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Home My WebLink About30139479 - Permitcity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA g27O? Plumbing Permit Counter: (714) 647-5800 lnspection Requests: (714\ 667-2738 lnspector Section: (714) 647-5853 Project Address: 2733 S Pacific Ave Assessor'sParcel: 14O-2A2-O4 Lot 40 Bldg: Tract: 5580 Address Range: Historic: No Suite Range: Zoning: R1 Phone Tenant Name Fabian Wizenfeld 2733 S Pacific Ave Santa Ana, CA 92704 (949) 899-s67s Owner-Builder Owner: Address: Contraclor Address: Feo Type Amount 01116002 51602 Gas Line alter/extend/a( 63.12 01116002 51600 General Plan Update 21.25 011 16002 51602 lssuance 52 98 Fes $63.12 $21.25 Eotch+:43968 - 5/24 /?t.tlg off ice! CTYH Tronsir 4Accti: Epf+: RceLir(!2279267 - 5.i ?4/?(rlg TronEoct ion Toto IFABIATI TI ZT.HFELO lofl 13917? s'6 Pll 7.35 Qty 1 .00 1 .00 1.00 I0r PZun iea J't:l 3:sllPhone Generol Plon t Pdotâ‚¬ FeP 01116002- 5140('000- P1urb ins 01 I I 6002- 5l 6(t20(rf.r- V isa CC+: r*I******f,r*4949 _ t21 .25 _ t116.10 t137.35 AUtli+: 123BtrD Building Use: Job Type: Nature of Workl Planning Conditions: Planning Approval By Plan Checked By: Permit lssued By: Subject to Field: Building Permit #: Occupancy: Constr Type Code: R-3, U VB cPc 2015 Chavez, Dave Every pemit issued shall become invalid unless lhe wolk on the slte authonzed by such pemit is commenced within 1 80 days afier its issuance, ot if the wod< authotized on the site by such pemit is suspended or dbdndoned fot a peigd ol 180 days after the time the wo* is commenced. o5t2412014 Account# Notes: Extendtalter existing gas system for outdoor firepit in rear yard. Owner-Builder form on file. $137.35 $0.00 $137.35 Date: Date: Date: Misc. Receipt: Misc. Receipt: Misc. Receipt: Total $21.2s $116.10 0'1116002 51600 01'116002 51602 Permit #: 30{39479 Pin #: 3E43E Unit: Block: NA State Lic #: Lic Tvpe: Bus. Lic #: Workers' Compensation lnsurance: Carrier: Policy #: Expires: Single Family Dwelling Miscellaneous Outdoor Firepit Fee Total: Paid to Date: Balance Due: lnspector MID#: 2018-143569 PLUMBING.INSPECTOR RECORD DATE ID/SIG.COMMENTS OWNEI BUILDER DELCARATION I hcrcby alfirh und6 lcnalr, of frj!ry thar I M crâ‚¬ry,r fon $c Clnrelo6 Lhen* llw for lhe toUowing M$n (Ss.7031.5 Bu.inc$ and Pmfeisio. C.de): Any Cny or Couory whih rquiB a F.mir ro oBrru.l, rlro. imphr, d.mlnh or Epcn uy struorc. prior 'o ns issumc. !!s r.auiEs tn lppltml aor su.h Fmi lo nk. sigr.d slarcmnl llEl lE or slt t li.cnsd ,tlrs6t ro lnc pEvicions of iE Comrero'3 Lic.ns{ L{w (Ch!flc, 9. Comftrcing wnh Sccrion 7000 of Diviion 3 of lh. Busincsr md Pmfissions Code) or thd h. or sh. is ercnpl lh@from ud the b!5i! for thc sllcgcd .r.mgiion. AnyviolariorofscdionT0ll.Sbyany ,pplicanr for . pcmn subjdrs rhc q,pliotrr to ! civil lcMhy of mt mrc rhu 6w t!.dtn doll]* (S500). Ed, as ownr or rhc pmrny, or my coplorss qirt s{e.s as lhâ‚¬ir sL conp.nssrion. will do t}p *dt .d th. slit16 is tur ift lcd trofercd fd slc (54,?044. Busincss dd P,oibssbrs Cdci Th. C-raldor's Liu* Llw d@s not apply ro e ow.o ol th. pDpcny wlD hiildJ o, inprbB tEb...rd *ho do.. sh e* hinscllor hdclfor t@udt nk or lE own.oployss. povidd lhar such inp|lwmds e ml hlcrd.d o.olY.rcd aor $lc. l[ howE dE toi]dtrE or inVrDEmit ! sld withi, oc ]@ of@nllhlbl! dE OwM Brilhr wiu lErc rlE htrkn ofFovi.E UEr h. or str did d htild or in{mE dE p,Dpsty for dE Flryoe of -1. rs owrcr of lh. ,"opcny, am cxclusivcly conhc'in8 with liccn$d ont@ros lo snnMt llE prere.l lSN. ?e4. Bulies a.d Pr.Esbn Codc Th. CrnrEcro. s Li..Ea Llw d@s nd lppty to d o{nc, or pmFny who builds or impmvcs rhcr.on. ,nd vho sntncrsfor slch phJâ‚¬rs sirh a Conr@ro(, liccnsd ,rusoanr rorhc Conracror's Liccn* t w) -l umeicmrrr lider Sccr D.b..r/zLl/(g "*ffia I lEEby dffrn lndo F..hy of pdjlry oe of lh. tollo*ing ddlmriois: I hr!.dd q ill nri'nri. a Crn,fiut of Con\rnr h Srlaln\urr fin sorkr^ ro tf,tr\dn . rs Dn'rill.d hrhyScdion.lTl)Ool rh. lrb.r (i d. i{n rh. |xnnnran.c.ldrc kod ntrs,hi.hrhc prinir h issucd _l hovc !d will miorain wortcB corye nsltion i.su6ncc. s EquiEd by Scc'ion l?m of E kbor Codc. tor rhc pnrol1rec or thc work for which lhn lcmil is hsucd. My qortcN comFnslhfl insuEmc trtr dd l,olty nlmho ei Ernn.s L&l ccni y rh inrhctcdorron.cofrhcwoikforwhichrhispcrenirh{ucd,Ishalln.t.nployanypcsonin!n,Nnid s as ro bcmm subiccl lo lhc wo s sryctrsthn hws of &lifomi!. lnd lgre rhot ifI should hecom slblrl ro 0r worlcK' mnp.n$rion lmvisions of S.nio. l?u, of thc &bor Codc, , nEll fonhrnh d,nlrly wirh rl6e polisioE.. WARNIIIGT Failure r. scnrc wGk is' onpcnsarion covcmSc is lnhviul. lnd shull rubFcl !n cntloFr ro dimiml lEmlrics tr.d .ivil fincs up ro om hundEd ltousnd dollaE ($,00,000). in addilion ro rhc co( of onwnslion, dNmgcs !s providcd for lhr SNlion 1076 oalh. bhor Codc. i crcsr lnd lnorryt fes o,n -IStl?aLfL- swu*, D!!t A&UIQN I hcfthy annmrndrr l.fulry.f Jtrrlurt lhrr I m li.cD{d uM$ frn,v,\nr olChitlcr 9lcannrncir! \irh Sc.ri{'n 7(X{)ofl)r'\nr l of rhc lJu\in.s\ rn(lllofcsion\ (id., ind nry lnr sc i\ i'r lnllnrdr r[r.r Lic.e Numbcr: CoNSTRUCT](N I TNDIN(i A(;ENCY I hcEhy rm,rn undcr Ftrdryofprrury ln3l rhcrc is u.onsrrucrbn lcdiu !scn., rd 'h. lLrrortunc. trrh. work for $hich rhis IEnnn is nsucd (sN 1097.civ. c ). aItutaNfDl:clrlaafirN I hNb,nflnnuM.r |rn.lry ol Nrlury onc ol rhc lolhwnrS Nla,rriotr{ Dcnv'lirion Pcrnir\ Alhc\ro\ Norificarn,n I;cdrrrl Rcguhrnnr (Tirlcl0, Prn6) Rcquircd If, Icr.l Noriliclri,,r l.cni!rlftt rhclcdcfulrcgulrri,in{ rc8{dirgr\hcqo\rcnr,r lar. Nr,'|)|nicahlc nr n,ttn+d rtnrlc 'mnri,,n.d nmr.n, f{n in\p.cin, lppli.!nl or AEcnl sknnlurc:x N d lZEttF.â‚¬t/), UNDER GHOUND Waste & Vent Water-Under f loor ualtj) Gas-tlntffiloor 6tocc, r\9-v4v V,l/{v, Buildinq Sewer U Area,/Storm Drain lnterceptor/ Clarif ier Waste & Vent Water Pipinq Gas Pipino Rool Drain Tub/Shower Test Rouqh Water Heater P{rap/Drain Line Main Drain/Pool Pipino Fill Line/Back Flow Pool Heater/Gas Line Miscellaneous Gas Service Water Service Lawn Sprinkler Sanitary Sewer/Cap Back Flow Device Rough Plumbing Final Gas Test 5-:d-tY X"W,i, FINAL 5-rd -ly Notes, Remarks, Etc.fY) --t APPROVALS TOP OUT POOL/SPA Meter Release vMJ4v) L.dd\ Addrsr: - I -i MAYOR MiguelA. Pulido MAYOR PRO TEM Michele IVlartinez COUNCILMEMBERS P. David Benavides Vicente Sarmiento Jose Solorio SalTinajero Juan Villegas ACTING CITY MANAGER Gerardo Mouet CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL l\4aria D. Huizar CITY OF SANTA ANA PLANNING & BUILDING ACENCY 20 Civic Center Plaza P.O. Box 1988 . Santa Ana, California 92702 www.santa-ana.org/pba NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at'L237 -9 lnc'r h/c N, S oS-l +fli c4 nv-?o1 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 ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. l:-l l. 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 prope(y 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 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 property. @2. I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are nol hiring a licensed Contractor to assume this responsibility. k*-Z I understand as an "Owner-Buildef' 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. f""' q I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. la 5. I understand if I employ or otherwise engage any persons, otherthan California licensed Contractors, andthe 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. ("rt A. t 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 compensation of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. Fau I . 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 SANTA ANA CITY COUNCIL moulido@sa.ta ana oro Mayo. Pro Tem, Ward 2 m,marl'.e2@santa-ana oro vsamre.lo@sa.la-anaoro rsororlo@sanla-anaoro dbenavrdes@sanlaanaoro villeoas@santa ana.oro stina ero@santa anE.oro 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 ContractE". -6, U. , understand as an Owner-Builder if I sell the property for which this permit as 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 workmanship or materials. (r" g 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 lnduskial 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 contractors. â‚¬V rc.1 am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party legall address: 2a y and financially responsible for proposed construction activity at the following 3 7 5 /n<;fJ c ,+.t= gt-J1 /r ./r'./ /? C44 .'t -LaQ , l'W ll .l 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. (t, p.l 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. form notarization, or other verification acceptable to the agency is rcquired to be presented when the permit is issued to the owner nature. Signature of Property Owner Print name of Owner caZt ?â‚¬ r,C.z' 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 llle 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 ALrhorized 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, or other verification acceptable to the agency is required to be presenled when the permit is issued to verify the property owner's signature. P..l],,:]:i.r-i.'l-lr\i:',-.r.:|i.'..']i)r:r',.:....),]...\,|. SANTA ANA CITY COUNCIL moul do@santa-ana oro Mayor Pro Tem. Ward 2 mrmart'nezaAsanta-ana ora Vicenle Samienro vsam enlo@santa-ana oro i!9Er!9@$!E:4a 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' com pensation 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. /Vote.' A copv of the propertv owner's driver's license. Phone Number of Authorized Agent: P Davrd Benavides Juan Vllegas Sallinajero Ward 4 Ward 5 Ward 6 dbenavrdes@sBntaâ‚¬naoro ivilleoas@santa-ana.oro sti.alero@sanlaâ‚¬nao.o