HomeMy WebLinkAbout10196319 - Permitcity of Santa Ana 20 Civic Center Plaza (I/-19), Santa Ana, CA 92702 Building
Permit Counter: (714\ 647-5800 lnspection Requests: (7141667-2738 lnspector Section: \714) 647-5853
Permit #: lO{963{9
Pin #: 31184
E
Project Address: 1142 S Ross St
Assessor's Parcel 013-094-23 Lot: 47
U nit Bldg: Address Range Suite Rangel
Zoning: RlBlock. NA Tract: 648 Hrstoric: No
Building User Single Family Dwelling Occupancy: R-3, U 1st FL Area: 0 Patio:
Job Type: Reroof Constr Type: V B 2nd FL Area: 0 T.l.Area:
Nature of Work: Reroof garage/patio demo Code: cBc2016 other Areas: o yards Req,d:
Existing Bldg. &Use: Sfd w/det garage Flood Zone: x-0602320276J carage Area: Vatuation: $4,OOO.OO
Proposed Use: # of Stories: Totat: O
Description of Work: Remove unpermitted patio cover at rear of garage - leaving a 2' roof overhang. Reroof garage only - remove existing & install new
layer of torch-down. Handout given.
Planning Conditions:
Owner:
Address:
Phone.
Tenant
Ford S Loverin
1 142 S Ross St
Santa Ana, CA 927071220
(562) 712-9356
Contractor
Address:
Owner-Builder
Engineer
Address
r,.n t,:h+ r 43562 - !-,/ 1/ ttit.B
lli f ice: {:TYH Trqns+r S1rl,:,.t,+: fiel+:
I'r, p ti: r:f22:i4?!I - 3/!/Ztttg
lr.(lnsoct ion TotnI
ID: oln{]t o 1.te l
Phonel
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Phone:
License #
Phone:
License #
lnl?4J
Jrirt t'lJ
t2?", . +.j
I i)rd S L0ver inArchitect /
Desiqner:
Address:
llrr ld lns
l t t 6r-U2- Sl6ulrlrin-,i1ir)en0] ['] cln [Jprlnte Fee
[1 I 16r:[_t2- 516Lx:r[{r0.-Llds Stds RevolvinE
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd
PWA lnsp. Req'd: No
Planning lnsp. Req'd: No
Fire lnsp. Req'd:
Police lnsp. Req'd
Gomez, Pedro
sden, Julie
Date: 05/01/2018 Misc. Receipt
Date: Misc. Receipt
Date: 05/01/2018 Misc. Receipt
Subject to Field:
No
No Account#
07776002 F6p#PFJgIIE$ 1 ..,
07776002 57672 Bldg. Stds. Revo
07776002 51500 General Plan Up
07776002 51601 lssuance
. Authi: /lvrng
date $21.25
$52.98
54.26
$1.00
$1
o
Total
Landscaping lnsp. Req'd: No Flood zone Cert. Req'd: No
Every permit issued shall become invalid unless lhe work on the site authotized by
such pefinil is commenced wthin 180 days after its issuance.ot il the work authorized
on the site by such permit is suspendecl ot abandoned lor a poriod of180 days aftet
the time the wo* is commenced.
$21.25
$207.24
$1 .00
$229.49
$0.00
$229.49
lnspector \lllD#: 2018-1431O4
01116002 51600
01116002 51601
01 116002 51612
Fee Total
Paid to Date:
Balance Due
Planning Approval By:
BUILDING- INSPECTOR RECORD
COMMENTSSITE-WORK DATE ID/SIG.
Set Backs
Forms/Steel/Holdowns
UFER Ground
SLAB Floor
Subf loor/Vent/lnsu lation
dz\rt2,EVBool Sheathino t-7-th"-
Shear Wall tal'dfrT \Framinq i- ) -rp,lr
lnsulation/Enerqy
Drywall
Ext./lnt. Lath
Brown Coat
[,4 aso n ry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report
Flood Zone Certif .
-\-Ueta{vt ?r')FINAL s-t-/t-
Certificate ol Occupancy
Notes, Remarks, Etc.
()\\\liR rl ILI)th l)l:1.(,\R,\ lll)\
I h.rchy ariinn undc! pcnalr, .r,'.riury rhar I m cr.nrlr riom rh ConracroF l,i..ns tjB lor rh. ftnb*ins ra$n lscc 70ll 5
Busincss .nd Pote*ion Codc): Atry Ciry or Counry shicn rrquircs a Pcrnir ro connrud. alro. improrc d''mlGh or Epan r'v
{ructurc.pri{,roirsisr'!.cd,al\.rcqnircsrheal]nli.!r.rsuchPcnnirrofilcnriSn.dinlcnEnlrhrrheorshctlicen\ctlPusuonr
b rhc pn;viridN Dl rh. conracrois Licentd kN (Chupicr g Commercin! wilh Scclion 7(x[ of Divnion ] olthc Busnr$ and
Pn,f.;i(insCodc)orlhir hcor sh. k cxcnPt llrcrclromand rhc$0sn furhd rllc8cd cxci{'tt'n AnvviolaiionofSccrt'n70ll5$vonv
lonlictrnr rord lrcnnn suhj(hihc rpflicnnr lo a.ivilp.trdliyofno( morclhatr nvc hutrdrd doll$ (S5m)'
L as owncr of rh. poren y. or my cmployccs * irh was.\ as rhct $lc conD.n{ ioo. will do rhc qo* and rh' srtrr!rc k tur
inrcnlL{ or offcrL\t ltr sL l S( T(X,l, Uusines rni PmLssinns CRlc l'hc Conrraci{tr-\ Li.cnsc L!* docs ret a0Ply b rn 'wn'r of
rhdfmJr y !h, ttuikls M imtmts rhcmn. a *ho Jms \kh s.rk hiaNelf ur hc6clf or rhoxeh his ff hs oan cmPlorecs'
p,"ri ri r r rt,n .u"rt improkftnrs nE rn inle.dcd or oficBl lor $k Ii lkNcttr. rh. hoiltlir3 " inlpolcft h sokl *irhi" uic )crr
;lcotr{'Lrri.n. rh. own;r Buikld willhorc lh. hurdm orPmviDa thlr hc or shc did nor hill or i'nprovc rh' pmrcn] lor rh' nxqD* ol
.ll
.nd Pmfssi'n ( odc: Thc Conlrrcttr s Li.cnsc Law dmr mr nprlv lo rno$ncr olpoPcny $ho huilds or i'npnivcr
,nd *ho .nnrnEr\ror {.h nmiccli wirh rCont0dons) lic.n\.d pusuau t, rhc cntrki.ror's t-tctrs tjw)
I rcxcmrrr undcr Sccr
7,f zotr l-*r.
I,&CI.A&IIgN
I lrkhy dfllrn utrdcr p.mlryol pcrinry onc ofrhc tullowinlll(lnntrioDs:
-Iha\r.rnBill'Enai.tCcnifrarcorconsntloscltlnsurcror*ortcFc.mtcnsalion.alroided"rhvSelion]Tmorrl''L.tnr C.d.. f.r rh. Ilcrfolrl@c of lhc{ork lbrwhi.h rhc Frmil is i\suM
Ih,vclndwilldannainrortcrrco'np.ns.rionn$nrrnccdsrcquncdhvs.crion:l?u'orrhctjhorCod'lorthcFrlolfumcof
rhc work rbr *hich rhh!.rmil is nucd Myworkeu d,nlP.trsdion inslmncc.Micr lul Brli'vflumbet sc:
Cmicr:-
Ir0ln v Ntrtrfi.r:
+f(t.n iry rhrr in rh. p.,r.rnunce oI rhe wor* ror which rhi\ ncnnir is i\sucd l ihrll .nr cmplol a'v PcGo! i' anv 'unNr_i*
r. *-* *ti*im,t" *ntkcr (,np.nsarion lau. .r c.lihrnia- and nBrce rh$ ifl sh'xld irccom \rhacr lo rhc
w.rkc6' conpcnsrii.n [ovhio.\ or sc.rion ]7dl or rhc hbr cfrlc. I shall. fonhwirh c'mllv *irh rno* provi\nrn\
WARNINCT itrihrc ro *cud workc c.r.Pcnsart{ covcra8c i\ trnhwful. rnd \hrll suhlccr nn dnplov'r ro 'riniml IEn ts rnd
civil fiNs u|rooN hundtd thous,nd dolhn ($l(xr.(xx)). in addirnnr lo llrc cos or compcosario'' dam'scs ds 'nv cdnrrhc"
S.crion :1076 ol thc tihor Codc, intcrc( md .rft Y s ltes
51, lro,* ^*,iit, 0o,..1 1-oor*-
I l(FNIFDC(rNrRrl('t(tR
IEUI.AXAIIAN
lh.nhylllt[undcrn.nyoipcrjlrylhdl.mli.cn{rlund.rProvisn]nofChaPIcr9(conlmncinswilhsdlboTlxnInfDivtion:]
oi rh. Rusirc$ 0nd PhfcasionsCodc. oJd nyliccne is i', fullforcc lndeffccr'
Li..n\. ( |tr\- l.r.cn\.N! 'lf,r
tolo
CONSTRT](]TIoN LT'NDIN(; AGFN(:Y
I h.rchy xfllrn undcr llci ryofPcrjryrharrhdchacon(rucli.nLndingag.ncyforrhct'cnnrmdccofrhcsorrnrnhi'hrhisFiinirn
t{,.d rsc. 1097. CN. C )
r .tr,t.,'\ ,lJcr
AIELTCANLI]ECLABA[IIJN
I Myloim uid.r pcnall, of Frjury oR of th. roll,rwine dalrorio.\:
D.mhi.n Pcrmiis Asbc(os Nolifi.arion F.dcml RcsnEin,ns (Tillc4l)- P,r16)
-Rcq!ircd
(rtrcr olNolifrurbn
I cdiylhol lhe r.dcralrcBulorions rsddinS ashc$stcrnovalarc nor aprlic,blc l(,lhn loj'tt
&"",
Llll
xhrd ntrtrri(nrd Dn,ncny nr irsnNr i(in pnrpo{!
l>/
l|l|)li. l nr Ag.nl Signslur(
l\'rn,il( n r.rlrinl)i
+€-.0 L{r4){4,;
Eto.l Lo-.,,,o F,",zo\g
Erection Pads
!
No
i
u.J
C)
a
-{m,-o
-o
L,l
Fzzm1
-tu
zq
mv,mo
ul
-{m
io -o9ia+
t-zlo\2| (t,t'o,m
o-Yt -{
EC
lrnloICta
o
oz
Z
3m
:I
\
@frCME;
8=-rB
-: t,Q2aari a
frx_'n!-l cJ{fi-6ixmm-(f#r
qs
8Az'0-{6
G]m
oo(ooQ
28'=62
EEqHEt 14a^i
aaeT?
IEa-a'iV :- -u!grI
'=, iZxaaOfoz4s/ c)
")o
oa
z
@
t)J
N
,
J
a-
?,
).
oCL
R
(rT
to
'o
t
>rf
l0
7
bt)
V-oq$'
OY \la5t-
o
1rr
0l
r...)
it
I
+
oooo
1
\
t
fE
t\cla.^<(fJ-(D
N-
d=a-
=N
N
v)
.3
a
IA
lA
q
cr
o6
0
)
d
J
m
C
u)i oJo.o
I\,4AYOR
Miguel A. Pulido
I,IAYOR PRO TEM
Michele Martinez
COUNCILI\,4EMBERS
P. David Benavides
Vicente Sarmiento
Jose Solorio
SalTinajero
Juan Villegas
ACTING CITY MANAGER
Gerardo Mouet
CITY ATIORNEY
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 permit has been submitted in your name listing yourself as the builder of the property
improvements specified "t lr-r z s ?oss s*Ca
We are providing you with an Owner-Builder Acknowledoment 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 offjcial 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 veify this information.
{&_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. I\4y 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.
$t Z , understand building permits are not required to be signed by property owners unless they are responsible for
the construction and are not hiring a licensed Contractor to assume this responsibility.
\,ff- S tunderstand as an "Owner-Builder" Iam the responsible party of record onthe permit. I understand that I may
ptotect myself from potential financial risk by hiring a licensed Contractor and havlng the permit filed in his or her name
instead of my own.
ttL 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license
numbers on permits and contracts.
\.$I_5 I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the
t6tal 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.
.[trt O I understand if I am considered an "employer" under state and Federal law, I must register with the state and
feberal 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 flnancial risk.
},lr'l- ,
'
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
Jose So oro
moulido@sa.ta'ana oro
Mayor Pro-rem, Ward 2
m mtsnlrez@sanla ana.o.o
v celre Sarmenro
vsam enlo@sa.la-a. a ora
P David Benavides
dbeGvrdes@santa ana.oro iv eoas@sanla-a.a oro slrnarero@sanla-a.a orosolorio@sanla-ana 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 Contractor.
lA-g t understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any
frnancial or personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the
workmanship or materials.
,ljC.-S I understand I may obtain more information regarding my obligations as an "employer" from the lnternal Revenue
Service, the United States Small Business Admin:stration, 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.
*{t f O. 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:
U\-1,1 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.
l,,lL rr. , 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 financlal 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. A/ote : A coDv of the DroDertv ow ner's driver's I icense-
form notarization. or other verification acceptable to t aqencv is reouired to be Dresented when the permit is
rssued fo verifu the propefty owner's signature.
Signature of Property Owner Date -9r , / zc,rf:
Print name of Owner FCeJ S+c.u+a,*L
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 flle the documents necessary to obtain an Owner-Builder Permit for my
project
Scope of Construction Project (or escription of Work)
Project Location or Address
Name of Authorized Agen
Address of Authorized ent:
Phone Number of A orized Agent
ldeclare
informati
Property
u nder alty of perjury that I am the property owner lly filled out the above
on an rtify its accuracy
r's Signature
Print Na oi Owner:
/Vofe;copy of the owner's driver's license, form 'ta rization, or other Yerification able to the agency is required to
be sented when the permit is issued to yerify p ro pe rty ow ne r's s i g n atu re
SANTA ANA CITY COUNCIL
the address listed above and I pe
Date:
moul,do@sanla ana oro
Mayo. Pro Tem, Ward 2
mlmadr.ez@santa ana.oro vsarmie.io@sa.ta-ana oro soloro@sanra-a.a.oro rv ecasOsa.la-ana oro stha ero@sanla ana.oro