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Home My WebLink About30138263 - Permit (2)City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CAq27O2 Plumbing Permit Counter: (714) 647-5800 lnspection Requests: (7141667-2738 lnspector Seclion: (714) 647-5853 Permit #: 30{38263 Pin #: 83513 Project Address: 1317 S Everolade St Unit: Block; l,lA Bldg: Tracl: 3531 Suite Range: Zoning: Rl b? Assesso/sParcel: 107426-11 Lot: 85 Owner: Address Blas & Bertha Mota 1317 S Everglade St Santa Ana, CA 927043'117 (714) 669-9941 01116002 51602 01116002 5'1602 01116002 s1602 01116002 5't602 0r 116002 51600 01116002 51602 Foo Type Shower Sewer Alter/Repair Wtr Htr (Res up to 50 g. Alter OrainNent General Plan Update lssuance Amount z'.t.42 42.45 21.42 42.85 21.25 52.98 Qty 1.00 1.00 1.00 1.00 1.00 1 .00 Fee $21.42 $42.85 s21.42 $42.85 $21.25 $s2.98 Phone: Tonant Name: Contractor: Address: Owner-Buildor Phone Stale Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance Carrier: Poliry f : Expires: Slngla Family Dwelling Alteratlon Plumblng R-3, U VB cPc 2016 Notes: Plumblng. Oryner-Builder form on file. Planning Conditions: Planning Approval By Plan Checked 8y: Permil lssued By: Subjecl to Field: Building Permit #: Chavez, Oavety Dale Date Date 071o6t2017 Account# Misc. Receipt: Misc. Receipt: Misc. Receipt: Total Ewry pemit issued shall bocgme invalid unless the wo* gn tha site autllgtized by such pemit is cgmmenccd within 1 80 days aftet its issuance, ot il the wo* aulhofied on ltlâ‚¬ site by such pennil is suspended o( abandoned lor a pedod ol 180 days aftet lhe time the wo* is comnenced. $21.25 $181 .s2 $202.77 $0.00 s202.77 lnspector MtD#. 2017-137255 01116002 51600 01116002 51602 Fee Total: Paid to Date: Balanco Duo: Address Range: Hisloric: No Building Use: Job Type: Nature of Work: Occupancy: Constr Type: Code: PLUMBING.INSPECTOR RECORD DATE ID/SIG..COMMENTS owNtt Bulurtr DEL xaTtoir I hadrr.ffm uldc pa.Iy of Firy Lh. I 6 a.q. to6 rh. Coffi. Li@ t4 6. lb. 6lbwiB !m (sa.?oll.J &!ijB lrd Fo&3ir Co&)i ,{., Cily q Cold, vtti .Gqunq . FEi lo 6di|(t .ha. nqo(, d@lu' or qt 5, i!,.irq Fb to ir brE . .ro ,qi- rlE +plid tu rdr Fon lo fir. . ria!.d rroat $r lE or rt ir ltd.d FBr, lo tt FDviin otlE Codrtd. tid Lw (ClrFa 9, Cdra.iia Eirh SaniD 7m of Dvirb! I of6. 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Gpclion W/ttSApplicml or Ardl sktrttu..: }LS L ffi -*.7- A- n UNDER GROUND Waste & Vent ,thJ\4, Water-Under floor \' \"1 \t I Iru Lr ) Gas-Underfloor Building Sewer Area/Slorm Drain lnterceptor/ Clarifier TOP OUT Waste & Vent Water Piping Gas Piping Roof Drain Tub/Shower Test Rough Water Heater POOUSPA P-trap/Drain Line Main Drain/Pool Piping 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 Meter Release tl FINAL Notes, APPROVALS K ltlsfL !4&7 k I II I I I I I I I L//1lrf,w//y/-- J I t' ' MAYOR Miguel A. Pulido MAYOR PBO TEM Michele l\.4artine2 COUNCILMET\.'IBERS P. David Benavides Vicente Sarmiento Jose Solorio SalTinalero Juan Viliegas ACTING CITY MANAGER Gerardo Mouet CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar CITY OF SANTA ANA PLANNINC & BUILDINC ACENCY 20 Crvrc Center Plaza P.O. Box 1988 . Santa Ana. Calrfornia 92702 wwrr.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 ments s pecified at t)t,3 qC L We are providing you with an OwnerBuilder Acknowledoment and lnlormalion 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 lorm lo us at our oflicial 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 INFOBMATON DIRECTIONS: Read and initial each statement below to signify you understand or verity this information. â‚¬-(r. , understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" building permit thal 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 linancial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowneis insurance may nol provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage lor injuries to workers on my property. 8-y-" I understand building permits are not required to be signed by property owners unless they are responsibte for the construction and are nol hiring a licensed Contractor to assume this responsibility. B Hg. I understand as an "Owner-Buildei' 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. 9-1"\ o. ,understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. 6 t4 U. ,understand il I employ or otherwise engage any persons, other than California licensed Contraclors, and the total value ol my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employei' under state and federal law. 6-{'( U. f understand if I am considered an "employer" under state and Federal law, I musl 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 f inancial risk. B--Wr. I understand under California Contractors' State License Law, an Owner-Builder who builds single-f amily residential structures cannot legally build them with the intent to offer them for sale, uniess a// work is performed by SANTA ANA CITY COUNCIL m,l,do@snla.a., 0.6 Eol!!@ltqi:alirlc P Davd Bonavdes dbâ‚¬navdesiAsnla.ana.o,o slrnabro@sanla-ana oro M'ahele [ran,nez Mayor Pro Tem, Ward 2 Bronrne2@snra a.a or. licensed subcontractors and the number ol structures does not exceed lour within any calendar years, or all of the work is performed under contract with a licensed general building Contractor. B--LU I understand as an Owner-Builder if I sett the property lor which this permit is issued, I may be held liable lor any financial or personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the workmanship or materials. Bj-r. I understand I may obtain more inlormation regarding my obligations as an "employer" from the lnternal Revenue Service, the United States Small Business Administration, the Calilornia Department of Benefit Payments, and the California Division of lndustrial Accidents. I also understand I may contacl the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.oov for more information about licensed contractors. 8-1,1 '10. I am aware of and consent lo an OwnerBuilder building permit applied for in my name, and understand that I am [", ligF "i5'l Y ^gw E"J"['i# faUp*&? "VE\IH" Hn f^' "t*' 2 * q t, t o,t 6-nd 11. 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 OwnerBuilders as well as employers. O-A" I agree to notily the issuer of this form immediately of any additions, deletions, or changes lo any of the information I have provided on this Iorm. Licensed contractors are regulated by laws designed to protect the public. ll 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 ol 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 lirm is injured while working on your property, you may be held liable for damages. ll 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 lhe status ol 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 lor issuing the permit. /Vole.' A copv ol the orcoertv owner's driver's license, form notarization. or other verilication ecceDte ble to the aoencv s reouired to be senled when the Derm s issued to verily the owner's sionature. Signature of Property Own I )ts {4/oT4 Date 03-ot prinrnameor o*^",,P,8/ AS lt/ oTV AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, lhe execulion ol which lunderstand is my personal responsibility. I hereby authorize the following person(s) lo act as my agent(s) to apply lor. sign, and,ile 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 ol Authorized Agenl Phone Number of Aulhorized Agent ldeclare under penalty of perjury thal I am the property owner for the address listed above and I personally filled out the above information and certily its accuracy. Property Owner's Signature Date Print Name ol Owner Note: A copy ot the owner's driver's license,lorm nota zation, ot other verilication acceptable to the agency is required to be presented when the permit is issued to verity the propetty ownet's slgnature. SANTA ANA CITY COUNCIL nel'.io@Fnla-ana.oro Mayor P.o Tem, Wad 2 mtunnâ‚¬r@snra ana cro slono@sanla.ana.oro P Oavd Benavdâ‚¬s t!e!rsd9@raqr:a!r,sc ,, eoas@sa1ra .' a o'o sr ld'e o(asdnra a.a o'. Address ol Authonzed Agent: