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Home My WebLink About30139567 - PermitPermit #: 30{ 39567 Pin #: 61983 Project Address: 505 E Central Ave Unit: Block: 1 Bldg: Tracti TR 39 Address Range: Historic: No Suite Range: Zoning: O q Assessor'sParcel: 016-090-22 Lot: POR 1 Owner: Address Delhi Community Center 505 E. Central Ave. Santa Ana, CA 92707 01116002 51602 01116002 51602 01116002 51600 01'116002 51602 Fee Type Sink Min Fee Adj General Plan Update lssuance Amount 12.23 58.41 21.25 52.98 Qty 1.00 1.00 1 .00 1.00 Fee $12.23 $58.41 $21.25 $52.98 Phone Tenant Name:Delhi Community Center Owner-BuilderContraclor Address: Phone gqtch+:44263 - 6/!2/2$lS I0: o,roffice! (TYH Tr(tns+: :i7 1Accbi: Reff: 30139 Rcpt+r(t2293584 - 6/12/2918 3'.fl9 1 TnsnEoct ion Totsl 1L44.! elh i Corlsun ite Center Building Use: Job Type: Nature of Work Other Miscellaneous Sink N/A N/A cPc 2016 Replace sink. Letter of auth on file. Planning Condilions: Date: Date: Date: Misc. R€ceipt: Misc. Receipt: Misc. Receipt: Total Plan Checked By Permit lssued By: Subject to Field: Building Permit #: , Julie o6t1212014 Accou nt# Every permit issued shall become invalid unless the ,vo* on the slte authoized by such pemit is commenced within 180 days after its issuance, or if the work authodzed on the site by such pemit is suspended or abendoned lgt a peiod of 1 80 days after the time the hlork is commenced. $21.2s $123.62 $144.87 $0.00 s't44.87 MID#: 2018-143943 01 1 '16002 51600 01 1 16002 51602 city of santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA,27O2 Plumbing Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: i.714], 647-5853 State Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance: Carrier: Policy #: Expires: Planning Approval By: Fee Total: Paid to Date: Balance Due: Occupancy: Constr Type: Code:Notesi lnspector PLUMBING-INSPECTOR RECORD APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDEI DELCARATION I hcrcb, lmrm under peMlry of tE.Jur, rnd I d cr.npl from rhc ConrmloE Liccne Li* for rhc following @rn (S.t.7011.5 B$in.$ arn Proac$io. CodcJ: Any Cily or C.uty *hth .cqlirci a FftI ro 6NlM( rli6. ioprow, .hrcfth or Npat {., rtrlcru.. rrt r lo its issulncc. ds riuircs lh. appltrnl for sh ,Emil lo nb d siSncd slltcrcnl lhll h. or sl* is lic€nsn pursu, lo ltE prcvisions of tlE Conhcloas Lien$d L{w (Chapter 9. Comm.rcing wirh Seclion 7(m of Divi.ioi 3 ol rhe Busii.s rid Pofcsions Codc) or rlEt hc or stc is cr.mpt rh.rcfron and rh. b&sls for thc .lLg.d crcmprion. A,y viohtioi of Sdbn ?031.5 by any applicabl lo lfmii {h}xr! rlE .pptic! lo a .i!il pe.lhy of nor me U.n fivc hurdrcd dolles ($500). -1. as owns of lh. pmpcny, or ny cmployec wilh wagc. a rhcir sk @np..srio., wil do thc mrt ard dr sletm i, ml inrcndcd or oll.Ed aor sh (SE-7044. Brsircis sd Pmfcssions Codc: Thc Cr.thcl.is Ucctr€ L* .ro.3 mr rpply lo !n owm of rh. Flrcty who hikG or inrms *Nn. ud sho do.s sxh tu* iinNclfor h.r$lfor rhhugh hi. or hd om.mployes, lrovid.d rhor su.h imFnkBirs e mr hkndcd qored lor$lc.lf. t x@i i* tsiuinS n inqrcEMr is sld whhin oft )e, of.orplclio( llc Owrcr Blildcr *ill hat tlE hlden of prcving thrr h. or sh. dil ml b'rild m irpmw fi. popsly for 0r porpoE of vfl*.*,.,r...,,,r.n'.,mi\.rr.rcr),,,r,rr,1Etrhh n,ir.,..\nr,.rr.Hu!T\.,U h,,k*i (1,1. lhr(-t{ rJ(ini, Lrcn..l..'n J',r\ rr rmlr- n, ni .wrr or fiotcrty sho hui]ds or nnFov.s rhrrcotr. md Nho @nt6c$ for such pmFck wirh a Conrrack,ns) liccn$d purru ro rfic Contractols I r ror. ,jn tklcr Srcr ,.*,-b-:-lZ I ll.rcby um.m und6 p.n lty of n€iury oe of rhc l:ft, Co(|.. LrrlNJ,cnoflurcc.rrtu rvijrk ri,r \rhir[ rlt Nnnir n i\ucd. _l haw and siu minuin {orlcn .omncnrarion insurarc. I rquicd by Serion 1700 of rh. Labor Code. tor dE F,to,il1'G oa ihe wort for whicn fih IEmi is i.ser,- My works' orp€tu rion inlumc .eic. altd polb, nlnbe. @: \ikl ccnrfvrhnt rnrhc n rr.tr uftcrrrhc work rn whrh rhis p.rmn is issucd. I shdllnol.mpk,t un, pcson inanyronE ll J\ro ksm.uhiNr ro rhc qn,tcr\ omFn{rinn Ltrs ofCrlilnmh. rnd agN rhd rfl shnuld t(onE suhFcr b,hc lLr Lo ', c.nFnsu.r Ir or n nns nl Scc! ion .171U .l lhc L{tnr C.nc. , rh.ll. ionh* h comlly wirh rh* fhvi},nn. . WARNIN(;: Frilurc b sur. work rJ .onFnsark,n .oknsc i\ lnlawrrl. md sh"ll \xbr.{r an c.rk)rr lo ftnn.,l tBtrlrics inrl i'Il..ii;#,::,:T.,I:tiTlJi:tiiT *: ,,", b'12-lr A lls\ (ll0l).l)ll0r. in dirn,n t, rhc .osr of ioredamgcs as pmvidcn for lhc I hcmhy rlflflnrnddr prirhyoftf,rjury rhrr I rnr I (co,nNcncingwirhS..rirnT(X{))ol Dni\ion:i of rnc Businessond PDfesionsCodc. md nryliccns h caxflBtJcuotrrllDlNc-aalNqr Ih.rcby rfinnr lcr Fnrlr,ofpcrJorvrhtrr rhcr r a .onrrud i,,n hf,di'r! rgcRt nnrhc p.rfonrui.d ofih.*ork tur shi.hrhtr linn a i\sucrt (Scc. .ll)97. Civ. C ) AtPrlc6lfD[cLrr.8 uoN I hrr6,allimondcr pcnlhyorperjuy onc of rhc follosins de.l alionsl Dcnnlirit)n l,.mirsAstr\tos Norificlln,r Ftdcial RcEUhrions frirt.1o. Pan() -Rcqut.J l.llcr ol Nrifi slioo I .drfvrhd rh. fcd.r.lEruLrons Ellrdru ssb$'o! Emvdl m m' otdtr.bh r. rhh Imje'. tfl .srify rhlr t havc,€ad rht unrlicurbo u.d srurc th.r thc otovc nrfomrion iscoret.l !3@ ro coqJly wnh lll Cirylnd C6ury rncc\ r Sric I rw\rL in8 k) huildin8con(rucriqr r t hcrch,rcEc\cnrarivcs olrhk Ciryxnd Comryt, Mtu. uF,n dc lbovc mtrtiored porcny ftr inslf,ction ,'urposs. ADpli(trnl or A,:enl siannlu 6-ra-lI Waste & Vent Water-Under floor Gas-Underfloor Building Sewer Area/Storm Drain I nterceptor/ Clarilier TOP OUT Waste & Vent Water Piping Gas Piping Tub/Shower Test Rough Water Heater POOL/SPA P-trap/Drain Line Main Drain/Pool Pipinq Fill Line/Back Flow Pool Heater/Gas Line Miscellaneous Gas Service Water Service Lawn Sprinkler Sanitary Sewer/Cap Back Flow Device Rough Plumbing Final Gas Test Meter Release FINAL b'29-18./,).{*u(t'g Notes, Remarks, Etc. Policy Nlmbcr:Jrnie(: _ t^ n,lcr\ AtlJn... UNDER GROUND Rool Drain T/AYOR Miguel A. Pulido MAYOR PRO TEM lVichele Martinez COUNCILMEI\,IBERS P. David Benavides Vicente Sarmiento Jose Solorio SalTinaiero Juan Villegas CITY OF SANTA ANA PLANNINC & BUILDINC 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 yourself as the builder of the property improvementsspecified" Dathi cev\ke-rr 5ioq €- c€]^4'ml Aw, sart"{a Av.a UQtnol 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 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. L.,t ( 1 I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" buihing 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 unl'censed person and his or her employees while working on my property. l\4y 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. L+( 2 | understand building permits are not required to be signed by property owners unless they are responsible for thb bonstruction and are not hiring a licensed Contractor to assume this responsibility. \-N,_4. I understand Contractors are required by law to be licensed and bonded in California and to list their license nultrbers on permits and contracts. VI'( 5. lunderstand if I em ploy or otherwise engage any persons, otherthan California licensed Contractors, andthe tot5l value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. 1v/}{ 0. t understand if I am considered an "employer" under state and Federal law, I must register with the state and fe&ral government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. W I I understand under California Contractors' State License Law, an Owner-Builder who builds single-family re$idential structures cannot legally build them with the intent to offer them for sale, unless a// work is performed by SANTA ANA C TY COUNC L ACTING CITY MANAGER Gerardo Mouet CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar mou do6sanla-a.a oro Mayor Pro Tem Ward 2 mrmarlinez@sanla-a.a oro Vrcente Samenro vsa16renlo@sa.l3-ana oro solono@sa.la-ana oro P David Benavdes dbe.avdes@santa-ana o.o v eoas@saita-ana oro s1 narero@sa.la-ana c,o Uh( 3 I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may prlltect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. 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. WI 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 finbncial or personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the workmanship or materials. , rt"J 9. I understand I may obtain more information regarding my obligations as an "employer" from the lnternal Revenue S{fvice, 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.qov for more information about licensed contractors. Yf7 ro. I am aware of and consent to an thJiartv leoallv and financiallv resoonsible aoaress: " ' Go5 3. 'C en+fal Owner-Builder building permit applied for in my name, and understand that I am for proposed cons ction activi ty at the fol owtn a4 \rk( 11 I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all hpplicable laws and requirements that govern Owner-Builders as well as employers. ){ p.lagree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the inftrmation 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 permit. /Vofe.' A coDv of the propertv owner's driver's license. form notarization, or other verification acceptable to the aqencv is reouired to be Dresented when the permit is Owner Date b -ta-t ISignature of Property Print name of Owner q-"fe^-lch'W AUTHORIZATION OF AGENT TO ACT ON PROPERry OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibjlity, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and tlle 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 Print Name of Owner: Note: A copy of the owner's driver'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 CITY COUNCIL mpLr dorosantz aoa.oro Mayor Pro Tem. Ward 2 m ma.l nez@sanla ana oro v.enre Sarmienro vsamie.to@sanIa-a.a oro isolor o@sa.la ana oro dbenav,des@sanlaa.aoro v eoas@sanla-ana.oro stiraero@sanlaanaoro issued to verifu the propertv owner's siqnature. t