HomeMy WebLinkAbout102104409 - PermitProj ect Address: 2214tN Edinqer Ave
Assessois Parcel 408-241-',17 Lot 2,3
Unrt Brdg Address Range: 2214-2218
Histonc; No
Suite Range;
Zoning: R2Block. C f(acl:737
City of Santa Ana 20 Crvrc Center Plaza (M-19), Santa Ana, cA.j::lcz ' Building
Permit Counter: (714) 647-5800 lnspectron Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 1O21O44O9
Pin #: 62657
Building Usel
Job Type:
Nature of Work:
Existing Bldg. & Use
Proposed Use:
Triplex
Alteration
Window CrO
Triplex
R-2
VB
cBc 2019
x-0602320257J
Patio'
T.l.Area:
Yards Req'd
Valuation: $15,000.00
Occupancy
Constr Type:
Code
Flood Zone:
# of Stories:
1st FL Area
2nd FL Area
Other Areas
Garage Area
Totat
Description of Work: Legalize window change outs through ouusame size, same style
Planning Conditions:
Owner.
Address
Contractor
Address.
Owner-Builder
Address
Francisco chavez
9081 Reading Ave
Westminster, CA 926834725
(71416224030Phone
Tenant
NOTICE OF VIOIATION
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Canier:
Policy #:
Expires:
Phone.
License #
Architect /
Desiqner:
Address.
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp Req'd:
Planning lnsp. Req'd:
Landscaping lnsp. Req'd
Graham, Jeffery
Hernandez, Kathy
Oate 08/2512020
Date:
Oate. O8l25l2O2O
Subject to Field:
No
Misc Receipt
lvlisc. Receipt
Misc. Receipt
0177600 2
otiuooz
0777600 2
07776002
0 777600 2
0777600 2
07776002
57607
57770
57607
57607
576 72
5 7600
57607
Permit Fee
Microfilm Records
lnvestigation
Penalty
Bldg. Stds. Revolving
General Plan Updale
lssuance
No
No
No
No
Fire lnsp Req'd
Police lnsp Req'd No Account#Total
$172.64
$4.05
$104.26
$261.96
$1.00
$23.79
$59.30
Flood Zone Cert. Req'd No
Every permit issuod shall becofie invahd unless the wo* on the site aulhorized by
such pemit is commenced wlhn360 days aket ls tssuance.ot t lhe wo* aulhonzed
on the site by such peml ts suspended or abahcloned lot a penoc! oi360 days aftet
the lime the work ts cornfiencecl
lnspector Iri'llD#: 2020-'161 049
Fee Total
Paid to Date:
Balance Due:
$627 00
$0 00
$627.00
01116002 s1600
01116002 51601
0'1116002 51612
01116002 57770
$23.79
$598.16
$1.00
$4 0s
Engineer
Phone:
License #
UILDING. INSPECTOR RECORD
SITE-WORK DATE ID/SIG.COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Roof Sheathinq
Shear Wall
Framinq
lnsulation/Eneroy
Drywall
Ext./lnt. Lath
Brown Coat
Ivlasonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Enqineer Final Reporl
Flood Zone Certif
FINAL il'l't"6rb,r/rzt WA
Certif icate of Occupancy
Notes, Remarks, Etc.
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Bcv. 08-0/.2015
Subf loor/VenVlnsulation I
Planning & Building Agency
Building Salety Division
20 Civic Center 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 applicati
specified at
on for a building permit has been submitted in your name I
)4/ q L.j ?[)t -"1t2r-a] Aat? I r1,t-'4,t
istino Vourself as the builder of the property improvements: h'r,q 1 * '7 )J ti '. 1'
WeareproVidingyouwithantomakeyouawareofyour
responsibilities and possible risk you may incur by having this permit issued in your names as the Owner-Builder
We will not lssue 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/OAIS: Read and initial each statement below to signify you understand or verify this information.
r*_1 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 flnancial risk for any iniuries 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 llmits of my insurance coverage for injuries to workers on my prop-
erty.
C tL ?. 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.
A)C 3. I understand as an "Owner-Buildel' 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 havrng the permit filed in his or her name instead of my
own.
F )< 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers
on permits and contracts.
E>._5. 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 flve hundred dollars ($500), including labor and materials, I may be considered an
"employe/ under state and federal law-
F I I 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.
tr > < 7 . I understand under California Contractors' Stale License Law, an Owner-Builder who builds singleJamily residential
structures cannot legally build them with the intent to offer them for sale, unless all work ls 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.
ay-.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 finan-
cial or personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the workman-
ship or materials.
r: \ L 9. I understand I may obtain more information regarding my obligations as an "employer" from the lnternal Revenue Ser-
vice, 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 -800-
321-CSLB (2752) or www.cslb.ca.qov for more information about licensed contu'actors.
E3-10. 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
legally and financially responsible for proposed construction activity at the following ad-
E)L:l 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.
F i (l Z. t 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 desrgned 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 OwnerBuilder 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 copv of the DroDertv owner's driver's license, form notariza-
tion. ot other verification acceptable to the aoencv is required to be presented when the permit is issued to verifv the
Dropertv ow ner's s ionatu re.
L t u+t(,A AL
Signature of Property Owner Date t )>r-/= ts
Print name of Owner F.rz,a w' ct 5 ( t Jeu,</l 1: rJ A\t-e-t
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-Burlder
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 s-o3A(>
Print Name of Ow net: (--.tzA r<Zt I (a I a U , er<. L )J /*Vf-7
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 vetry the propafiy owner's signature.
r+A
=-=-
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF