HomeMy WebLinkAbout101102452 - PermitProject Address: 71 1 1/2 S Van Ness Ave
Assessor's Parcel:010-204-03 Lot 3
Bldgi Address Rangei 711-713
Tract: POLYTECHN|C VTLLA Historicr No
Unit Suite Range:
Zoning: SO40Block: 14
City nf Santa Ana 20 civic center Plaza (M-19), santa Ana, cAg27o2 Building
Permit Counter: (7'l.4) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Occupancyl
Constr Type
Code:
Flood Zone:
# of Stories:
R-3, U
VB
cBc 2016
x-0602320276J
1
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area
Total:
Patio:
T.l.Area
Yards Req'd
Valuation:$4,000.00
Description of Work: Change out (8) windows on 2nd floor Wsame size/style. Owner/bldr form filed.
Planning Conditions:Wood trim around windows & same sill hoight to be maintained.
Owner:
Address
Phone:
Tenanl:
Contractor
Address:
Engineer
Addressl
W R WIRTZ
PO BOX 747
Fallbrook, CA 92088
(530) 9134224
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensalion lnsurance
Carrier:
Policy f:
Expires:
Phone:
License #
Architecl /
Desiqner:
Address:
Phone:
License f
Planning Approval By
Plan Checked By
Permil lssued 8y
NPDES lnsp. Req
G ro
eri
07776002
017 76002
0 7776002
0 77 7600 2
07776002
57607
57770
57612
5 7600
5 7607
$166.s3
$3.91
$1.00
$22.95
$s7.20
Permil Fee
Microfilm Records
Bldg. Stds. Revolving
General PIan Updale
lssuance
ki, T
o
PWA lnsp Req'd: No
Planning lnsp. Req'd: No
Fire lnsp. Req'd:
Police lnsp. Req'd
No
No Account#Iota I
Landscaping lnsp Req'd: No Flood Zone Cert. Req'd: No
Every petmit issued shall becomo invaltd unless the wo* on lhe sile authoized by
slch potmt is commenced w hin 360 days aftet its issuance,ot il the wo,k authoriaod
on lho site by such perfil is suspencled or abandoned fot a period of360 days after
lhe time the work ts commenced
lnspector MID#: 2019-156213
01 1 16002 5't600
01 1 't6002 51601
01116002 51612
01116002 57770
$22.95
$223.73
$1.00
$3.91 Fee Total:
Paid to Date:
Balance Due:
$251.59
$0 00
$251.59
Permit #: 1fJ11o2452
Pin #: 71701
Building Use: Ouplex
Job Type: Alteration
Nature of Work C/O Windows
Existing Bldg. & Use: Ap1 eysT g273gq
Proposed Use
Date: 12105/2019 Misc. Receipl
Date: Misc. Receipt
Date: 12105/2019 Misc. Receipt
subjecl to Field:
BUILDING. INSPECTOR RECORD
SITE-WORK DATE ID/SIG.COMMENTS owNEll Bllll-oEn D1:LcaRA'l'loN
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Bl6rn6s rxj Prol6ron (ird.l: A.y ( [y o. counry whi(h r.qutr6 a p6mil k] coBrtud. ah6. ihp.ot , donolish or r.?ot any
slrudu.. rio, to i'! Nuuc.. al56 rqun6 rh.0ralicel lM suct lFhil 10 lil.. sisNd 316l.I@! lhd h. or 5h. is liccE J PlNel
rrt rh. rulirio.r of rlE Conrerors l-'co*d hs' (Cfi,Ind 9- C.nno.'nr snh SfrlNn 7000 ol DNisi.n I of!h. ABi6r lnd
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CONSTRT]CIION LENDING GENI-Y
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'o
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- ^,. rl /r//t
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loor/VenUlnsulation
Roof Sheathinq
Shear Wall
Framing
lnsulalion/Energy
Drywall
Exl./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
ld: fl, /so:lo r$9 'rLalh,trd
Certificate of 0ccupancy / /V\J
Notes, Remarks, Etc
w(s
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FINAL
*,,SANTA
ANAJffi
Planning & Building Agency Smoke & CO
Alarm Affidavit
20 Civic Center Plaza Ross Annex
P.O. Box '1988 (M-19)
Santa Ana, CA92702
(714) 647.s800
www.santa.ana.orq
rNSP-02 2013 CRC
This document moy be lound ot,,,htto://www. santa-ana.o rolobal
(Please use a black or blue ink ball-point pen)
Project Address:711.5 South Van Ness
Permit Number:101102452
Property Owner:Walter R. Wirtz
License #: 274400
State of California requires that smoke and carbon monoxide (CO) atarms 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 required locations.
fl sott boxes below 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.
Ed 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. lfurther 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
manufacturer's instructions.
lcheck onel License d Cont tor tr Property Owner
NOTE: Ihrs sef-c ertificotion is only used lor projectsthot oflect the EXTERIOR oJ the structure. This
process is applicoble ONLY to projects where occess to the interior ol the dwelling by o Sontd Ano
lnspector is not required.
Signoture:,Dote:06/29n020
Have this completed form and the job-card readily available on final inspection!
I
Contractor:
I
Plannlng & Buildlng Agency
Bulldlng Safety Dlvlslon
20 Clvlc Center Plaza
P.O. Box 1988 (M-19)
Sants Ana, CA 92702
(71t|) 8/r7.5800
wrnv.arnt!-rna.org
APP-'t3 CgC 20 r6
NOTICE TO PROPERTY OWNER
Dear Property Owner:
An appl ication for a buildin sp ermit has been submitted in our name li ng yo lf as th builder of the
specified at
tm ments
,
Weareprovidingyouwithantomakeyouawareofyour
responsibililies 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 otficial 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
OTRECITOIVS: Read and lnltlal each statem'nt below to slgnlfy you underctand or verlfy thls lnformatlon.
&. tunderstand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" build-
lhlapermit 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 sub,iect to serious flnancial risk for any injuries sustained by an unlicensed person and
his or her employees while working on my property. My homeownefs insurance may not provide coverage for those iniunbs. 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.
A ,understand building permits are not required to be signed by property owners unless lhey are responsible for the
ionstruction and arB not hiring a licensed Conkactor to assume this responsibility.
@, I underctand as an "owner-Bui*er" I amthe res@nsib,b pa dy ot recoa, on the pemit. I uNerstand that t may protect
'llryself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my
o\rvn.
&runderstand Contractors are required by law to be licensed and bonded in California and to list their license numbers
on pormits and contracts.
& ,understand if I employ or otherwise engage any persons. other than California licensed Conkactors. and the total
value of my construction is at lgast five hundred dollars ($500), including labor and materials, I may be considered an
#,*ilffi **,,, r**;ill** ir1[fi irril.?]';ifl ri,::i'rJili'rii*Hi:"x*"H;i:l
pensation of each "employee," I also understand my failure to abide by these laws may subject ms to serious financial risk.
Z-understand under California Contractors' State License Law, an Owner-Builder who buifds singte-famiTy residen(iat
9lfuI[res cannot l€gally build them with the intent to offer them for sale, unless all work is performed by licensed subcontrac-
tors and the numbor of structures does not exceed four within any calendar years, or all of the work is performed under contract
d:-;;'t*;.ffi tffi',:ti"'#:iy.,T,,,r"*Tir:***',,*milr:*,'tJ*'fi :ui;Jff :
ship or materials.
dn. ,understand I may obtain more information regarding my obligations as an "employe/'from the lnternal Revenue Ser.
vlEE, the United States Small Business Administration, the California Department of Benefit Payments, and the California Divi-
sion of lndustrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1 €00-
321-CSLB (2752) or,iwvw.cslb.ca.oov for more information about licensed contractors.-/)
Zro I arn awae of and @nsent la an @ter-But*er building permt agptie<t tor in fiy nafie, and u&erstand thaa l am ttre
party legally and financially responsible for proposed construction activity at the following ad-
dress
1 1. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
applicafle laws and requirements that g
@r l agree to notfy the issuer of th
have provrdeo on tnls lorm
overn Owner-Builders as woll as employers.
is form immediately of any additions, deletions, or changes to any of th€ information I
Licensed contractors are regulated by laws designed to protect the public. lf you conkact with someone who does not have a
license, the Contractors' Slate License Board may be unable to assist you with any financial loss you may sustain as a result ol
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 hel(
liable for damages. lf you obtain a permit as Owner-Builder and wish to hire Contactors, you will be responsible fi1r verifying
$,helh6r 6r nol those Conttactols are properly ,iceDsed and the status o, ,he,r workers' co.Drpe.Dsation inswa nce cotterege.
Before a buildlng permit can be i6sued, this form must be completsd and signed by ths property owner and returned
to the agency responsible for issuing the permit.
^rote:
A copv of lhe Dropertv owner's drivet's licanso. fon nolarlza.
tion, ot other varification acceptable to the adencv is reauired to be presented when the Dermit is issued to varifv the
prooertv owne," s sldnature.
Signature of Property Owner Date a,/oz/^
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 tor, sign, and file the documents necessary to obtain an Owner-Builder
Permit for my pOect.
Scope of Conslruction Project (or Description of Work)
ProJect Location or Address:+,Q>to
Name of Authorized Agent:G.rr^.',, GaJr\bavnY
Address of Authorized Agent:S f.>7
Phone Number of Authorized Agent:7 rq - 33 oo10
I declare under penalty of perjury that lam the property owner for the address listed above and I personally filled out the above
)ntfimabon and cefily its accuracy.
Property Owner's Signature Ort".. /J
Prinl Name of Owner:
Note: A copy of lhe owner's driver's license, form notarizatlon, or other varllication acceptabls to the agency ls re-
quPod ,o E prcseitd tuh€n the pemlt ls lssud ,o vslry the prqany owner's slgoarub.