HomeMy WebLinkAbout10294188 - Permit9?
Project Address: 105 S Birch St
Assessor's Parcel 398-276-02 Lot: POR 4
Unit Bldg: Address Range:
Tract: HENINGER'S RESUB
Suite Range:
Zoning: SO40Block: 3 Hisloric: No
City of Santa Ana 20 civic center Plaza (M-19), Santa Ana, cA 92702 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714J.667-2738 lnspector Section: (714) 647-5853
Permit #: 1o294188
Pin #: 91731
Building Use: Single Family Dwelling Occupancy: R-3, U 1st FL Area:
Job Type: Alter Materials/Methods Constr Type: V B 2nd FL Area:
Nature of Work: Legalize window Code: CBC 2016 Other Areas:
Existing Bldg. & Use: SFO wdet carage Flood Zone: x-0602320276J Garage Area
Proposed Use: # of Stories:
Totat:
Description of Work: Legalizo window change out at Garage and remove unpermitted olectrical inside Garage.
Patio:
T.l.Area:
Yards Req'd
Valuation:$1,000.00
tlli ,-t
Planning Conditions: Wood window, wood trim ll Tron
Owner:
Address:
M & R MATTINGLEY
1OO2 N ROSS ST
Santa Ana, CA 927013315
Owner-Builder
Engineer
Address
Phone:
Tenant
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policy #:
Expires:
Architect /
Desiqner:
Address:
Phone:
License #
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp. Req'd:
Planning lnsp. Req'd:
Landscaping lnsp. Req'd
Soto, Ricardo Date: 09/18/2017
Date:
Date: 09/18/20'17
Subject to Field:
Misc. Receipt
Misc. Receipt
Misc. ReceiptChavez. Dave 4?/
0 77 7600 2
0 77 7600 2
0 77 7600 2
0 77 7600 2
0 77 76002
0 77 7600 2
$154.26
$93 17
$234.08
$1.00
$21.2s
$52.98
57607
57607
57607
57672
57600
57607
Permit Fee
lnvestigation
Penalty
Bldg. Stds. Revolving
General Plan Updale
lssuance
No
No
Yes
No
Fire lnsp. Req'd:
Police lnsp. Req'd
Flood Zone Cert. Req'd: No
U Account#Total
01 1 16002 51600
011 16002 51601
011 16002 51612
$534.49
$1.00Every pemil issued shall bocone invalicl unless the wotk on tho site aulhoized by
such peinil is commencod within 1E0 deys aftet ils issuance,ot il the work authorized
on the site by such pemil is suspendod or abandoned tor a penod of 180 days aftet
the line the wod is comfiehced.
lnspector MtD# 2017-137834
Fee Total:
Paid to Date.
Balance Due
$556 74
$0.00
$556.74
Contractor
Address:
Phonel
License #
.i
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS orxN ER B! ,Dr:X DE|_(-A i T|ON
I hd.b .mrm undd td,h, o f Fjnry lhd I m .r@rrr rrom lh. Codrdo6 Lkd. h$ lor rh. followtrU r.Mn ( S( 701 1 s
lrusin6! 3*l Prcfdi.n Cod.)r ,{ny ( iry or County *fiich r.qoir6 r tEftir lo conntud. th6. imp.ov€. &ioli5h or rqsn ey
srruduq Fior to irJ Ls!e(.. lbo r.qut6 rlE qplicd for $.h Emi nr frk a lBn d xdmr rhd h. or !h. ! li.4rd lntusr
ro rh. Fn!6bB ol r ('.nt*rc-s Licdrn L.s (chrF6 e, coMftr.3 *nh Sdrn 7000 of Dnsi,n I orrh. Bu!6t rnd
Pr!f*on! Cod.)or lhr lE s rE is c!mp( ll'q.&om ud tn b6t [or th..lks.d doFn An, \iohnnofsdb.70ll ! ht tn,
,pphc!.r ior ! rrn subJdr3rh. rFpli.lnl ro rcivilpmhyofnor mor.rhd fivc hu.drcd &rlld (St00 )
'l..rn{ffinfrhcrmrEd}.orm}mnlo6trnhs.*6srnnsko'rp.Gdion."ill&,llE$qtsdllt!t(r@ud
iddrli soll6.d ror qL (s( 7ol.l- BuriB r(l PnlBnB Cod. Ili(tirdor!Ik.@lr$&dmrq'PlvroMo*n(of
rh. FFt {h.h)ikld sgorBiE6r rn uho.l(Esh tr! hi'Mlf lEElro. tlmu*fi fin or llF o*n mpkr!€.
Fo\ ikn rh.r .ud mrmrgtds e r{ ddxrrj M orrtd n{ d. ll hr$6r. ltE hildnrr c ,irmrffi ir $tl untu oE \w
ofconl9klx'n. rhc Osrd lru'ld.r will h.v. rh. hrtor ofForr.s lhd h. or s\c d'd mr hrild o qi.\. th! FnFry adr $. Frrnk.f
l.6.sG of rh. F Frr, aacldnrltcoddins *nh lkaB.d contrlc'o Ndtud llr FoF lsc 7orr. &!i,6
nd hlksCod. 11. (tnrr*roir l. icorc l,s &6 mr qplt ro uo$nd otFoFt! trho builds or im ovdrhdtun,
mn *ho .odr&l' ror uch Foj.rti Nirh. cont donr kdsal plllI@ o rh. Codrdoar l-i.(e k{ )
I tunflanF undd sdrnin
,,,.. ?\,1 \r ,,",_ \{_ )-- 'ruiursEsEhsr:rc1Dt(lJ.8arq!
I hd.t, ifinn und6 to.hr.alrjuryon.oirlr f0l16*inr d(ld.rioB:
I h!\. rt *ill mrr.'. . (-difk.r. of (\Mr ro s.lf- IBUr. lor $116' smFMi1., B Folid.d for br S.clhn 1700 of rh.
ti&r (irl. lor rh. Frffi. of {lt ur* lor *trh rl! Fn a su.d
F I hn!. MJ q ill miinr.i. so,t6 conFm.lhr iNU6n... f,r r.q!n.d h, Sd'on I7OO of lt. hbor Cod.. aor rrE p6aome. of
lhc work fttr whrch thb p6nir i3 irscd M, worl6 comFroltion i6umc..end dd policy "!dbd es
lc.nifvrhlr inrhcp.rfodorccofrh.*ort lir *hicfi rhi!Frnil is irrucn.l shrll nnr ontloli., F$n in.nr mmnd
$ arotBom.sut <rbrh.*oltd comrf,Mio. htr! of( .lifomi.. Md +ft rhd if I3h.old tE omc3ub6t toIh.
\ odda ..qml{n F,v6i.B of sd$n l Tm oath. l,hor (iJd . I lrsll. f.dhe nh omplt u trh rhov For Noc
wlnllN(; r.ib. ro suc trlrt6 FmrEMhn m\d8. ir unbtrtul.,n 3hall suhFl d o,9hlE k, min i FEriF.nd
cnil fin6 uD ro orc hlndr.ij rhoued dollB ttloo.(x)i,). r ldd'rion ro rh..oq ofmnrFsrnn. d!h+6 B Fo\ d.d ntr rh.
sdtun 1076 of rhc uhy (id.. inr66l dd .trodEyi fc
t(rx 1/ )a>--UTEIiELCONIaa(fOA I
DE4.IJ8AIIA!
I H'1 .mm undcr,qrlly or pqju J- lnd I n lica!.d und6 rml ision oa ( firpls 9 (enmcnB s irh s?db. 7()()0) of Dn irn\n ]
.f th.8$incud Phfalion3 Cod., 'l mr licN i! in ttrllfor..dd.ficr
calilf,ucrlo!-LElDttrclcErqr
I hd*t fm ud.r Frtt of Fl!4 thr rlE. i . NEMh. L.di.g .stry ev th. Ff(ffiG ortk s{ri f.r trtth lhir Ff,i 6
isu.d isa. 1097. cn c)
AIIII(AIiLDI]CIJa6IAN
I hddr arnn undd ,.n!lr' ol rc.juD_ onc ol rhr {ollon nr tLrldir ionr
Don.lirion ldn:irl^stEr's NDrilicdion lialdal R.xularionrlrnl.40, P.n6)
R.\r tr.n Ldr6.ltJdi6cdio.
I (6! rt rhn th. fRi.r.l ESuhio6 FtrrdlnE abcbr rEno\ .l e mi ,mlkibL ro ths F.ld
!1lh.rity rhar I n 'c E rhn lpph.alion erj r!r. rhil rhc.hrv. infomdnrn i! coftcr lryrE16conply$,rhrll('ityrnd ( odnrr-
ddt.nc6 od Sr.r. L,q! rchri.u ro b'ldins .oGtru(ion. dd hRby sulhorn! qrdardivd .l rhi! Cny !d (ooni, lo 6ra u,[n rn(
abr. ,ffiti,.al p.op.d\ I Gttt1ion tuFB
^pplt.nr
or
^16r
shirrnru X
Y-
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Roof Sheathinq
Shear Wall
Framing
lnsulation/Energy
Drywall
Ext./lnt. Lath
Masonry
Pool Fence
T-Bar
Handicap Req.
Qgputy Final Report
Engineer Final Report
Flood Zone Certif
,1
FINAL
Certificate of Occu pancy
-,
I
ISubf loor/VenUl nsulation
Brown Coat
I
Notes, Remarks, Etc.
MAYOR
MiguelA. Pulido
MAYOR PRO TEM
Michele Martinez
COUNCILMEMBERS
P. David Benavides
Vicente Sarmiento
Jose Solorio
SalTinajero
Juan Villegas
INTERIM CITY MANAGER
Cynthia J. Kurtz
CITY ATTORNEY
Sonia R. Carvalho
CLERK OF THE COUNCIL
Maria D. Huizar
CITY OF SANTA ANA
PI.ANNING & BUILDING AGENCY
20 Civic Center Plaza
P.O. Box I988 . Santa Ana. Calrfornra 92702
www-5anta ana.orq.i 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
7 ,,t \ 5 6,rcL sr t*^l A^" (c {z )ol
We are providing you with an Qgqgqfuilgpfq@owledqment 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 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 ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON
DIRECTIONS: Read and initial each statement below to signify you understand or verify this information.
"i* 1. I understand a frequent practice of unlicensed persons is to havethe property owner obtain an "Owner-Buildea 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 Ilnancial risk for any injuries sustained by an unlicensed person and his or her
employees while working on my property. N.4y homeowner's insurance may not provide coverage for those injuries. lamwillfully acting
as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property.
117.'- 2. I understand building permits are not required to be signed by property owners unlesstheyare responsible for the
construction and are not hiring a licensed Contractor to assume this responsibility.
/j:!_3. I understand 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.
L4 I understand Contractors are required by law to be licensed and bonded in Califomia and to list their license numbers on
permits and contracts.
/:l_5. I understand if I employ or otheMise engage any persons, other than California licensed Contractors, and the total value of
my construction is at least flve hundred dollars ($500), including labor and materials, I may be considered an "employer' under state
and federal law.
^l- 6. I understand if lamconsidered an'employer" understateand Federal law, I must register with the state and federal
government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment
compensation ofeach "employee." I also understand my failure to abide by these laws may subject me to serious flnancial risk
t\ 1' 7.1understandunderCaliforniaContractors'StateLicenseLaw,anOwner-Builderwhobuildssingle-familyresidential
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.
f1.l:_8. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any financial or
personal injuries sustained by any subsequent owner(s)that result from any latent construction defects in the workmanship or
materials.
SANTA ANA CITY COUNCIL
mouldoAsanla-ana do
Mayor Pro Tem, Ward 2
m'man n.rOsa.ia-ana @o
v cenle samienlo
\6afr re.roassnrr-ana oro Edse@i!!la:a!!-ss dbenav,desosa.re.a^a oro !M eoasrosanIa-a.a oro sr naerooss^ra-ana oro
r!\''^ 9. I undersland I may obtain more information regarding my obligations as an "employer" from the lnternal Revenue Service, the
United States Small Business Administration, the Califomia Department of Benellt Payments, and the Califomia Division of lndustrial
Accidents. Ialso understand Imay contact the Calilornia Contractors State License Board (CSLB)at 1-800-321-CSLB (2752) or
www.cslb.ca.oov for more information about licensed contractors.
,\i* 10.l am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party
legally and financially resronsible for propgsed
address: f i, i \ L, rL \^ \, ) r,.--
con
G
slruction activitv at the followind^^. (; 9Lzt I
I
l' ).- 1'1. 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 Owner-Builders as well as employers.
+rl'12.Iagreetonotifytheissuerofthisformimmediatelyofanyadditions,deletions,orchangesloanyoftheinformationIhave
provided on this form.
Licensed contractors are regulated by laws designed to protect the public. lfyou contract with someone who does nothave a license,
the Contraclors' State License Board may be unable to assist you with any linancial loss you may sustain as a result of a com plaint.
Youronly remedy against unlicensed Contractors may be in civil courl. lt isalso important for you to understand that if an unlicensed
Contraclor or employee ofthat individual or firm is injured while working on your property. you may be held liable for damag es. lfyou
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.mit.Note: A copv of the propedy 9y4er's driverb license, form notarization, or other
verificalion acceDtable to the aoencv is reouired to be orese when the permit is issued to verifu the oroDertv owner's
sionature.
I ltrlrSignature of Property Owner Date
Print name of owner ,!l I tlTJ l),,,r4r;h,r1ta
:1
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 for, sign, and flle the documents necessary to obtain an Owner-Builder Permit for my
prolect.
Project Location or Address
Name of Authorized Agent
Address of Authorized Agent
Phone Number of Authorized Agent:
I declare under penalty of perjury that I am the property owner for the address listed above and I personally fllled out the above
information and certity its accuracy
Properly Owner's Signature Date: (Ir,lt I
Print Nameof Owner' ,",\ r(.-.i "l nrlt\,,',(t
Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is required to
be presented when the permit is issued to verify the property owner's signature,
SANTA ANA CITY COUNClL
mou do@sanla-an3.qo
l,layo. Pro Tem, Wad 2
m marllne2@santa'ana oro E9&!9@sE!h:@r.!a
P Oavid Benavldes
dbenaMdes@sa.ta-.na o.o iylleoas@ssnlts-ana oro sl'naE.olAsaota'en. orolsarm e.toaAsanta a.a oro
ScopeofconstructionProJect(orDeScriptionofWork);
2r$l--L
.-
)
ryN{\
lr
)o
{AtsA5
z\
)0,\2a0o L.J*6Pn$E
5(!
IUao(/
)oz5F=-o])a:t
zFIxIJI
otU_(
r
lotUEozzuJ
u.
/
(r
N\SG,
zFItrdo€(nz
FoFoJstr!FJ{x Fdl!F&oi!xt1
,oI
JotrtItr!Fz.]
zoozo()coIoJ!ot!oU'
:UJtoFF
L
U)oaAJ
tJ(rFf,
rr
.
u.olLu)z5o.z'
.
tl
J
:)
F.
l!ft
..
t
r\s€,:
UJzoz
xI+scLUJz
oUJuqzoFoUJo.
(r
t=o7zz5o-
lJFo
d)oUJEtlub7dF N
{.UF-{oili
€i
ct
ra
l
\L
c).a
"/s/
o-o
).
.
\10
l-
\
.M,ss\
i
I
Itt!FU)
I
o9w9>:
/-
t
o
YoF;
<5
o.
roA37z
$r54)
\t
aY
('
^
AJ
d1
IV
a
Z4
,)crg"€
5r] rj ur '
3b
v! o" ?
2
D-9
IE.9ocoq,3o(Lpo.N(!ocoo)
(!Ec)oo6'c3
-o
rC)o-oo-osocc
.g
)
.
9
U,
6
tr
d
-(
,
5a
o)
!
o<
<B
q)o2
,dC/t
,Se.:'t\tJt!zFzE.
(L
r
-.
:
Yd)
LUFoUJdfFzoa
o!
-c
q)
-=
aJ
C:
0
)
o)
<
0
)
o.
9
O
o
.l
g
>,
-
c
B
!-
o
(!
:
c
9E
>.
6
h=
.-
0)
-
6
[L
-
5
or
L>
;
uJ
=-
gE
i
t3
F
!'
;
(6
PE
q,
c
()
.
=
3
q.
e
>.
o
(D
QE
3
oO
(E
rl
.
b-
c
P.
e
6i
.
e
-
(I
)
;
BE
d
-
o.
q
I
or
=
I
d'
c
.
EollILozo=ozFadUJozl>
=Il
Jt[!
'z
(
o
6>
r
-
3
-<
!
x
F-
6
(
.
)
q
2>
?
<;
g
>
>'
5
9
=
t
s
U
P
u
hE
F
P
E
s
l
3
E=
B
f
t
i
?
6
6
Jt
*
X
E
5
i
E
=i
:
x
H
f
H
P
r
t6
=
=
a
9
>
>
T
9a
3
=
"
'
9
H
6
5
lI
l
i
!
tl
JOz
='
H
=
-E
;
*
oo
t
r
i9
z
ZZ
U
uj
*
l
ul
l
t
n
>
--
??
H
A
P=
Z
zF
f
=
l_
S
i
{
O
--
.
r
ii
r
zL
t
dE
g
E
t-
,
g
t
)a
a
i
\
>
q
9
?
,
B3
=
"
'
e
E
;
E
=
zz
l
y
t
t
>3
.
)
LU
C
|
(
J
=
<
<
t
l
l
u
J
r
r
j
oN
o
(
/
)
>
r
L
o
z
(
,
oIJ
JoUJ1l
lzthJodo-o-
l!oIJ
Jo-F=
oo,
o-F
cIo,-oo6cr
)
o,
)
-J
Ez.9IooaEzo
z^JI-(
)
q,6a
\
t
Jc
-
,
a-
\
szE2
JJ
ot
_
t
JIsv.Jc^:
qJoC.9(!ooJ
9o-a0_6_9i5EN,EI;Q(!
l'iUJ
\f
-uI5:yr-
l
V1
zotr
\
<-
)
=-
]
]
d,o5
ll
-
r\
z
cY
FEqul
]1
i
o9
(EO-
r
-:
UJo!;;o':z.EE
J)\J
Ez(.
)6=
E2(L()Iolel'
-
t
lE
5
ln
'
s
IEIL
sE
lF{iJ;
1{
1lc(geclo
Ez==
y.JNJ\
:-d)ag7ts+.
eJ
\)
J
EzoBoEnJ
loIElsoL.
t:
It
!
l9t:
le
Dl.
.
.
JJtr
'Nt"
\
tnJI+J;'lJJtEc3o6cr
)o)
zoFEdol!=Fz9Jo-0-&.
IJ
JzBo
JFst
F<
zo
uJ
=
ot
a<HZ
FoJdluzUJo
ot
ED€
i€
'
E
.,
=
Ed
i
s
i
o
?
E
I<
+
P
E
E.
E
E:
8
8
tt
6l
-
x
E
F
E
a
a
9
o<
!
l!
'E
E
.
2
@
o
a
3
cE
(
.
)
,
-
i
:
r
5
E!
^
9
ei
t
o-
o
-
&
o
-
(
/
,
5
.
==
2
-a
-
_
=
.
2
44
=
||
|
l
l
t
Heninger Pad(
tlistorical Dishict
5eplember 6, 201/
fle: 105 5. Enrh Slreet
A 105 yeor old home buih in l9U
ilt-20t/.?.HP
a
Deor Rirordo,
(ommeflt!:
o.0riginolwood windovs ond y00d kim oppeor i 0d ond ron be seen lrom lhe slreel 0l thie 105 yeor old home.
Ttonl you,
Heninger Porl Arrhileourul leview (ommittce
GH
Eo
E
L
E
E,
first Street
tlcFadden Avenue
.t
tr
-
Ilh
tr
[.
Reommendolions:
L Reploring o vinyl goroge rindor rith o wood double-hunq rood rindov rilh originol style wood trim 05 propsed ir oppropriole
ond recommended.