HomeMy WebLinkAbout10295750 - PermitProiect Address: 2341 S Park Dr
Assessor's Parcel: 140-142-31 Lol 30
Bldgr Address Range Suite Range:
Zoning: RlBlock: NA Tract: 2458 Historic: No
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana CigZtOZ Building
Permit Counter: (714],647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 1O29575O
Pin #: 69309
Building Use: Single Family Dwelling Occupancy: R-3, U 1st FL Area: Patio:
Job Typei Alteration Constr Type: V B 2nd FL Area: T.l.Area:
Nature of Work: Window & Remove Mandoors Code: CBC 2016 other Areas: yards Req,d:
Existing Bldg. & Use: 55p e7136 g3rsgs Flood Zone: X-0602320259J Garage Area: Valuation:
Proposed Use: # of Stories: , ,o,",,
Description of Work: Legalize ('l) new window @ garage. Remove/filFin (2) interior mandoor openings in garage. NOTE: 5/8" Type x Drywall
garage side wall.,'.:,.
Planning Conditions: i r,.iri ii ii,rri,:, :.,,
$2,500.00
is req'd on
Owner:
Address
Phonel
Tenant:
Johnathan Jimenez
2341 S Park Dr
Santa Ana, CA 927073122
(714179'l-0759
Conlraclor:
Address:
Owner-Builder
Address
Architect /
Desiqner:
Address:
, 1 61-l l l,llJlr -
evoivine
il612l-ltlu-
Plon up,1flt
-:i16{r:lu0r
Phone:
License #:i,,i,fif(l 1
rr Il l6urll
ilr i ld ins
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Phone:
License #:
Planning Approval By
Plan Checked By:
Permit lssued By;
NPDES Insp. Req'd:
PWA lnsp. Req'd:
Planning lnsp. Req'd
rdo
ski Teri
077750 0 2
0777600 2
0 777600 2
017760 0 2
0777600 2
0 77760 0 2
Permit Fee
lnvestigation
Penalty
Bldg. Stds. Revolving
General Plan Update
lssuance
$ 154.26
$93.17
$234.08
$1.00
$21 .25
$52.98oFire lnsp. Req'd:
Police lnsp. Req'd il: Account#TotalNo
NoLandscaping lnsp. Req'd Flood Zone Cert Req'd: No
Every permit issued shall become invalid unless the work on lhe sile authoized by
such pomit is commenced within180 days aftet ils issuance,or if the work authonzecl
on the site by such permit is suspended or abandoned for a period of 180 days after
the time the wo* is commenced.
ItillD#: 2017-140596
011 16002 51600
011 16002 51601
0't 1 16002 516'12
Fee Total:
Paid to Date:
Balance Due
$21 .25
$534.49
$1.00
$556.74
$0.00
$556.74
q
Unit:
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expares:
Engineer:r,ti rtr?264:is1 - i/ !:,/2tl1g 1ti4
0ns(lct ion fotal $ili,t,
l,-rhrrnthnrr,li m.rn,:;
57601
57607
57607
57672
57600
51601
Date: 03/05/2018 Niisc. Receipt:
Date: lvlisc. Receipt:
Date:05/15/2018 l\.4isc.Receipt:
Subject to Field:
lnspector
BUILDING- INSPECTOR RECORD
SITE.WORK DATE ID/SIG.c OMMENTS OWNIiR IIU!I-DEI' DI'LCARATION
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Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loor/Vent/l nsulation
Rool Sheathing
Shear Wall
Framing
lnsqlation/Energy
Ext./lnt. Lath
Brown Coat
It/ason ry
Pool Fence
T-Bar
Handica Re
Deputy Final Report
Engineer Final Report
FINAL rpllll9la ia'tolPutL t25)4*r. cxJ \^-,L-
Certilicate ol Occu anc
Noles Remarks, Etc
t1
L1
l.rtrdc,'' Ad,lc*
Drywall
Flood Zone Certif.
t/* , *T
\
ACTING CITY MANAGER
Gerardo Mouet
CITY ATTORNEY
Sonia R. Carvalho
CLERK OF THE COUNCIL
Maria D. Huizar
CITY OF SANTA ANA
PLANNING & BUILDINC 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
improvements specified at
permit has submitted in your name listing yourself as the builder of the property
3'// s (-k-5 e o
We are providing you with an to make you aware of
your responsjbilities and possible risk you may incur by having thls 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_=_A_1 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. 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.
)-_L2. I understand building permits are not required to be signed by property owners unless they are responsible for
fhe construction and are not hiring a licensed Contractor to assume this responsibility.
I \ 3. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may
-prbtect myself from potential financial risk by hiring a licensed Conkactor and having the permit fited in his or her name
instead of my own.
J-t+. I understand Contractors are required by law to be licensed and bonded in California and to list their license
numbers on permits and contracts.
J-Is. 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
"employer" under state and federal law.
-\ . t O. 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' com pensation 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.
) . f z. t understand under California Contractors' State License Law, an Owner-Builder who builds single-family
residiential structures cannot legally build them with the intent to offer them for sale, unless a// work is performed by
SANTA ANA CITY COUNCIL
mourdo@sanla-ana.oro
Mayor Pro Tem. Ward 2
mrmanhezlOsanla 6na.oro EarmienrorAsanlaanaoro isolodo@sania-anaoro
P David Eenevdes
dbenavldes@sanla ana.oro uiX!9!s@Ed?=!@.9rs slinaiero@ssnla-ana oro
MAYOR
N4iguelA. Pulido
I'AYOR PRO IET,4
Michele Nlartinez
COUNCILI\4EMBERS
P. David Benavides
Vicente Sarmiento
Jose Solorio
SalTinajero
Juan Mllegas
/
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 Iicensed general building Contractor.
t I 8. 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 oipersonal injuries sustained by any subsequent owner(s) that result from any latent conslruction defects in the
workmanship or materials.
!LIg. 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. 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.
jJ10. 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:
J...,-L11 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.
\ . \12. 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 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.
returned to the agency responsible for issuing the p ermit. Nofe-' A copv of the propeftv owner's driver's license,
form notarization or other n table to the enc ,s ired to be
re,
Signature of Property Owne Date D O -/ \r-/?
Print name of Owner
AUTHORIZATION OF AGENT TO ACT ON PROPERry OWNER'S BEHALF
Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the
followirig 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
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
Nole: A copy of the owner's diver's license, form notarization, or other yerification acceptable to the agency is required to
be presented when the permit is issued lo verify the propedy owner's signature-
:i ., irra itl_.i,jAr,r,,ri:..-:ra rr!- -.i:F.-.,.irFr- :.:'i :':
SANTA ANA CITY COUNCIL
mourdorosanla ana oro
Mayor P.o Tem Ward 2
mmaninez@sanla-anaoro vsarmrento@sa.la'a.a oro so oro@sanla'a.a.oro
P Oavid Benavrdes
dbenavdes@sanla ana o.o Mlleaas@sanla-ana oro stinaierc@sanla-ana ora
Before a building permit can be issued, this form must be completed and signed by the property owner and
Address oI Authorized Agent:
Print Name of Owner:
stqn2
re