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Home My WebLink About40134887 - Permitcity of santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Mechanical Permit Counter: (714) 647-5800 lnspection Requests: (7141667-2738 lnspector Section: O14) 647-5853 Permit #: 40134847 Pin #: 71773 Project Address: 3620 S Main St Assessor'sParcel: 932-91041 Lot: NA Unit: C Block. NA Btdg: Traclr NA Suite Range: Zoning: C4 Phone: Tgnanl Name: Contractor: Address: Rosie Hitzeman 3620 S Main rC Santa Ana, CA 92702 (714) 337-5949 Owner-Builder Fse Type Amount 01 1 16002 516(N Fumace/Comp Combo 136.71 01116002 5160C General Plan Update 23.79 01116002 51604 lssuance 59.30 011 16002 5777C Microltlm Records 4.05 Qty 1.00 1.00 't.00 't.00 Feo $136.71 $23.79 $59.30 $4.05 Phone State Lic #; Lic Type: Bus. Lic #: Workers' Compensalion lnsurance Carrier: Policy #: Expires; Planning Conditions: Planning Approval By: Plan Checked 8y: Permit lssued By: Subjecl to Field: Building Permil #: Graham, Jeffery 09to3t2020 Misc. Receipt: Misc. Receipt: Misc. Receipt: Total Condominium Miscellaneous FAU/Comp Occupancy: Conslr Type: Code: R-2 VB cMc 2019 Noles. Dale Oate OaleHernandez, Kathy Ewry perfiit issued shall bacome invalid unless th6 wo* o, the sile authonzed by such pemt is commencad within 360 days aftet s issuance, ot if the wo* authonzod on the sile by such permit is suspended ot abondoned tot e ponod o!,360 days after the tihe the wo* is commencod 09103,2020 Account# $23.79 $196.01 $4.05 lnspector MID#: 2020-'161291 01 1 16002 51600 011'16002 51604 01116002 57770 Fee Total Paid to Date: Balance Due $223.85 $0.00 0223.85 AddressRange: 3020-30a0 Historic: No Ownerl Address Building Use: Job Type: Nalure of Work MECHANICAL-INSPECTOR RECORO APPROVALS DATE ID/SIG.COMMENTS oIINER DUtI,DEN DELCAXATl('N I hcr.l't nlltm uftld n rllry o, FrruD' rhr I n.t r{)i nun r (irntif,r.N l.{cnc l, ntr rh. n,ll'*ioF Elrr rS..70ll 5 Busi',c\\ ui lroL$nrn (in r Ant (iir or Counrl *hih r.qutr.l ! 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Equipment Ouct Work Pre-lnsulalion lnsulation Smoke Detectors lnstalled Rouoh Ductwork Vents Toilet Room / Clothes Dryer Residential Ranqe Other Hood Type I Hood Type ll Hood Grease Ducl Fire Damper Openinqs lnstallation F.D. Drop Test Above Hard Lid Above T-Bar Rough Mech. Final Test Meter Release FINAL Notes, Bemarks, Etc. ,BK I I r< YI I 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-,i3 CBC 20,t6 NOTICE TO PROPERTY OWNER Dear Property Owner: An application Jo a buildin p ermit has been submitted i n your r+ (-name listing ursel as the buil dFr of t[e rrope4y improvementsl+ LI L tC Ispecified at ^\q 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 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 ACKNOWLEGMENT AND VERIFICATION OF INFORMATON D/RECI/OiVS; Read and initial each statement below to signify you understand or verify this infomation. hrl {4, ,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 iojuries to workers on my prop- erty. I U 2 I understand building permits are not required to be signed by property owners unless they are responsible for the *instruction and are not hiring a licensed Contractor to assume this responsibility. 3. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect yself from potential financial risk by hiring a licensed Contractor and having the permit flled in his or her name instead of my own .n"ll\M_q I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers hn permits and contracts. U}(_5 I understand if I employ or otheMise engage any persons, other than California licensed Contractors, and the total iplue of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employe/' under state and federal law. \IDLO. I understand if I am considered an "employer" under state and Federal law, I must register with the state and federal lbiernment, withhold payroll taxes, provide workers' compensation disability insurance, and contnbute to unemployment com- pensation of each "employee." I also understand my failure to abide by these laws may subiect me to serious financial risk. Nn ^0V-i\ Z. I understand under California Contraclors' State License Law, an Owner-Builder who builds single-family residential {tructures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontrac- tors and the number of structures does not exceed four within any calendar years, or all of the work is performed under contract with a licensed general building Contractor. H8. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any finan- personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workman- ship or materials A,$l S. f understand I may obtain more information regarding my obligations as an 'employe/'from the lnternal Revenue Ser- vibe, the United States Small Business Administration. the California Department of Benefrt Payments, and the California Divi- sion 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. c,Dl lO.l am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that lam the pdrt/ legally and financially responsible for proposed construction activity at the following ad- d ress a 1 1. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all icable laws and requirements that govern Owner-Builders as well as employers 12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I 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 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 rnsurance 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 per mit, ivote.' A copv of the propeflv owner's driver's license, form nota za. tion, or other verification acceptable to the aqencv is required to be presented when the permit is issued to verifv the p ropertv ow ner's sio natu re. Sagnature of Properly Owner Date uw Print name of Owner 3os,+u* \(pps,s ) \q114rvwn 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 Sagnature Date Print Name of Owner: Note: A copy of the owner's driver's ,icensg form notarization, or other verification acceptable to the agency is re- quired to be presented when the permit is issued to vetry the property owner's signature. a I *,SNTA NA,rffii Planning & Building Agency 20 Civic Center Plaza Ross Annex P.O. Box 1988 (M.19) Santa Ana. CA 92702 (714) 647.5800 www.santa-ana.oro Smoke & CO Alarm Affidavit rNSP-02 2013 CRC This document mqy be lound ot...http://wwv. santa-a na.orq/pba/ (Please use a black or blue ink ball-point pen) Project Address:l.oz (eyi-* CuftPr \ D \ \ozlsc9 Property Owner: Contractor:Co.-Aan4r -1-e-*License #: 1?ZCt-l I C-.lto State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential b u ildings. 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. f\ ,o,n boxes below must be checked:I B 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 ap2liances (i.e hot water heater, cooktop, furnace) or a fireplace. d 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 pro.ject. 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 lwill retest the alarms per the manuf acturer's instructions. lcheck onel Licensed Contractor tr Property Owner NOTE: Ihrt sef-certificdtion is only used for projects thdt dflect the ErTERIOR of the structure. This process is applicable ONLY to projects where access to the interior oI the dwetling by o Santa Ano lnspector is not required, Dote 4 [q lzozo Have this completed form and the job-card readily available on final inspection! I I Permit Number: I I Signoture:I