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Home My WebLink About10180953 - PermiteF Project Address: 320 N Tustin Lot: POR 14 Historic: No Citv of Santa Ana 20 Civic Center Plaza (M-'19), Santa Ana, CAI27O2 Building Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853 Permit#: lO'tEO953 Pin#: 12276 Occupancy: Constr Type Code: Flood Zone: # of Stories: M, S-1 VB cBc 2013 x-0602320277 J 1st FL Area: 2nd FL Area: Other Areas: Garage Area Total: Patio: T.l.Area: Yards Req'd: Valuation: $1,500.00 0 Description of Work: lnstall demising wall to create Unit A for Smog Test Only Station. Planning Conditions: lnterior T.l. Only Owner: Address: Phone: Tenant: L'inc D'aline Corporation 320 N. Tustin Ave. Santa Ana, CA 92705 (714) 835-8097 tbd Phone: State Lic #: Lic Type: Bus. Lic #l Workers' Compensation lnsurance Carrier: Policy #; Expires: Contractor Address: Owner-Builder Enqineer Architect / Designeri Address: Phone: License #: Phone: License #: Planning Approval By Soto, R Plan Checked By; Permit lssued By: NPDES lnsp. Red PWA lnsp. Req'd: Dale: 0312112014 Misc. Receipt Oale OSl12l2O14 Misc. Receipt Date: 05/13/2014 Misc. Receipt Subjecl to Field: No No Account# No , Jason ki, Teri 61840 Total 07776002 07776002 07776002 07776002 077!6002 07776002 57 607 s3600 57770 57672 57 600 57607 $138.22 $191.62 $3.24 $1.00 $19.04 $47 .48 o No Fire lnsp. Redd Planning lnsp. Redd: No Police lnsp. Req'd Landscaping lnsp. Req'd: No Flood Zone Cert. Reqd Every pemit issued shall become invalid unless the wofu on the site authotized by such pemit is commenced within 180 days after its issuance, or if the wofu authoized on the site by such pemit is suspended or abandoned for a peiod of 180 days after the time the wotk is commenced. lnspector MID#: 2014-1 13360 01116002 51600 01't'16002 51601 01'116002 5'16'12 01116002 57770 $19.04 $185.70 $1 .00 $3.24 Fee Total: Paid to Date: Balance Due $400.60 $191.62 $208.98 Assessor's Parcel: 400-091-06 Unit: A Bldg: Address Range: Tract: MAYBURYBlock: NA Suite Range: Zoning: P Building Use: Commercial Job Type: Alteration Nature of Work: Demising Wall Existing Bldg. & Use: Commercial/cas Station Proposed Use: Address; Permit Fee Plan Check Fee Microfilm Records Bldg. Stds. Revolving General PIan Update lssuance BUILDING. TNSPECTOR RECORD rD/srG.COMiIENTSSITE-WORK Set Backs Forms/SteeuHoldowns Erection Pads UFER Ground SLAB Floor SubfloorNenUlnsul. Roof Sheathing ,l Shear Wall A.-,,Framing --2: lnsulation/Energy -t>t Drywall {/ zc/d Ext./lnt. Lath 4' Brown Coat Masonry Pool Fence T-Bar Handicap Req Deputy Final Report Engineer Final Report Flood Zone Certif. FINAL 6/< /,rr w/4 ) Gertiflcate of Occupancy Notes, Remarks, Etc. dod-Bliud Debn ir I hd.br rn@ ud- Fr!, of Fi..y l!.r I u cdDl foc t!. Cdsr t'LLd.! ljP lb ttE 6lbrb8 lq&t (E?o!1.5 a6ld. .nd ft.t .bn Cod.): Ary Cry d Cody r,ti.i t giq . Fni! lo .otitud, r!c. l!|Fot!, .tcolit or .".n .!, run or!, Fi, !o itr irEn ., .lo .q!iE lh. rrplird f.. r'*t FDlr !o 6L . .i!r.d ddad l[.t lL ot rL i Xc@d Idn !l b lio ,.!vilo!r of tL cdd..'o. , Iia.d t l (clrltr 9, Cddtii. f,tn s..d.n Tooo olDiviiou , ortb Adin , .d Prott bG C.d.) d drr t6 d .n ! ddDr 6a!G!o !..t rh. t .i 61 ll..!cr.d t4 rrd.r.Art rlohhd of Saio! m!l.J !y.,,.Pgli..rn 6.. FDI ttbj..it lt rppllan l. . dvil Frlt, of mt B! G.r dE lrldod .lollrD (iJOO). I, ! olE of t!. p,oFry. or Ey .erLrg with uSr u th.e &h 66podlo4 eill do d. 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F6'De of lt srt lbr rti.! rlfi p6l . truGd. My wtd' !6aadio! hrurnE 6ni. .rd t lk, o6li e Gl ! *d! ....1 Br t6 6ql.r.d If llE ,..Dit L br Oa hrid.ld &[]t (tl0o) q L.r) _I drif, tn.l i. tl'. Fb,ffi of tlE wt h. be.e dbj.d ro 6. s 6 ' @'g.urlo. lE &, Fr.6 b e, or!.r ,o r to @mpdl.lh! F.vtioir ofs.aih l70O ofit bbo(I ftr6r:rl' corgt xlt 6... I w.uxnc,ruuoro r* *r-.' ftr uD !, 6 h!'(U th.tIud &tLn i. 6lutu\ rd r!.ll obja u dpLF !o â‚¬,ond poti6 &d civil b rb.or of 6ip{rb.. nEt gF!vid..lfortt S.dlon3@6ot dr r.nd Cod., ilncr .rd .rEart ta SCEIE.CANI&GIPE!.DICIAIASO! I l'.dy .mE !.dG p6.b, oa p-rry ftr I 6 li6d rrd.. F6rib. orqt,6 9 (@..br xlt S..rh. ruq dDiviion ! ot ltl. BriE .!d lroBtloi C.d., .rd d, Ihd. L h nll 66 !r.l d.a MNIIIICIIOdJ.IdDAIGIGEICT I lE.ly rdlE undd pdty olriity 6,.r th.! h r id*!d..' lo{bt !a6c, ior th. Ftudlt oldE wL for siio! tlit FDn L i..Ed (Se ,097, CiY C.). I?t_tcANT'S DECITf, lTrOrY D@tilbn Emit!-/lrL.rd Ndinanh Ldd.l R.s.ldbo. Grb aO, llt O_ n qliEd r,.nn of NolfdIid _I6rify rhrl th.6ddlE lLrbd qrdii8 !b.dd @dEl e aor.rrlirlL to dlt prDj..r I T irb.,!.tlr l, .on d. I .8ra b 6rpt wit ! dl Cty ..d Cqurty Dtu&. Fr.E lr.dE oflit Cl, rnd Ciut, b dd EFi tt II I I II DATE /)1/zn/trt MAYOR MiguelA. Pulido MAYOR PRO TEM SalTinajero COUNCILMEIMBERS Angelica Amezcua P. David Benavides Michele Martinez Roman Reyna Vincenl F Sarmrenlo CITY OF SANTA ANA PLANNINC & BUILDING ACENCY 20 Crv ( Center Plaza P.O. Box 1988 . Santa Ana, Calafornia 92702 www.Santa ana.orglpba NOTICE TO PROPERTY OWNER Dear Property Owner An application for a buildi it has been subm tted in your name lis rself as the buil of the prope(yg you improvements specified at 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 INF ORMATON DIRECTIONS: Read and initial each statement below to signify you understand or verify this information- 'Z-a!t I I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" building 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. lrly homeowner's insurance may not provide coverage for those iniuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. =-fAZ I understand building permits are not required to be signed by property owners unless they are responsible for me construction and are not hiring a licensed Contractor to assume this responsibility. .Zl]S. I understand as an "Owner-Buildea' I am the responsible party of record on the permit. I understand that I may orotect myself from potential frnancial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. I ZYq. I understand Contractors are required by law to be licensed and bonded in California and to list their license r1!mbers on permrts and contracts..t -ZA, I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the lotal'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. -1-I1A. I understand if I am considered an "employer" under state and Federal law, I must register with the state and tederal government. withhold payroll taxes, provide workers'compensation disability insurance, and contribute to unemployment compensation of each "employee." l also understand my failure to abide by these laws may subject me to serious financial risk. l.-Bl 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 subcontractors 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. CITY I\,IANAGER David Cavazos CITY ATTORNEY I Sonia R. Ca.valho CLERK OF THE COUNCIL Maria D. Huizar I , t. Z-t-18 I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the workriranship or materials..t(2t19. I understand I may obtain more information regarding my obligations as an "employer" from the lnternal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of lndustrial Accidents. Ialso understand lmaycontactthe California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.oov for more information about licensed contractors.rl?Z) )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 legally and financially responsible for proposed construction activity at the following address: 1 '1. I agree that, as the party legally and financially responsible for this proposed constructjon activity, I will abide by all applicable laws and requirements that govern Owner-Builders as well as employersrl.7---DlZ I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the -informationl 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-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 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. lVofe :A coDv of th e rtroDertv ner's driver's license form notarizetion or other verification a le issued to verify the propeftv owne|4 siqnature. n ired to be ented when the C- Signature of Property Own o^rc, D5 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 Aqent Address 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: Noae: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. PLink:WP51/Counter Activity/Assembly Bills/Notice to Property Form 03-13-2014 SANTA ANA ClTY COUNCIL M,quera o-hoo I sa' ,-a*o iMav!, Mdvo Po l"^ waab i MoLhoo@s..ra a.d oro sT'.aâ‚¬'odsanrr-r.a o'o Vsarm enlolasania a.a or.MMan .ez@sa.ra -a.a crq i Angercâ‚¬ Ahezcla ii ward3 i' AAmezoaasanla an. orc :D8enavrd6 6san|a-ana orc RRev.riAr.nr:-r.: 6r. Phone Number of Authorized Agent