HomeMy WebLinkAbout101104850 - Permitcity of Santa Ana 20 civic center Plaza (M-19), sanla Ana, cA 92702 Building
Permit Counter: (7'14) 647-5800 lnspection Requests: (7'14) 667-2738 lnspector Section: (7 14) 647-5853
Permit#: lOl{O485O
Pin #: 53780
Project Address: 1507 N Dresser St
Assessor's Parcel 398- 142-'t 4 Lol: 7
Unit Bldg Address Range Suite Range:
Zoning: R3Block. C Tract 276 Histonc. No
Building Use:
Job Type:
Nature of Work:
Existing Bldg & Use
Proposed Use:
Fourplex
Reroof
Reroof
Fourplex w/garages
R-2
VB
cBc 2019
x-0602320163J
1st FL Area:
2nd FL Area:
Other Areas.
Garage Area:
Total:
Patio;
T.l.Area:
Yards Req'd:
Valuation: t13,000.00
0
Description of Work: Tear off comp and apply comp to fourplex
Planning Conditions:
Owner:
Address
Phone:
Tenant
Conlractor
Address:
Engineer
Address
Lydia Hinojosa
5395 Concha Drive
Mira Loma, CA 917522902
(9sl ) 385-208r
Owner-Builder
Phone:
State Lic #l
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policy #:
Expires:
Phone
Lrcense #
Archilecl /
Desiqner'
Address:
Phone
License #
Planning Approval By:
Plan Checked By:
[' Permit lssued By:
1. t'tCOrS lnsp. Req'd:
L PWA lnsp. Req'd;
Planning lnsp. Req'd:
Landscaping lnsp. Req'd
Arechiga, Liana
Verduzco. Violet
Date: 10/05/2020
Date:
Dale 1010512020
Subject to Field.
Misc. Receipt
Misc Receipt
Misc. Receipt
Flood Zone Cert. Req'd: No
Every pennit issued shall become nvalicl unless the work on lhe site auLhonzed by
such pefinit $ commenced within360 days aftet tts issuance.ot if the work authonzed
on the stte by such pemit is suspended or abandoned tor a penod of360 days after
the time the wod< ts commenced
07776002
0 7176002
0 77 76002
0777 60 0 2
07776002
57607
57770
57672
s7600
57607
$345.28
$4.05
$1.00
$23.79
$59.30
..N
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Updale
lssuanceNo
No
No
No
Fire lnsp Req'd:
Police lnsp. Req'd
No
No Account#Total
$433 42
$0 00
$433.42
lnspector MID#: 2020-1619'16
01 1 16002 51600
01116002 51601
01 1 16002 51612
01116002 57770
$23.79
$404 58
$1.00
$4.05
Occupancy:
Constr Type
Code:
Flood Zonei
# of Stories
Fee Total:
Paid to Date:
Balance Due:
BUILDING. INSPECTOR RECORD
SITE.WORK DATE IDiSIG.COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loor/VenVlnsulation I
Rool Sheathing lolT =l?/
Framinq
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
Ivlasonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Engineer Final Report
Flood Zone Certif
I
I
FINAL tffi-{btz )Z:Wh '/l
Certif icate of Occupancy I ,U
Notes, Remarks, Etc
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Shear Wall
Planning & Building Agency
Building Satety Oivision
20 Civic Center Plaza
P.O. Box 1988 (M-19)
Santa Ana, CA 92702
(714) 647-s800
www.santa-ana.org
APP-13 CBC 2015
NOTICE TO PROPERTY OWNER
Dear Property Owner
An applicati
specified at
on for bui ing permit has been submitted in your name listing yourself as the builder of the property im rovements
T'
Weareprovidin9youwithantomakeyouawareofyour
res pon sibilities 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 otflcial address indicated. An agent of the owner cannot execute thjs notice unless you, the property owner,
obtain the prior approval of the permitting authority.
OWNER'S ACKNOWLEGMENT AND VERIFICATION OF INFORMATON
D/RECITO,VS.' Read and initial each statement below to signify you understand or verify this information,
Dtl.^fu I . t understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" build-
l"ng 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 vvorking 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 prop-
erty.
2. I understand building permits are not required to be signed by prope(y owners unless they are responsible for the
ons truction and are not hiring a licensed Contractor to assume this responsibillty
o tl4ll l. t understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect
iryself from potential flnancial risk by hiring a lacensed Contractor and having the permit flled in his or her name instead of my
own.
dY_4 I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers
%n permits and contracts.
.lll, S. I understand rf 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 ($500), including labor and materials, I may be considered an
"employer'' under state and federal law.
"411,
U , understand if I am considered an "employer" under state and Federal law, I must register with the state and federal
fovernment, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment com-
pensation of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk.
dL I I understand under Callfornia Contractors' State License Law, an Owner-Builder who builds single-family resldential
structures cannot legally build them with the intent to offer them for sale, unless a/l work is performed by licensed subcontrac-
tors and the number of structures does not exceed four within any calendar years, or all of the work is performed under contract
with a licensed general building Contractor.
,r$ a I understand as an Owner-Euilder if I sell the property for which this permit is issued, I may be held liable for any finan-
tial or personal tnjuries sustained by any subsequent owner(s) that result from any latent construction defects in the workman-
ship or materials.
, tl
f/LS. 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 Department of Beneflt Payments, and the California Divi-
sion of lndustrial Accidents. I also understand I may contact the Californla Contractors' State License Board (CSLB) at 1-800-
321-CSLB (2752) or www.cslb.ca.qov for more Information about licensed contractors.
dL,
farty le
d ress:
0. I am aware of and consent to an OwnerBuilder building perm jt applied for in my name, and understand that I am the
gally and flnancially res onsible for proposed construction activi at the following aty I
d{11.1 agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
eFplicable laws and requirements that govern Owner-Builders as well as employers.
,lrlL,r. ragree to notity 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 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-Bualder 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.
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 coov of the Drooertv ownet's driver's license, form notariza.
tion. or other verification acceotable to the adencv is reduired to be presented when the permit is issued to verifv the
D roDertv owne r's s i a n atu re.
Signature of Property Own Date -.{-J0Jo
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)
Pro.iect Location or Address
sfr
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 fllled 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 acceptable to the agency is re-
quired to be presented when the permit is issued to vetify the propefty owner's signature.