HomeMy WebLinkAbout10596494 - PermitEr
Proiect Address: 21 19 S Fairview St
Assessor's Parcel 40a-222-',t2 Lol: 184, POR185 Block: NA
Bldg: Address Range Suite Range:
Zoning: R3Tracl 2260 Historic. No
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, cA 92702 Building
PermitCounter: (714) 647-5800 lnspection Requestsr (714\ 667-2738 lnspector Section: (714) 647-5853
Permit #: t0596494
Pin #: 75810
Building Use:
Job Type:
Nature of Work:
Existang Bldg. & Usel
Proposed Use:
Fourplex
Alteration
Windows
Fourplex Watt garage
Residential
U, R-2
VB
cBc 2016
x-0602320258J
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area
Total:
Patio:
T.l.Area:
Yards Req'd:
Valuation:$2,000.00
Description of Work: Legalize all windows changed out in all units
Planning Conditions:
Bntchi:44145 - 6/1/21:tt8tlff icel (IYH 'lrons+: g7
Ir)
Owner-Builder
Engineer
Addressl
Owner:
Address
Phone:
Tenant:
Eufracio Villa
2601 S Shelton St
Santa Ana, CA 927073322
(714) 651-3256
I f.ufroc io Vi]1q
Phonel
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policy #:
Expires:
Architect /
Desiqner:
Address;
Phone:
License #:
Phone:
License #:
8u i ld ins
r:rl l l6!lB2- 5160100(t-
Elds Stde RevoIv ine
rll t 16002- 51612u0rj-
6enerrtI Flon Updote Fee
I.r1l161102- 5l6r'tu000-(nsh
(:honge
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
r(*Hernandez, Kathy
Date: 06/05/2018
Date.
Date: 06/05/20'18
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt;
07776002
0 77760 0 2
07776002
0 77760 0 2
077760 0 2
017760 02
Permit Fee
lnvestigation
Penalty
Bldg. Stds. Revolving
General Plan Update
lssuance
5760 7
57607
57607
57612
57600
57607
No
No
No
No
Fire lnsp. Req'd:
Police lnsp. Req'd
No
No Account#Total
Flood Zone Cert. Req'd: No
Every pemit issued shall become invalid unless the work on the sito authorized by
such pemil is commenced within180 days after its issuance,ot if the wok authgized
on the site by such permit is suspended or abandoned for a period of180 days after
the Une the work is commenced.
lnspector
01116002 51600
01116002 51601
01 1 16002 516'12
$21 .25
$s34.49
$1.00
Fee Totall
Paid to Date.
Balance Due:
$556.74
$0.00
$556.74
Unit:
Occupancy:
Constr Type:
Code:
Flood Zone:
# of Stories:
Contractor:
Address:
i67-3738
R,:pti:02288615 - 6/1/?it|g r,:.iiInonssct ion Totql S5::;6
$154.26
$93.17
$234.08
$1.00
$21.25
$52.98
MID#: 2018-143798
BUILDING. INSPECTOR RECOBD
SITE.WOHK DATE ID/SIG.COMMENTS oWNER tII]II,DER DI]I,CARATION
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DECLABAIII}N
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Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loor/VenUlnsulation
Roof Sheathinq
Shear Wall
Framing
lnsu latio n/E ne rgy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Engineer Final Report
Flood Zone Ceflif .
. .. /-\'
FINAL -i -tK-tK X JV+)U
Certificate of Occupancy tJ v
Notes, Remarks, Etc.
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FLOOD ZON
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YES NO
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P.O. Box 1988 (M-'19)
Santa Ana. CA 92702
(714) 647.5800
w'r/rtv santa-ana orq
Smoke & CO
Alarm Affidavit
INSP-02 20r3 CRC
This document mqy be found ot.http:ii \,^ ,^ /,/. santa-a na-OfSlpOa/
(Please use a black or blue ink ball-point pen)
Project Address:2lt1 -f. friDvrEvt /x;
Permit Number:l0s%41'r
Property Owner:€^A,a, /////
Contractor:License #:
State of California requires that smoke and carbon monoxide {CO) alarms are installed in residential
b u ild ing s.
California Residential Code (CRC) Section R314.1and 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 requ ired locations.
fl eo.n boxes below must be checked:
d Carionmonoxide alarms: Are installed outside of each sleeping area in the immediate vicinrty of
bedrooms and also on each level of the dwelling. Alarms are required in bedrooms with gas-fired
applrances (r.e. hot water heater, cooktop, furnace) or a fireplace.
d Srnot " alarms: Are installed in each room used tor sleeping, in each hallway outslde ot 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 1.0 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
man ufactu re r's instructions.
lcheck one)Lic e nse d Cont rac tor Property Owner
NOTE: Ihis sef-certification is only used fot projects thdt offect the EXTERIOR of the structure. This
process is opplicdble ONLY to projects where occess to the interior ol the dwelling by d Santd Ana
lnspector is not required.
Signature:,--/-/.ttrZ-r'a-
Dote:1-lr-lg
Have this completed form and the job-card readily available on final inspection!
*,SNTA
NAqffi
Planning & Building Agency
20 Civic Center Plaza Ross Annex
MAYOR
Miguel A. Pulido
MAYOR PRO TEI\4
Michele [.4artinez
COUNCILMEMBERS
P. David Benavides
Vicente Sarmiento
Jose Solorio
SalTinajero
Juan Villegas CITY OF SANTA ANA
PLANNING & BUILDING ACENCY
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
tm ents s ed at
4 lz ..4
ACTING CITY MANAGER
Gerardo Mouet
CITY ATTORNEY
Sonia R. Carvalho
CLERK OF THE COUNCIL
Maria D. Huizar
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.
i l/ l. t undersland a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder"
building 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 maynot provide coverage for
those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for iniuries to
workers on my property.
-/tfZ. I understand building permits are nol 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.
/t/ S. I 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.
Z-Lq I understand Contractors are required by law to be licensed and bonded in California and to list their license
riumbers on permits and contracts.
dtl S. lunderstand if I employ or otherwise engage any persons, otherthan 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.
Zjf-A 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 compensation of each "employee." I also understand my failure to abide by these laws may subject me to
serious financial risk.
1/ t. t 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
SANTA ANA CITY COUNCIL
mp! dolasanta ana.oro
M3yor Pro Tem, Ward 2
m maninez@sanla-ana.oro
Vicente Ssrmienlo
vsamiento@sanla-ana oro irslg!is@s4!:4?4
P Davld Benavid€s
dbenaedes@santa ana oro iulleoas@sanla ana.oro slinaieroaAsant3 ana oro
{t/ rc
the party
address:
Signature of Property Owner a o^t", 96 -of - /f '
I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am
legally nd financiall sible for prop osed con truction activ at the
tL--l/
/ ll 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.
y'l1,z.l agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the
i-nformation 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'
compensation insurance coverage.
issued to verifu the propertv owner's siqnature.
a
Print name of Owner /
AUTHORIZATION OF AGENT TO ACT ON PROPERW 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
project.
Scope of Construction Project (or Description of Work)
Name of Authorized Agent
Address of Authorized Agent:_
Phone Number of Authonzed 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 acceplable to the agency is required to
be presented when the permit is issued to verify the propefty owner's signature.p .r \ri,:-:r -r.-A1. ,:r::i-:,il i'.-...t.?.,."..;r' -):!a".
SANTA ANA CITY COUNCIL
moulido@sa.ta-ana oro
l,layor Pro Tem, Wa.d 2
mimartinez@santa-ana.oro isolorio@sanla-ana.o.o
P Dard B€navides
dbenavides@santa-ana.oro villeoas@sanla ana.oro slinaiero@santa-ana.orovsa rh e.ro@ sanra 'a.a .ra
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.
1 U 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
financial or personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the
workmanship or materials.
/ t/ g. I understand I may obtain more information regarding my obligations as an "employer" from the lnternal Revenue
Service, 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.oov for more information about licensed contractors.
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 copv of the propertv owner's driver's license.
form notarization. or other verification acceptable to the aqencv is required to be oresented when the permit is
Project Location or Address: