Hrslonc No
@ City of Santa Ana 20 Civic Center Plaza (M-19)' Santa Ana, CA\27O2 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Sectron: (714) 647-5853
Permit #: 1O11o276lJ
Pin #: ,t"irv
Burlding Use: Single Family Dwelling Occupancy: R-3, U 1st FL Area: Patio
Job Type: Reroof Constr Type V B 2nd FL Area: T lArea:
Natureof Work Reroof Code CBC 2019 other Areas: yards Req,d:
Existing Bldg. & Use: Sfd Watt garage Flood Zone. X-0602320257J Garage Area. Valuation: S4,000.00
Proposed Use # of Storiesr
Totat:
Oescription of Work: Roroof house & attached garage - remove comp, replace any damaged sheathing, install new 3o-year shingles. Handouts given.
Owner authorization on file.
Planning Conditions: Roplace any damaged wood mombgrs, fascia, gaves, rafters, etc prior to final approval.
JUAN JOSE LOPEZ ALVAREZ
1923 W Jan Way
Santa Ana, CA 92704
(7141 737 -037 4
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$1 1S. 1?
Engineer
Address:
LlriiOwner:
Address
Phone
Tenant
Conlraclor
Address
Owner-Builder
ior tocol
Phone;
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policy #l
Expires:
Phone
License #
Archilect /
Desaqner
Address:
Phone:
Lrcense #
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Planning Approval By:
Plan Checked By
Permit lssued By
NPDES lnsp. Req'd:
PWA lnsp. Req'd:
Planning lnsp. Req'd:
Landscaping lnsp. Req'd
Orozco, lvan
Chavez. Dave
No 2a
No
No
No
Date: 01/06/2020
Date:
Date 01/07/2020
Subject to Faeld:
07776008t 57601
otttsodtt'tlzzo
07775002 57672
07776002 57600
01776002 51607
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
Misc Receipl
Misc Receipt
Misc Receipt
$3!3 06
s3 9l
$1 00
$22 95
$57.20
Fire lnsp Req'd. No
Police lnsp Req'd. No
Flood Zone Cert Req'd. No 01116002 51600
011 16002 51601
0r 116002 51612
01116002 57770
$22 9s
$390.26
$1 00
$3.91
Account#Total
Every perfiil issued sha become invalid unless the work on the srte authoized by
such peml is commenced wlhin 360 days atlet its issuance,o( il lhe wo* eutbonzed
on tho sle by such pemil B suspended or abandoned lor a period ol 360 daysafter
the hfie the woll< is commenced
lnspector
Fee Total
Paid to Date.
Balance Oue
$418.12
$0.00
$418.12
Assessor's Parcel 109-523-08
MID#: 2020-'156905
BUILDING- INSPECTOB RECOBD
ID/SIG.SITE.WORK DATE
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
Subf loor/VenVlnsulalion
t q.2o
Shear Wall
Framin
lnsulationi Ene
allD
Ext./lnt. Lath
Brown Coat
Mason
Pool Fence
T-Bar
Handica Re
En ineer Final Re ort
Flood Zone Certif.
FINAL
Certif icate ol Occu n
No emarks Etc.
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COMMENTS
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SLAB Floor
Roof Sheathinq a-* ra
Deputy Final Report
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Planning & Building Agency
Building Safety Division
20 Civic Center Plaza
P.O. Box 1988 {M-19)
Santa Ana, CA 92702
(714) 647-s800
www.santa-ana.org
APP,13 CSC 2016
Dear Property Owner
An applicatio uilding
NOTICE TO PROPERW OWNER
has been submitted in your me li rng yours lf as the b r of the pro improvementsI
specified at C\
We are providing you with an l-kn nt and lnformation Verification F 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 permifting authority.
OWNER'S ACKNOWLEGMENT AN D VERIFICATION OF INFORMATON
D/RECIIO/VS: Read and initial each statement below to signify you understand or verify this information.
-=J I 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 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.
-,=.=-2.
I understand building permits are not required to be signed by property owners unless they are responsible for the
construction and are not haring a licensed Contractor to assume this responsibility.
=l-S
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 hirlng a licensed Contractor and having the permit filed in his or her name instead of my
own.
=S_a.
I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers
on permits and contracts.
=t=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
'employer" under state and federal law.
=f--0.
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 sub.iect me to serious financial risk.
:=L_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.
-E=_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 finan-
cial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workman-
ship or materials.
-1=t_9 I understand I may obtain more information regarding my 6blagations as an "employed from the lnternal Revenue Ser-
vic6, the United States Small Business Administration, the California Department of Benefit Payments, and the California Divi-
sion of lndustrial Accidents. lalso understand I may contact the California Contractors' State License Board (CSLB) at1-800-
321-CSLB (2752) or www.cslb.ca.oov for more information about Iicensed contractors.
=_->L10. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the
party
dress lr nd finan responsible for pro sed con structio activity at the fol lowi ng ad-) 7az-r,ui CL
5{-,t t. I agree that, as the party legally and flnancially responsible for this proposed construction activity, I will abide by all
applicable laws and requirements that govern Owner-Builders as well as employers.
'lS--t Z 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 civi! 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 fo[ 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. ivote; A copv of the prooertv owner's driver's license. form notariza-
tion. or other verification acceptable to the aaencv is reouired:Lo b9 pfqsented when the permit is issued fo verifv the
propeftv owner's sidnatu re.
Signature of Property Owner
--,,.--\
, /t/ :, ;r,Date
Print name of Owner
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Excluding the Notice to Property Owner, the executaon 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 prolect.
Scope of Construction Project (or Description of Work)B e lc+ce- 3L,"bs R ((fr(,,,
Project Location or Address gI,3 w
Name of Authorized Agent :
U LJL
? z-70u=-J I-->ct ^ \,,.-/ ct
(!
Address of Authorized Agent:L.\
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 fllled out the above
information and certify its accuracy
, l,l *r,,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 issued to verify the property owner's signature.
a
I ,a
.1
Property Ownels Signature:
*,SNTA
NAJffi
Planning & Building Agency
20 Civic Center Plaza Ross Annex
P-O. Box 1988 (M.19)
Santa Ana, CA 92702
(714) 647-s800
www.santa-ana.orq
Smoke & CO
Alarm Affidavit
Project Address:lq23 {ttt l/V &
Permit Number:t o //o77aO
Property Owner:Aw ft,
Contractor:License #:
lNSP,02 2013 CRC
This document moy be found at-..htto://www. sa nta-a na.oro/oba/
(Please use a black or blue ink ba -point pen)
State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential
b u ild ings.
California Residential Code (CRC) Section R31.4.1and R315.2 states in part that existing dwellings be
"retrofitted with smoke alarms and carbon monoxide alarms. cRC section R314.3 and R314.3.3 define
the required locations.
f\ eoth boxes betow must be checked:
E carbon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of
bedrooms and also on each level of the dwelling. Alarms are required in bedrooms with gas-fired
appliances (i.e. hot water heater, cooktop, furnace) or a fireplace.
E Smoke alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping
room, and on each level of the dwelling.
Retrofitted detectors may be battery-operated for buildings where no interior alterations are
performed. Combination Smoke/CO alarms must comply with all applicable standards and be approved
by the State Fire Marshall (SFM). Battery life must be 10 years.
I hereby certify that I am the contractor or the property owner of the above project. I further certify
that smoke alarms and carbon monoxide alarms have been installed in compliance with the governing
Codes and have been tested to be functional. l, also, hereby certify that I will retest the alarms per the
ma nufactu rer's instructions.
(check onel tr Licensed Contractor Pro erty Owner
NorE: rhrs serl-c ertiftcotion is only used for projects thot offect the EXTERI1R of the structure. This
process is applicoble ONLY to proiects where occess to the interior of the dwelling by a Sdnto And
lnspector is not required.
.t't/<-/',4-1 S C,c._Ddte:tlq I 7d
Have this completed form and the job-card readily available on final inspection!
I
Signature:
l
)