HomeMy WebLinkAbout102104570 - PermitProj ect Address: 14225 Mohawk Dr
Assessor's Parcel 407-103-10 Lot 31
Unrl Bldg: Address Range Suile Range:
Zoning: RlBlock NA I (acl 3627 Hrstoric No
CiQ of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, cAg27o2 Building
Permit Counter: (714) 647-5800 lnspection Requests (714) 667-2738 lnspector Sectron: (714) 647-5853
Permit #: 1O21O457O
Pin #: 44569
Building Use:
Job Type:
Nature of Work
Existing Bldg. & Use
Proposed Use:
Single Family Dwelling
Alteration
N/V - Patio Cover
SFD w/att Garage
R-3, U
VB
cBc 2019
x-0602320256J
1st FL Area:
2nd FL Area:
Other Areas.
Garage Areal
Total:
Patio.
T.lArea:
Yards Req'd:
Valuation: S1,000,00
Occupancy:
Constr Type
Code:
Flood Zone:
# of Stories:
Description of Work: Remove unpermitted patio cover. Owner-Builder form on file
Planning Conditions:
Owner
Address
Phone.
Tenant:
Contractor
Address:
Engineer
Address:
Maria De La Luz Leon
1422 S. Mohawk Drive
Santa Ana, CA 92704
Owner-Builder
Phone:
State Lic #l
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policy #:
Expires:
Phone:
License #
Architect /
Desrqner
Address
Phone.
License #
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd: No
PWA lnsp. Req'd: No
Planning lnsp. Req'd No
Landscaping lnsp. Req'd No
Arias, Fernanda Date: 09/03/2020
Date:
Chavez. Dave Date: 09/03/2020av'-c'
subject to Field:
Frre lnsp Req'd. No
Police lnsp. Req'd: No Acco
57607
57770
57607
57607
57672
57600
s7607
$172 64
$4.05
$104 26
$261 .96
$1.00
$23.79
$s9 30u nt#Total
Misc Receipt
Misc. Recerpt
Misc. Receipt
o7775002
07776002
0 77 76002
0 77 76002
077 76002
07776002
07776002
Permit Fee
Microrilm Records
lnvestigation
Penally
Bldg. Stds. Revolvrng
General Plan Update
lssuance
Flood Zone Cert Req'd: No
Every pemit issued shall becohe nvahal unless lhe work orl lhe s,le authoflzec! by
such peml B commenced wlhin 360 days atler ils tssuance ot iflhe wo* authonzed
on the site by such petm B suspendec! ot abancloned for a penod of 3@ days allet
the lme the wo* ts commenced
lnspector MtD# 2020-161307
01 't 16002 51600
01 I 16002 51601
01 1 16002 51612
01116002 57770
$23.79
$s98 16
$1.00
$4.05 Fee Total
Paid to Date:
Balance Due
$627 00
$0 00
$627.00
BUILDING. INSPECTOR BECORD
SITE-WORK DATE to/stG.COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loor/VenUlnsulation
Roof Sheathinq
Shear Wall
Framino
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
Ivlasonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Engineer Final Reporl
Flood Zone Certil.
I
-p&t4FINAL/a/zl /t r*o
Certiricate of Oc'cupancy \-,..
Notes, Remarks, Etc
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Rev. OB-0/-2015
/\/\ * vi A D, I eo 1,1
Planning & Building Agency
Building Safety Division
20 Civic Centei Plaza
P.O. Box 1988 (M-19)
Santa Ana, CA 92702
(714) 647-5800
www.santa-ana.org
aPP-13 CBC 2016
NOTICE TO PROPERTY OWNER
Dear Property Owner
An application for a building rmit s been submitted in your name listing yourself as the builder of the property improvements
specified at
We are providing you with an Owner-Builder Acknowledqment and lnformation Veriflcation 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
DIRECTIONS: Read and initial each statement below to signify you underctand or verify this information.
\, t ,' t)7 I 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 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 inluries. 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.
,l'r2r-_2 I understand building permits are not 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.
,|JAL_3. I understand as an "Owner-Builde/ 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.
i I I t);4. lunderstand Contractors are required by law to be lacensed and bonded in California and to listtheir license numbers
on permits and contracts.
/!JDL,. I understand if I employ or otherwise engage any persons, other than 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
"employe/' under state and federal law.
z UjAf..6. 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 com-
pensation of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk.
; t\ i);1 . I 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 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.
i'l\ l) L8. 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-
cial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workman-
ship or materials.
, tlr!, I understand I may obtain more information regarding my obligations as an "employe/'from the lnternal Revenue Ser-
vice, the United States Small Business Administration, the California Departr,ent 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 -800-
321-CSLB (2752) or www.cslb.ca.oov for more information about licensed contractors.
lY\-2-L1 o I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the
party
dress
and financiall responsr for propo sed construction activ ity at the following ad-legally
tiDtt t. I 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.
A]DU Z I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information 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 impo(ant for you to understand
that if an unlicensed Contractor or employee of that individual or firm is injured while working on your prope(y, 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 veritying
whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage.
tion, or other verification acceptable to the aqencv is required to be Dresented when the Dermit is rssued to verifv the
p roperiv ow ner's sionatu re.
Signature of Property Owner \ \nr/. Vfix"^Date 20 zo
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 file 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, ot other veification acceptable to the agency is re-
quhed to be presented when the permit is issued to verw the property owner's signature.
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. /Vote.' A copv of the propertv ownet's driver's license. form notariza-
qlt