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Home My WebLink About20166675 - Permit@ City of Santa Ana Permit Counter: (714) 647-5800 20 Civac Center Plaza (M-19), Santa Ana, CA 92702 Electrical Permit #: 20{ 66675 Pin #: 6983{ l nspection Requests: (7 1 41 667 -27 38 l nspector Sectaon: (7 1 4\ 647 -5853 Project Address: 714 W Memorv Ln Unit: Block: NA Bldg: Tract: 3374 Address Range: Historic: No Suite Range: Zoning: R1 E Assessor'sParcel: 002-034-02 Lot: 20 Owner: Address Alfredo Amezecua 714 W Memory Ln. Santa Ana, CA 92705 (7141315-8774 Fee Type 01 1 '16002 51603 Re-Set Mtr 01116002 51600 General Plan Update 0'11'16002 51603 lssuance Amount 22.O8 55.04 Qty 1 .00 1 .00 1 .00 Fee $53.28 $22.08 $5s.04Phone: Tenant Name Contractor: Address: Owner-Builder hrt 0f'f /L5izttlt,rnnsir,l/ Rer'+- 8/!1/21)tricp Li: Tronsc AIf red 6ener'o State Lic #: Lic Type: Bus. Lic #: workers' Compensation lnsurance Carrier: Policy #: Expires: lp 6 (lt, iuu(r0rl ;r1.JIlIrl *r*tjlj Building Use: Job Type: Nature of Work Single Family Dwelling Swimming Pool/Spa Meter Re-set Occupancy: Constr Type Code: R-3, U VB cEc 2016 Noles: Meter re-set. Owner-Builder form on lile Planning Conditions: Planning Approval By Plan Checked By: Permit lssued By: Subject to Field: Building Permit #: Chavez, Dave -7L' 10196398 Date Date Date 08/15/20't8 Account# Every permit issued shallbecorne invalid unlessthe wod< on lhe sile authorized by such permit is commenced within 180 days aftet ils issuance, or il the wo* authotized on the site by such permil is suspended or abandoned fot a peiod of 180 days after the time the wo* is commonced. lnspector MID#: 2018-'143292 01 1 16002 51600 01116002 5'1603 $22.08 $108.32 $130.40 $0.00 9130.40 Phone: Authi: l\4isc. Receipt: lvlisc. Receipt: lvlisc. Receipt: Total Fee Total: Paid to Dale: Balance Due; ELECTRICAL-INSPECTOR RECORD APPROVALS DATE ID/SIG.COMMENTS OWNER AUILDER DEI,CARATION I hcrcby rrarn und.r p.nalry or rcrjury rhar t dr crcopr ft,nr rlE cont,.k,n Li.ctr$ ltrw ror lhc lollorinS rc.{',n (Scc.70ll.5 Businc$ md Profcssion Codc): Any Cil, or Cou.ly whih rcquncs 0 pcrmil ro con(rucl- aircr. iryrorc. &mlnh or rcn, r rn, ocrurr, prior b irs hslMcc. rl$ rcqun \ rh.,ppltd tu \uch lErhir t,liLn ii8 cd narcmm rhlr h.orfi. is liansci pu6u0nr ro lhc pmvhions ot thc Co racrnr'r Licen*d Li* (Chaprcr 9. Conmcrcins wiln S.crn,n 7(ljo oa Divixion I orrht Busnt$,trd Pan.sqt,ns C.d.) or rhdr t*orshd i(cxcnp hcrcfio mdrhchbsi\lbrrhcallcgddcrcnrrlion.AtryliollliotrolSdbn?0ll5byrny irpli..nr lor 0 Fmi suhj(r rh4 aptlic0trr to 0 civil Fnrhy of nor rcrc rh.n nvc hundrcn doll$ (S500) ll. r\ osn.r of rhc pn,Fdr", or ity cntpk,y.r\ sirh srrc\ r\ rhcn s)E co r$ \rrn,n. * ill du rtr *hlk Md th. n ndu!- r\ nor i cndcd or ufi.rcd tur \ c (Sc.70,1-1. Busirc* rnd Pn)fcs16ns Cu c Th. (in*i.tx s Lic.n{ tiw docs mr anlly lo raowrr o{ rhcl^,p.rry *ho huikls or nryotls ltENn. afrl who dNs {Eh qrrk hms.li.r hcr*llor rhmugh hn or hcr osn.nrplol&\, m)vidcd rhnr nkh inrpR,!.nrnknrc n.ri'n.'ylcd.ron'cRl lbr {lc Ir.lar*crcr, rhc huildnE or i'npnnmrcni i\ s) wirhi1oN}r,tr ofcon1l)Lri,n. rhcOsrcr Bui}ilcr eill hnk rhc budcn olprorin3 ihf,i hc or \hc dil tror buikl or inpmvc rhc pmFiy ftn rhc I,UqxN or ,{5--. "**, r,* a"*y. dmcx.lusNcl, conrhcrin! wirh licenrd conra.tuR ro $nifld rlE pmi{ (s.c. ?u4. ausimss1-?f a"ts'i,, c,'.r" iil c.1",*.,'' u"""* r"" o.!. "or.pplr ro anoqncr orpropcny sho l,uiids ". impr"vc" rhcicon. and who co.lmcn ror sudh pmjeB wnh a O E.k (g li.cn*d lunurnr ro rh. co ftcrorsLd.scljf,) I rnrc\cmnrrndcr Sdln ,",".&//tf r ( "*** OECLIEAIIIIN I hcrchy a nn undq ,En.hy ol lx ju,y om ol rhc lolk,wina dcclarurn,trs -lhavcandsillnuinrainaCâ‚¬niarareo,Cons ro Scll lnsur. f{tr workcs conEo\lrion. N p,oeided ror by s&rn l70o.rrh. Llhor Codc. lbr rhc !c omtuc ol rhc work for which rhc prmil is hsucd -l hrlc rnd sill'nri din worker'cofllpcnsdlinn insurnnce. !s requncd hySccrion 17006frhe ljb.rG)dc. f* lh. Fnirrturn.c or rh.workInrwhkhlhispcrlnnisissucn.Myu,oricrs.omlcnslrio.iNuratrcccrricr.ftlp.licynumbcruc ,.$(*n'ry m, i",r." p",ri.rtrun(c nr,hc {o* l.' whtrhthhpcnnir is nsucd.lshrll nor c,nrloy ony peson in lnymrtrncr -i,,f\ ro hccnm \ut cd h rhc *orlcn .nmFnsrriir la*s olCdirorni( lnd lsN rtar irl sh.lld lrcom.ubj.cr k, rh. s.rlc^ conrpcn\ari,r pnivi\ions ol Scdn,n.l7(xJolrhr I rhtr Co,lc.l shrll. nfihBirI conplt wirh rlr\c pn'!ni(i rs WARNINC: Irxilu'r b \cru( (orkrr\ .o'nprtr\rli{n, corrrrc hiccr trn flnpk)yor io di'nnril Nmtr\ rtrd .ivil fitrc\ up t' otr. hundftd rhot$nd dollrr\ lsllx)-(xr(). in dir .dN of.onp.nsrnrn. drrog.r rs [ovided lor rh. ::::"'." :"' ^ iilrJTi i"" "" npXerr:X\ DEIIAAAIIo! I hcrchy afirm undcr Fnallyoip.riurylhat I om liena.d undcr rrovllion ofChaplc.9 (commncins wilh Setion 7000) orDivhio.l of lhc Businc$ and Ptua.$ions Codc, rfll myli..nsc h in rullr(tr. d.fidr. IONIIIIUCUOI{!INIIINCrIIjENCI I h.Eb, dmr und$ Fmlry ot p.r.iuiy rhr rh.rc is a snnrocrion lc.ding ,gck, 16r rhc lxriormm of rh. wort for whicn tht Fmil G hsucd (Sec 3097. Cir. C.). A.TEII(3!fDECI.ABAII!}N I h.rctry lnlhn undcr Fnalr, orFrjury oft orrhc rollowing declda'iony Dcnbhbtr Pcnic-Asbcsros Noriricrrion F.ncrcl Re3llarions (Tirlc 40, Pan6) -R.quied l,rrcr of Norifi uiioo l.cnilyrhrr rhcltd$rl'c8nl ions rctedi|8 dshno(tonn)lrl c.or tpl'.rhlc ro rhn!tutc.r k,ll,,ll l,nr.ill,'"r,,rx ah^c nrc rn)nrd pn,lcnt lnr i,\pcdnn, nrr,,."n, ", n*.n, a,*nr"." X= O--r*--*'Onr,,( f rlr dh,!c irlonr(i(!r is. Ir c fi-C ?. aats^ ro conDly *irh all Ciry rnd Couf ry"':,':.':"';i,{il" Sile-Work Underground Pole Bases Light Standards Spas, Pool, Founlains Siqns (monument) Life Safety /Low Voltaqe F ire Alarm / Dampers Communications Cable Building Bonding / Groundinq / UFER Transformers Torqueing Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Rough) Ceilinqs (Hard & Soflit Rouqh Ceilin gs (T-Bar Rough) Meter Release eu6lt$ *.\.arb t '45.4N Rough Service l\/leter I I FINAL 'l p\tb .z4Z-//4b) Noles Remarks Etc.I - \ rtr-,-2. c ? 'Drl,4- .J)-v-:- Under Slab / Floor Liccnsc Clas -Li.cnsc Numbcr - Da(q Conlrr.rorl L.nde r Addrc$. - I\,4AYOR MiguelA. Pulido MAYOR PRO TEM Michele Martinez COUNCILMEMBERS P. David Benavides Vicente Sa.miento Jose Solorio Sal Tinajero Juan Villegas CITY I\4ANAGER Raul Godinez ll CITY ATTORNEY Sonia R. CaNalho CLERK OF THE COUNCIL Maria D. Huizar CITY OF SANTA ANA PLANNING & BUILDING AGENCY 20 Civic Center Plaza P.O. Box 1988 . Santa Ana, California 92702 www.santa-ana.org /pba NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at -, ,-'-- --..' //q Q. //)r,no''4 lr) -T We are providing you with an to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your names as the Owner-Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. AT,l l\ +!kt I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. l, as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. n( -l$'t- z. I understand buildinq 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. rlt #S I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may piotect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own.rl MO I understand Contractors are required by law to be licensed and bonded in California and to list their license onumbers on permits and contracts. M I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the \6{al value ol my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an M;;;;;ffi ,ffi 3:,;"*5r'H::r*i:iii::i::xri,ui#:::?::rrli'x,rr,,'J?:"'* unemployment compensation of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. 7. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family ential structures cannot legally build them with the intent to offer them for sale, unless a//work is performed by SANTA ANA CITY COUNCIL moUido@santa-ana oro Mayor Pro Tem, Ward 2 mimaninez@sa.la-ana oro vsarmiento@sanla-ana ora iso o.o@sanla-a.a oro P David Benavldes dbenavldes@sa.la-ana o.a iv eoas@sa.ta-ana ora sl.aiâ‚¬ro@sa.ra-ana oro OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON licensed subcontractors and the number of structures does not exceed four within any calendar years, or all of the work is ormed under contract with a licensed general building Contractor 8. I understand as an Owner-Builder if lsell 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 workmanship or materials. M 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 rvww.cslb.ca.oov for more information about Iicensed contractors. k o I am aware of and consent to an Owner-Builaer building permit applied for in my name, and understand that I am the party legally and finFnciglly responsible for proposed construction activity at the followingaddress: / 14 ld /T?r n a re l- f) . . .lWr't I agree that, as the party legally and financially responsible for this proposed construction activity, I wall abide by4ll applicable laws and requirements that govern Owner-Builders as well as employers. M,r. ragree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the iffirmat;onl 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 pe rmit. /Vote: A copy of the property owner's driver's license, form ired to be ted when the it is issued to veri the ow nature. Signature of Property Owner Date Print name of Owner Lu /^,. 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 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 Agent: Address of Authorized Agent; Phone Number ofAuthorized 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 lhe owner's driver's license, form notarization, ot other yerilication acceptable lo the agency is required to be presented when the permit is issued to verify the property owner's signature. P i! ii:: !..r"--ai_,,., ir:i".,,i i^i]:..i.l'.r:inrI-_. aII:1:.-. SANTA ANA CITY COUNCIL mou ao@sa.ra-ana oro M.yor P.o Tem Ward 2 h man nez@sanla a,rE.oro vsam ento1osanla-ana.o.o Eolono@santa-ana oro dbenavides@santaâ‚¬na oro vrlleoas@sanla-ana oro strnaâ‚¬rc@santa-ana oro