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Home My WebLink About20153662 - Permit (2)City of Santa Ana Permit Counter: (714) 447-580C 2C Cr/ic Cenler Plaza (r:.i9) !:an:a Ana, CA 92702 Electrical Permit #: 2O153662 Pin #: 5EO9Elnspectior Requests: (7 14\ 667 -2738 lnspectci' Se''::or: (714) 447-5853 Project Address: 3009 W Cubbon St Unil: Block: NA Bldg: Tracl: 4025 Address Range: Historic: No Suite Range: Zoning: R'lAssessor'sParcel: 109-742-08 Lot: 86 Owner: Address: Heriberto E Maria Murillo 3OO9 W CUBBON ST Santa Ana, CA 927041517 Fee Type 01116002 51603 Serv Meter 01'1 16002 51600 General Plan Update 01116002 5'1603 lssuance Amount 45.96 19.04 47 .48 Qty 1.00 1.00 't .00 Fee s45.96 $ 19.04 $47 .48Phone; Tenant Name: Contraclor Address: Owner-Builder State Lic #: Lic Type: Bus. Lic #: Workers Compâ‚¬nsation lnsuranca Carrier: Policy #: Expires: Single Family Dw6lling Miscellaneous Service Meter Occupancy: Conslr Type: Code: R.3, U VB cEc 2013 Notes: Upgrade from 100 amp service to 200 amp Planning Conditions: Planning Approval By Plan Checked By: Permit lssued By: Subject to Field: Building Permit #: Chavez, Dava Date Date Date 04/142011 Account# Misc. Receipl: Misc. Receipt: Misc. Receipt: Total Every psmit issued shall become invalid unloss tho wot* on the site authodzed by such pemit is commonced within 180 days after ils issuance, or il lhe wo* authoized on the sile by such pemil is suspended or abandoned for a peiod d 180 days afrer the time tha wofu is commenced. $ 19.04 $93./14 $1 12.48 $0.00 1112.4A lnspector 01't 16002 51600 01116002 51603 Fee Total: Paid to Date: Balance Due: Phone: Building Use: Job Type: Nalure of Work: MID#: 2014-1 '13671 ELECTRICAL.INSPECTOR RECORD Ogc-Build. D..l.,.iio. I !.6, .fi6 udr Frh, of Fiury rlu! 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FDFi, wno hil.L d inFoE 0E6c .id eto dd..n w!, hjm!.lf d lE'.lf d rl're8n hi q hq @n dploy..r !@i.t d U.r scl inprMdallt e nor i .i.L.l or ofs.d br oL 14 howq, rhc hildint or inP..Eh.Dl i! rolt witin oe yd of @m!tabi. dE Ow-Build6 qll t E tll hrh. of F@il{.t r lx d rlr d hild q iDprcâ‚¬ &. lh. n Do* of d.) &ogMof 0E p6Frr, u*luivdy @rnâ‚¬in8vth li.6r.d @f.aoEb 6rrd rFoid(Sc 70a4, BlrG!.rd Cod. Tt Cdlnad'! Li$ L,r.loâ‚¬ B.ptl, to aolâ‚¬of FlFry *to boit.tr d ioElBrnas,.!d rtb @ma. fq ocl pbjdr wnn. Contr..rq{r) ticdEd purunr io ll! Conrmolr Lic..r t * ) _l6.rE F r!& Sci, -B M. 6. dA E s ^,. lLt:l:14 IPORXf, RS c('M?ENSATTON Df, CI,ARATION I hdll,y .!Em uids ps'.hy of Fju.y @ of rh. fdLuiry dcl[xiD rnd will mndu . C.ni6c& ofc@ b S.|fi.$a fo, srl6' cmp.ut,o'\ .r p.ovnhl lor by SdDn 1?OO of th. Cod., td t!. prfol M of.lr wt 6. *lich rt Fdr ir iu!., _lhe..ilwilltui ri. wto dnr.uri6 i llle, u .!q!ir!d b, S..tioi 37OO of dE t bd Codq fo.l,l. 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Cod., idr... .!n &drr! fd LICENSED COIYTT .:IIOTS OECLAN TIOI{ I lE.dy.fir unds p.r.t, of Fisy 6.1 t 6li@t .l uldr Fwidh of Ch.r.6 9 (olrleein8 *irt Seid ?Ooo) of Didrio, ofll. a!i'i6. ul PDt .bd cod., &.1 o, lic.e it ii tutt f.re uit .tr c consTnucTroN Lz,{lrmc actr{c1 I hd.by .rnm unds Fnrlty ol pGro,y d.r 116. it . .olm.uctid t.ndiis .S.rEy tu lh. F.fottu@ of lh. rcrt f6r which Oi! !ffiir i.i.a.d (Sc ,09?. Civ C ) APPLIC ^'?S DECT,AE IION DoEhio. radu-Arbclo lrhinoil F.dr.l lraul.rid (rnt {O, Pd 6) _R q!i!.1t n6 ofNdifidiod I â‚¬it da dE todarl .q IiE r.S.dtrU .tb.ror t!fuv.l e 'tor .Dotic.bt. lo d$ D.oi.r ry rh{ I h.v. Ern tnil &plic.rion Md rrc rh.t rt. .bow inaorn.rion r cor.c I tgrc ro @pty wnh dt Cny .nt Cou y ud SlI. L,E rdxi,{ ro hililaaa .d hrlryutdn,t'rs.'r dcof dirC'iyrnCorlyro.d6tPonrll6oc .m6..d FlFty ft, 'trtt cii +y14- APPROVALS DATE ID/SIG.COMMENTS Site-Work Pole Bases Light Standards Spas, Pool, Fountains Signs (monument) Life Safety /Low Voltage Fire Alarm / Dampers Communications Cable Building Under Slab / Floor Bonding / Grounding / UFER Transformers Torquing Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unil Walls (Conduit) Walls (Rough) Ceilings (Hard & Soffit Rough Ceilings (T-Bar Rough) Meter Release Rough Service Meter FINAL Notes, Remarks, Etc -l Redd <,oc 03 31 06 /.rq-/l I Underground I I MAYOR MiguelA. Pulido MAYOR PRO TEM SalTinajero COUNCILMEMBERS Angelica Amezcua P. David Benavides Michele Martinez Roman Reyna Vincent F. Sarmiento CITY OF SANTA ANA PLANNINC & BUILDINC ACENCY 20 Crvrc Center Plaza P.O. Box I 988 . santa Ana, Califo.nta 92702 www.santa-ana.org / pba NOTICE TO 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 1 /o,l k. r ,^ lL; ^ CITY MANAGER David Cavazos CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Mana D Hurzar 9).9n)n /tu^ (o. qLlJq 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 rssued 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 INFORMATON DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. uildi s I understand a frequent practice of unlicensed persons is to have the property owner obtain an 'Owner-Builder" 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. l/2, I understand burlding permits are not required to be signed by property owners unless they are responsibte for ''the construction and are not hiring a licensed Contractor to assume this responsibility.,, //21t. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may/ 'protdct myself from polential flnancial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. 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 H 5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the tota 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. //&u I understand rf I am considered an "employer" under state and Federal law, I must register with the state anda 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. resident I understand under California Contractors State License Law, an Owner-Builder who builds single-famlly ial 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. Dear Property Owner //4L, I understand as an owner-Builder if I sell the property for which this permit is issued, I may be hetd liabte for any / / finahcial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. ervice, I understand I may obtain more information regarding my obligations as an "employer" from the lnternal Revenue 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.qov for more information about licensed contractors 0. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am he arty legally and financially responsible for proposed construction activit y at the following addrcss:7ooq i^.C^hA,- 91. <.^t.?27 ,4 //Z', I agree that, as the party legally and financially responsible for this proposed construction activity, twiu abide by' all applicable laws and requrrements that govern Owner-Builders as well as employers. H4t, 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. Llcensed 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 af 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. ,Voter form notarization, or other verification accep table to the agency is required to be Dresented when the permit is issued to verifu the ertv owner's sionature Signature of Property Print name of Owner Owner Date 4-tq-L AUTHORIZ.ATION OF AGENT TO ACT ON PROPERW OWNER'S BEHALF Excluding the Notice to Property O\,vner, 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 of Authorized Agent I declare under penalty of periury 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 vedfication acceplable to the agency is required to be presented when the Wrmit is issued to verify the propefty owner's signalure. PLink:WP51/Counter Activrty/Assembly Bills/Notrce to Property Form 03-i3-2014 SANTA ANA CITY COUNCIL Mevry A!-16 W3.4 6 ST'.asolasanlz a6a m A^q6r,o &e/o,a , P O6\.n Baaudâ‚¬s iwiftl , wdil Ar@oaAsara'rE m i pâ‚¬sBhdâ‚¬.6sl3{rE m i RRe!.aAsa^ra a.a c.. l A coDv of the DroDeftv owner's driver's license,