HomeMy WebLinkAbout10293432 - Permit9?
Assessor'sParcel: 411-062-08
Unit Bldg: Address Range: 601-603
Tract: EMMETT,S ADO #3 Historic: No
Suite Range:
Zoning: R2Block: Q
city of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA\27O2 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714).647-5853
Permit #: 1o293432
Pin #: 73049
Building Use:
Job Type:
Nature of work:
Existing Bldg. & Use
Proposed Use:
Single Family Dwelling
Alteration
Legalize window c/o
SFD wrdet Garage
R.3, U
VB
cBc 2016
x-0602320278J
Patio:
T.l.Area:
Yards Req'd:
Valuation: 92,000.00
Occupancy:
Constr Type
Code:
Flood Zone:
# of Stories:
Description of Work: Legalize window change out. (4) windows. Owner-Builder form on file
Planning Conditions: Repair any damaged trim, stucco, stc., and paint to match existing if nocessary'
O\,Yner:
Address
Phone:
Tenant
Daniel Silva Jaimes
603 E. Emmett Street
Santa Ana, CA 927073534
(949) 394-3410
Conlractor
Address:
Owner-Builder
Engineer
Address
Phone:
Slate Lic #:
Lic Type:
Bus. Lic #;
Workers' Compensalion lnsurance
Carrier;
Policy #:
Expires:
Phone:
License #
Architect /
Desioner:
Address:
Phone:
License #
Planning Approval By:
Plan Checked By:
Permil lssued By;
NPDES lnsp. Req'd: No
PWA lnsp. Req'd: No
Planning lnsp. Req'd: No
Landscaping lnsp. Req'd: No
Mar. Escarlel
Chavez, Davec2.
0777600 2
017160 0 2
07776002
077760 0 2
o7776002
0777600 2
57607
57601
57607
57672
s7600
57607
$154.26
$93.17
$234.08
$1.00
$21.25
$52.98
Permil Fee
lnvestigalion
Penalty
Bldg. Stds. Revolving
General Plan Update
lssuanceFire lnsp. Req'd:
Police lnsp. Req'd
Flood Zone Cert. Req'd: No
Ewry pennit issued shall become invalid unless the wo* on lhe site authonzed by
such pemit is connenced within 180 days after its issuance,or if lho wotu authotizod
on tho sile by such pemit is suspended ot sbandoned lor a period of 180 daysaftet
the lime the wotl< is cofirnenced
lnspector MtD#. 2017-137218
No
No Account#Total
01 1 16002 51600
01 1 16002 51601
01 116002 s1612
$21.25
$534.49
$1.00
Fee Total:
Paid to Date:
Balance Due:
$556.74
$0 00
$556.74
Project Address: 603 E Emmett St
Lol 15 & 16
1st FL Areal
2nd FL Area:
Other Areas:
Garage Area
Total:
Dalet 07lOSl2O17 Misc. Receipt:
Date: Misc. Receipt:
Date: O7tOSl2O17 Misc. Receipt:
Subject to Field:
BUILDING- INSPECTOR RECORD
SITE-WORK DATE O\f, NER BUIT,DER DEI,CARA'TION
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irud@, riFr lo (: sue.. .b. r.qun6 lh. ppltMr ld such Fnn to 6k . n8..d sldml rhn lE or shc ir licdFd puNi.n
lo lhc Foviions oflh. aontdLlr s Licdsd lr* l( h.trd 9, ('{'nm.n.ins sirh S.ciion 7(r(m oa Division I oflhr I}usin.$ ind
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rltlt.ni for a Fmd rubr(R rh. rrf lkr.! id . .ir il p.tuh) of mr tuG rha 6r r huid.J dnln ( l5m),a-
lalf I xnnrttncrorEtt. rm) cmn,n,6 wih u 686 s rh.ir "n. Nmp.n$ti.f,, will.h lh.*o*od h. snf,luc ir ml
-mdrlRt lrolTn d lnreLls( 7tq{, Bs'B ud Profdiocco<t lh(Co r*ois I tlu ljs &6nolppl} touo\Not
rh. FDFy u'ho t!&il or irlror6 dEq- !n r b &E mh *o* h'lMlatu h. lf or rhniu*h his M hd .*n mphr6.
Fovidcn rhd r$h inFoeffis m mr idodal oroffd.i for sL lf, nu6d. rlE ia'Hi'{ or nr{ro\d n $E tr iihn orc ts
ofcompkiotr rhcown6 Buildc willh.* rh. t!r&,orF(,vifl{ lnd h. orrhc did rr trildor i'nlroE thc Ir1 rEry ror rhc flqirs or
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d }hfi*.n ( od.: I hc Co.kacls's l-icor. Laq do6 nol apply lo dn os ns o t Fop.ny $ho builds or nnrrorcs rhqNn.
d sho co RlrtusuchFqds"ihrGlnk.dodr) lic6B rj N,sMr hthccont.dori t.ic4. l,s)
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rh. rort rorqhichthisFnn nisd MvtrorlG co'n .M6n i.surmc. cmid en polic) nunbd6.
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cnil find up 6.ft hu.d.n rhonend.hlla (ll$-tuO. m !.ll x,n ro rh. corl of conpcerron, rhtrus6 a rrordd for rh<
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llECLrSAIlAr
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or lh.ll$inssJ Prof6io6 (-od.. &d mr li.m{ B
'n
lull nft. a.d.Irrr
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0lirButtrotrtl,lDlrc-acl;!(Y
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$u.J(Sa 109r.(i C)
a8tu(/rtrLDl:gd8Anr)!
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lxnol'lf. Pmn}A3tEbr Nr{iri.dio. t.n r.l R.su!,, nN iTnt {0. Pfi6)
R.quncd Ldr6 of Ndi6.d$n
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@cafi ta t ta'c aarna.pf li(rrio. ar] r!r. rhll rh. ltFrqnlomd ion i3..rcd l urd ro comply sirh all C(r ind Counr'
(irtlman.6.nd Slar. l.i$s rchrinx ro b{ildi.l Elrqolarn 6 orrhis Cily and ( ounry t) s16 uB)n (h(
alx\.,k nndllnltEl\ tu ffBrlon
,\ppliotrl o. Arml Sirr.lur.:
Perm ile n.m. (prlnl ): L A t1 "-/5,(o.u
I r,'t-11
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loor/VenUl nsulation
Roof Sheathin
Shear Wall
Framing
lns u lation/Energ y
Drywall
Ext./lnt. Lath
Brown Coat
lt4ason ry
Pool Fence
T-Bar
H andicap Req
De puty Final Report
Engineer Final Report
Flood Zone Certif
FINAL 7-21- t7 J)c 5z'b(s)
Certificate of Occu pancy
Notes, Remarks Etc
+
ID/SIG. COMMENTS
*,. - ? -r5--l+
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MAYOR
iriguel A. Pulido
MAYOR PRO TEM
Michele Ma(inez
COUNCILMEMBERS
P. David Benavides
Vicente Sarmienlo
Jose Solorio
Sal Tinajero
Juan Villegas
ACTING CITY MANAGER
Gerardo Mouel
CITY ATTOBNEY
Sonia R. Carvalho
CLERK OF THE COUNCIL
Maria D. Huizar
Dear Property Owner
An application lor a building permit has been submitted in your name listing yourself as the builder ol the propert v
improvements specif ied at T .+1
We are providing you wilh an OwnerBuilder Acknowledoment and lnformation Verification Form lo make you aware of
your responsibilities and possible risk you may incur by having this permil 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 olficial 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 ACKNOWLEDGME NT AND VERIFICATION OF INFORMATON
DIRECTIONS: Read and initial each statement below to signity you understand or verify this information.
-V-c|. I 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. I,
as an Owner-Builder, may be held llable 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 nol 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.
95 z. lunderstand building 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.
L7 S. lunderstand as an "Owner-Builder" 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.
I understand Contractors are required by law to be licensed and bonded in California and to list their license
numbers on permits and contracts.
fi? S I understand if I employ or otherwise engage any persons, other than Calilornia licensed Contractors, and lhe
total value of my conslruction is at least live hundred dollars ($500), including labor and materials, I may be considered an
"employea' under state and lederal law.
LA. I understand il I am considered an "employer" under state and Federal law, I must register with the state and
federal gouernment, withhold payroll taxes, provide workers' compensation disability insurancel and contribute to
unemployment compensation of each "employee." I also understand my failure to abide by these laws may subject me to
serious financial risk-
)-
resr denti
I understand under Calirornia Contractors' State License Law, an Owner-Builder who builds singleJamily
al structures cannot legally build them with the intent to offer them for sale, unless a// work is performed by
SANTA ANA CITY COUNCIL
lBldo@san€ ana do
Mayor P.o I6m, W.rd 2
mronrnE2(asanb'ana so
V,csnte Samenlo
,sa.denro@sb ana do sobndaenla'ana.oro dbenavd*6$nra ana oro N I eoasosania.sna.oio sn.M.o@snra ana oro
CITY OF SANTA ANA
PLANNINC & BUILDINC AGENCY
20 Crvrc Center Plaza
P.O. Box I 988 . Sanra Ana. California 92 702
www.santa-ana.org pba
NOTICE TO PROPERTY OWNER
8. I understand as an OwnerBuilder if I sell the property lor which this permit is issued, I may be held liable for any
financial or personal lnjuries sustained by any subsequent owne(s) that result from any latent construction defects in the
workmanship or materials.
ACY. )9. 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 California Department of Benefit Payments, and the
California Division ol 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 contraclors.
licensed subcontractors and the number of slructures do,es not exceed four within any calendar years, or all of the work is
perf ormed under contract with a licensed generallLitdfi'g Conlractor.
e4
tfie da legally and tinanciaf,y re
10. I am aware of and consenl to an Owner-Builder building permit applied for in my name, and understand that I am
rty nsibl for pro sed constructi ivity a followingn
addresse\
-all appl
'1. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by
icable laws and requirements that govern Owner-Builders as well as employers.
ab" , agree to notity the issuer of this form immediately ol any additions, deletions, or changes lo any ol the
inf 6rmation I have provided on this form.
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. ll is also important lor
you to understand that if an unlicensed Contractor or employee ot thal individual or firm is injured while working on your
property, you may be held liable for damages. lf you obtain a permit as OwnerBuilder 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
relurned to the agency responsible lor issuing lhe permit. /Vore.' A copv of the propertv ownet's driver's license.
fom nota zation. or other rilication acceDte ble to the a ,s uired to be sented wh n lhe Dermil isoencvreo
issued lo theven
Signature of Property Owner Date 7- s- t4
Print name of owner b
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 lor, sign. and file the documenls necessary to obtain an Owner-Builder Permit for my
project.
Scope ol Construclion Projecl (or Description of Work)
Project Location or Address
Name ol Authorized Agent
Phone Number of Authorized Agent
ldeclare under penally of perjury that I am the properly 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 ol Owner
Note: A copy ol the owner's d ver's license, torm notarizalion, or othet verilication acceptable to lhe agency is required to
be presented when the permit is issued to verily the propefty owner's signature.
SANTA ANA CITY COUNCIL
aq1lil!@I3!ja:3!3.9rc
Mayor P.o Tem. Ward 2
fr mnr.er@santa-ara oro !$.!]f-c!i!.rir-erljl:n:-ail, ]l!qa]es?!B:!!
P Oavld Benaud€s
dbenav'd€s@sanla.ana oro ivr!9ce@$dr:4a-qg gErie!!@!a!E:a!r.q9
Address ol Aulhorized Agent:_
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