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Home My WebLink About20163643 - Permit (2)ft2 City of Santa Ana Permit Counter: (714) 647-5800 20 Civic Center Plaza (M-19), Santa Ana, CA92702 lnspection Requests: (7 1 41 667 -2738 lnspector Section: (714) 647-5853 Electrical Permit #: 2O163643 Pin #: EGE76 . Project Address: 2521 W Sunflower Ave Assessor'sParcel: 412-381-01 Lot: 1 Unit: N-5 Block: NA Btdg: Tract: 9980 Address Ranger 2501-2521 Hisloric: No Suite Range: Zoning: Rl q Owner: Address Contraclor Address. Shahla S. Fathy 2042'l Mooncresl Cir Huntington Beach, CA 92646 (714) 878-06s4 Asim Ahmed Owner-Builder Amount 23.87 21 .25 52.98 Fee $23.87 $21 .25 $52.98 Qty 1 .00 1.00 1 .00Phone Tenant Name State Lic #: Lic Type: Bus. Lic #: Workers' Compensalion lnsurance: Carrier: Policy #: Expires: Building Use: Job Type: Nalure of Work Condominium Miscellaneous A/C & Furnace R-2 VB cEc 2016 Occupancy: Constr Type Code:Notes: Direct change out. Planning Conditions: A/C on rooftop Planning Approval By: Plan Checked By: Permit lssued By: Subject to Field: Building Permit #: Every permil issued sha become invalid unless the wo* on the sito authonzed by such pemit is commenced within 180 days afret ils issuance, or it tho wo* authonzed on the sile by such pemit is suspended or abandoned lor a peiod o1180 days aftet the lime lhe wo is commenced 071'1012017 Account# Date: Dale: Dale: Misc. Receiptl Misc. Receipt: Misc. Receipt: Total lnspector MtD#. 2017-137312 01 116002 s1600 01 116002 51603 $21 .2s $76.85 Fee Tolal: Paid to Date: Balance Due $98.10 $0.00 $98.10 Foe Typs 01'r 16002 51603 FWU 011'16002 51600 General Plan Update 011'16002 51603 lssuance Phone tr'&\@- ELECTRICAL.INSPECTOR RECORD APPROVALS DATE ID/SIG.COMMENTS Site-Work Underground Pole Bases Light Standards Spas, Pool, Fountains Signs (monument) Life Salety /Low Voltaqe Fire Alarm / Dampers Communications Cable Buildinq Under Slab / Floor Bonding / Groundino / UFER Transformers Torqueino Sub-Panels Air Conditioners Rool Top Equipment Factory Wired Unit Walls (Conduit) Walls (Rough) Ceilings (Hard & Soflit Rouoh Ceilings (T-Bar RouOh) Rough Service lvleter I FINAL |-r-l /Y \411 Notes, Remarks, Etc. owN!f, otJll,rlEn DELCAnAIloN I lEEby rfrnn uBlcr lrMxy i,f F lr,t rhd I ln .r.n9r rn,r rh. G'd tu(a Li.drr u* t" rtr r,'ll'ri"F ru! tr' l S.. 70l l 5 Burims< r.d Prrfcr.Nh (lihr ny ( iry o. 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"'yrtrt|xrwtrrtrrn I0n r !)0(t,hc.un.\uhrcrt,rhwuk.'\(ntrtrtr!k[ln*rur(rlir,nir.nrilrBrc.rh rlI \lr{rhl lk,trrr {n,r\r r,rh. wnrlc(dnntrr{[i t,rnvntr]tr\dlSrdirrrlT(rr.lrlf,l.hr(ixlc.l\lrll.hrlrsirhdnt'lytrirl,rlr,{.tr,!ni,r'\ .ivil lin.\ up k, o'r hrrl(l rl'. !'trrl dolh^ ((xr.o(xrr. trr rrllirirnr ri rlf, fon '1x0x$. x\ t,,olklLrl Iq th. E1t.-t'?- t0 - t1 &"A-b 5 u(.L)llj!lMl-B[rali t2t !L\B_rlt!^ I h.r.h) allnr uRt.r p.mlr! rl F,[]'\ I tu lcrro!i!b.ofchqndt)krtrn rnstr(hSetir l(rrl)orl)iyisbnl o, rlE BuiiEs r,n &or*!inr (i\lc, rn my li..nr n h lull nne !d .fiN sl!$alrcraNrENDtll.Acli!1jr I h.rh, sm.m trnLr lEtrrlryolFru,y rh r rh.'c t r $nnturir L'rint oB6xy f r rlr F!nnr!trkr ol rlf, s'rl li, \l'il,rnnFEil is t\kd (Scc :1197. (ir C I LPfl,lr Nlll;rl.ltf,allad l ,Etl'y 00inn urrtr Etrrlry ur p.rjurynE orrtf, ri'll'unr8 iNluhrinr Dc niion Pcijnilr-Ast {o. Norili.drr lrtrulRreuhrirnc r'lirlc rl). P.n6r -R.quircd trtr.rnl N{ilt iln , n! nnr'nlt r hrll(''ry rl(.!nry rr rhtr ( {r rnt (-'rr.rIn, Nid upor dE b.t ?-lc'11 -l drly rh.I rhg lcncrlE3uhrnN EtdJnB Nhrft\,cnrtrrlac 'i* q.|'lixht x, rhn n, -,-Ln,,f *, 'n".*rrrh,n!d {.,crhd,h.rh\c 'nro,'m,ih nn,mr rl.m * Nc,\Sl.l.-. Fbl'ltl h r!rlltl! ntn{nrJn( 4l tmhr.dtnrit nFdlhrs, rrFw m bnllrn'Fny rd m$dm nurr$;'ffi;;" '"?lia'c- I trq/F.milc n{g!p.l' / Meter Release Crh.: MAYOR Miguel A. Pulido MAYOR PRO TEM Michele Marlinez COUNCILIT.lEMBERS P. David Benavides Vicente Sarmiento Jose Solorio Sa Tinalero Juan Viliegas ACTING CITY I\,,IANAGEB Gerardo Mouel CITY ATTORNEY Sonia R. Carvalho ' CLERK OF THE COUNCIL Maria D. Huizar I a sunaiero@enta-a.a.oro CITY OF SANTA ANA PLANNINC & BUILDINC ACENCY 20 Civtc Center PIaza P.O. Box 1988 . Santa Ana, Calrfornra 92702 \{ww.santa-ana.or9 pba NOTICE TO PROPERTY OWNEB Dear Property Owner An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specif ied at A// We are providing you with an Owner-Bullder 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 OwnerBuilder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form lo us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval ol the permitting authority. OWNEB'S AC KNOWLEDGMENT AND VERIFICATION OF INFORMATON SANTA ANA CITY COUNCIL m!l'do@snta-ana oro Mayo. Pro Iem. Ward 2 mrdr3nrne2@santa-ana oro V'cenG Same.lo vsa.@onlo@sanla ana.oro lsolo.o@enla.ana ord dbenav,des@sa.raan.ord v,lle.as@sanla.araoro DIRECTIONS: Bead and initial each statement below to signify you understand or verity this lntormation. g( 1 I understand a trequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" b[ilding permit that erroneously implies that the property owner is providing his or her own labor and material personally. l, as an OwnerBuilder, may be held liable and subJect to serious financial risk lor 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 willlully acting as an Owner-Builder and am aware ol the limils ol my insurance coverage for injuries to workers on my property. \)' Z. t undersland building permits are not required to be signed by property owners untess they are responsible for lhe conslruction and are not hiring a licensed Contractor to assume this responsibility. -P-3 I understand as an "Owner-Buildef I am the responsible party of record on the permit. I understand that I may protect myself lrom potential financial risk by hiring a licensed Contractor and having the permit liled in his or her name instead of my own. 5)' +. I understand Contractors are required by law to be licensed and bonded in Callfornia and to list lheir license numbers on permits and contracts. \, 5. I understand if I employ or otherwise engage any persons, other than Calilornia licensed Contractors, and the total value ol my construction is at leasl five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and lederal law. <rz^) / 6. I understand if I am considered an "employer" under state and Federal law, I must register with the state and federal gouernment, withhold payroll laxes, provide workers' compensation disability insurance] and contribute ro unemployment compensation of each "employee." I also understand my failure to abide by these laws may subject me to serious f inancial risk. ) ) 7. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family re-sidentiat structures cannot legally build them with the intent to offer them lor sale, unless a// work is peiormed tiy licensed subcontractors and the number of slructures does not exceed lour within any calendar years, or all of the work is performed under contract with a licensed general building Contractor. h> 8. I understand as an Owner-Builder if I sell lhe property for which this permit is issued, I may be held liable for any fina9cial or personal injuries sustained by any subsequent owner(s) that result from any latent construclion delects in the wolkmanship or materials. 5) g. t understand I may obtain more inlormation regarding my obligations as an "employef'from the lnternal Revenue Service, the Uniled States Small Business Administration, the Calilornia Department of Benefit Payments, and the Calilornia Division of lndustrial Accidents. I also understand I may contact the Calilornia Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.oov for more inlormation about licensed contractors. .10. I am aware ol and consenl to an OwnerBuilder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the rollowing address (4 t t. I agree that, as the party legally and linancially responsible for this proposed construction activity, I will abide by all'applicable laws and requirements that govern Owner-Builders as well as employers. Sl lZ. 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 resull ol a complaint. Your only remedy against unlicensed Contraclors may be in civil court. lt is also important for you lo understand that if an unlicensed Contractor or employee ol 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 verilying whether or not those Contraclors are properly licensed and the status of lheir workers' compensation insurance coverage. Belore a building permit can be issued, this lorm musl be completed and signed by the property owner and returned to lhe agency responsible tor issuing the permil. ,Vole.' A copv of the propertv owner's drivet's license, torm notarization. ot other vetification acceDtable to the adencv reouired to be Dresented when the Dermit is,s issued to verifv the v owner's sionature. /-,4 a-lo-/ )Signature of Property Owner Print name of owner f tl r4lt C fr .f F47H Date r AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNEB'S BEHALF Excluding the Notice to Property Owner. lhe execulion of which I undersland is my personal responsibility, I hereby authorize the iollowing person(s) to acl as my agent(s) lo apply ior, sign. and iile lhe documents necessary to obtain an Owner-Builder Permit for rny project. Scope of Construction Proiect (or Description o, Work) Project Location or Address Name ol Authorized Agent Address of Aulhorized Agent Phone Number of Authorized Agent I declare under penalty of perjury lhat I am the property owner for the address listed above and I personally filled out lhe above inlormation and certify its accuracy. Property Owner's Signature Dale Pnnt Name ol Owner Note: A copy ot lhe owner's driver's license, form notarization, or olher verification acceptable lo the agency is required to be presenled when the permit is issued to verify the prcpedy owner's signalure. SANTA ANA CITY COUNCIL e!!.0!@r4!la;r!! qc Mayor Pro Tem. Ward 2 aman'ne2@san!a.ana.o.o Vice.te Saimenro Bme.to@snla-ana oro 6oro.ro@snr3'ana oro P. Oavd Bâ‚¬navdes !!e!ryce!@$!E:4i ^'lleoas(asd' :a a, a o'o sr -de,o6sa' la.a.a o(