HomeMy WebLinkAbout10295773 - Permitcity of Santa Ana 20 Civic Center Plaza (M-'19), Santa Ana, CA 92702 Building
Permlt Counter: (714],647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Project Address: 1330 S Rita Wav
Assessor's Parcel 109-375-09 Lot: 61
Bldg: Address Range
Blockr NA Tractr 2070 Historic No
Building Usel
Job Type:
Nature of Work:
Existing Bldg. & Use:
Proposed Use:
Single Family Dwelling
Addition
Addn
Sfd Watt garage
Occupancy:
Constr Type
Code:
Flood Zone:
# of Stories:
R-3, U
VB
cBc 20't 6
x-0602320257J
1
1st FL Area: 45
2nd FL Area:
Other Areas:
Garage Area:
Tota l: 45
Patio:
T.l.Area:
Yards Req'd:
Valuation:$4,900.00
Description of work: Legalize expansion of (e) 1/2 bathroom (portion of front porch enclosed) to become a fuf,dd*oofil.lilgIE/1lg.SQpR {raIQXljlFPt es t g
FROM GARAGE TO BEDROOM. Provide 1/2"drywall ongaragesideof wall. 0ffice: (:TYH Trnns+i :,rr 1of 5Ai.it+! Frlir lt-t"lq5ll3
planning Conditions:All materials to match existing including new bathroom window. f;ret9:9229967?bi- 6/;:1i-r,r?ttlVl4r17Ff'l_1_
Engtneer
Owner: Tracy Vu Contractor: Owner-Builder Ir flcv Vt,
Address: 21845 Michigan Lane Addressr Ad.iress'
Lake Forest, cA 92530 Prrildins $69(l'?3
phone; (s4e) s10-6661 phone: phone: illlfl]lt;,ll'flilXfl" ,." $21.?r
Tenant: State Lic #: License #; rll I 16ll[]2- 516rlrl0(rt1-
Lic Type: Arr P'Ids Stds Revolvins $1,t1[l
Bus Lic#: ,"*ffi:ll 3:[liJl"i$Bffim'PBl3l]l!;,, ,;.,,Workers' Compensation lnsurance; Address: PO Box 3ql4tr6tltl2- 5777r: ltlrl-Carrier: Downey, g[It0239 $Lt .61r
Policy #: Phone: (562) 7154g7tllr:rrrl- ?4rllltrllll0-
Expires: License #: Iil' {:heck 0(1541 $1r81li'9'-'
Planning Approva
Plan Checked By:
Permit lssued Byl
NPDES lnsp. Req
lBy
PWA lnsp. Req'd:
Planning lnsp. Req'd
E anny
Kathy
ki, Teri
Misc. Receipt
Misc. Receipt
Misc. Receipt
0 77760 0 2
o77760 0 2
077760 0 2
017760 0 2
017760 0 2
o8907007
o77760 0 2
077760 0 2
077760 0 2
57607
s3 600
57770
5760 7
5 7601
24000
57612
57600
57607
$300.00
$300.00
$3.62
$93.17
$234.08
$0.64
$1.00
$21.25
$52.98
Date: 03/06/2018
Date; 06113/2018
Date: 06/20/2018
Subject to Field:
70926
Total
a
,d
No
No
Fire lnsp. Req'd:
Police lnsp. Req'd ffi Account#
Landscaping lnsp. Req'd: No Flood Zone Cert. Req'd: No
Every peftnit issued shall become invalid unless tho wo* on the site aulhotized by
such permit is cofifienced wthin 180 days aftet its issuance,or if the work authoized
on lhe site by such permit is suspended or abandoned for a peiod of180 days afte.
the time the wo* is commenced.
01 1 16002 51600
011'16002 51601
o1116002 51612
01116002 57770
0890'1001 24000
$21 .25
$680.23
$1.00
$3.62
$0.64
$1,006.74
$300.00
$706"74
lnspector lVllD#: 2018-141900
Fee Total:
Paid to Date:
Balance Due
Permit #: 1o295773
Pin #: 814{9
Unitl Suite Range:
Zoning: R1
Permit Fee
Plan Check Fee
l\4icrofilm Records
lnvestigation
Penalty
S[ilP - Category 1
Bldg. Stds. Revolving
General Plan Update
lssuance
NOTICE OF VIOLATION
BUILDING- INSPECTOR RECORD
SITE-WORK DATE IDiSIG.
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
Subf loor/Vent/lnsulation
Roof Sheathin
Shear Wall
wallD
Ext.i lnt. Lath
Brown Coat
lVlason
T-Bar
Handi R
Final Re r1Deut
Flood Zone Certif .
FINAL
Certificate ol Occu n
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susnr$ nd Pn,rcsn,n Cd.): Any Ciry or Counry thkh rcquncs ! lcrrnir b cotr(rud. !lr'r' nnptovc. dcnoli\h or rupxn inv
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Pmfc$ions CoJ.) or lhrl lEortlt k cxcmfl rhcrelromand rh. b.sis fnrrh.nllc8cdcxcmDrion Anv vn)ldiono'scclion70ll5 bvanv
!t'!lic!nl n al.flnir subjcc( rhc dP,,licanl ro rcivilp.nukyolnol nn,rrhan fivc hun&cd dolles rs5oor
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lhc w.rk for wh,.h rhis Pcrmir i\ L$udl M y t.rt.r{ conrrcnsir ion in\or,ncc crdcr n'ld Flicv nun$o e'
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ol rhc Bu\irc$ nd llolt s\ ions Codc. . myliccn* n ii fulltncennd.fla.r
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nsucd(Sc. .1097. Civ C I
trndcis A{ldrcls:
-
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Cn! in,lCouNt n, cnhY trl,. rhc
Lb I3-a 101
COMMENTS
SLAB Floor
Framinq
lnsulation/Enerqv
Pool Fence
Enqineer Final Report
Notes, Remarks, Etc.
tFdn\ \Jm
APPLICANT DF() ARA'I'ION
I hcrcnyammundcqrnrlly ortdrruty onc ol rhc r(,lk,wing dc.l{rart'h\
n. !.t ntr Pc nl\ A.h"J..Nn tr:rtr{l'dc'J'R.gJLri.tr\'l[lc4r.Prror
Rc!uir. lrrr$ uf Norilicrrim
tognnlirEi\hc{o\r.n)vnl.rc'tri,'mli.ahlck)rhi\Pn,jrcr
-4r
MAYOR
Miguel A. Pulido
MAYOR PRO TEM
Michele Martinez
COUNCILMEMBERS
P. David Benavides
Vicente Sarmiento
Jose Solo.io
SalTanajero
Juan Villegas
Dear Property Owner
ACTING C Y N4ANAGER
Gerardo Mouet
CITY ATTORNEY
Sonia R. Carvalho
CLERK OF THE COUNCIL
Maria D. Huizar
CITY OF SANTA ANA
PLANNING & BUILDINC AGENCY
20 Civic Center Plaza
P.O. Box I988 . Santa Ana, California 92702
www.santa ana.orglpba
NOTIGE TO PROPERTY OWNER
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements Spec{ied/at t , t, ta -t _ ttzAnr>7. pt.t-r)..- Vlil4 - )Nfl AltA . CA '/2lr?t7
We are providing you with an nF to make you aware ofti
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
thisform 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.
=lZ1
I understand 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 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.
-_i-lr_z. I understand building permits are not required to be signed by property owners unlesstheyare responsible for
the construction and are not hiring a licensed Contractor to assume this responsibility.
-f | 3. 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 Conkactor and having the permit filed in his or her name
instead of my own.
1i4 I understand Contractors are required by law to be licensed and bonded in California and to list their license
dunibers on permits and contracts.
-J ,' 5 I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the
totaYvalue of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an
"employef' under state and federal law.
-f I 6. I understand if I am considered an "employer" under state and Federal law, I must register with the state and
fdddral government, withhold payroll taxes, provide workers' com pensation 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.
'i h. I understand under California Contractors' State License Law, an Owner-Bullder who builds single-family
ref iddntiat structures cannot legally build them with the intent to offer them for sale, unless a// work is performed by
SANTA ANA CITY COUNCIL
hpulido@sanra€na.oro
Mayor Pro Tem Ward 2
mrm6ninez@sanla€na.oro
V cente Sam enro
vsaft e.lo@santa-ana oro isolorio@sanla-a.a oro dbe.avrdes@sa.la-a.a oro iv eoas@sa.ta-ana oro sl .arero@sa.ta-ana oro
lacensed 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.
I V' A. I 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
workmanbhip or materials.
I 1,9. I understand I may obtain more infor.nation regarding my obligations as an "employer" from the lnternal Revenue
Set'vice, 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.
I V. 10. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am
thb party legally and financially responsible for proposed construction activity at the following
address:
f\,tll.l agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by
af applicable laws and requirements that govern Owner-Builders as well as employers.
Il/lZ.I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the
iAfdrmation 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. /Voae.' A copv of the propertv owner's driver's license.
form notarization, or other verification acceptable to the agency is rsquired to be Dresented when the permit is
issued fo verify the property owner's signature.
Signature of Property Owner Date 2ol
Print name of Owner
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 Ille the documents necessary to obtain an Owner-Builder Permit for my
project.
o
Name 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
mpulidorosanla-ana o.o
Mayor Pro Tem, Wa.d 2
mimadinez@santa ana.oro vs.rm ento@sanla ana.oro soonorosanta 8na oro
P David Aenavdes
dbenavrdesasanla€.a.oro iv eoas@sa.ta'..a o.o snnaiero@sanla a.a.oro
Scope of Construction Project (or Description of Work):_
Project Location or Address: _
Address of Authorized Agent:
Print Name of Owner: _
Note: A copy of the te to the agency is required to
be presented when the permit is issued to verify the property owner's signalure.
! :rr ,^i t: : ir - ., n,. t. i...'.- :l:: i -!.r:i lr p _;..ir ;..- l: in la ':
SANTA ANA CITY COUNCIL