HomeMy WebLinkAbout10193454 - PermitCity of santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CAI27O2 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 1O1 93454
Pin #: 64424
q
Project Address: 2332 S Lowell St
Assessor's Parcel 140-154-09 Lol 89
Unrt Bldg: Address Range
I
Block: NA Tract: 2458 Historic: No
Euilding Use: Single Family Dwelling Occupancy: R-3, U 1st FL Area: 340 Patio:
Job Typei Addition Constr Type: V B 2nd FL Area: T.l.Area: 540
Nature of Work: Addition/Porch Code: CBC 2016 Olher Areas: yards Req,d:
Existing Bldg. & Use: 5pp w136 g373gs Flood zone: x-0602320259J Garage Area: vatuation: S40,000.00
Proposed Use: Residentiat # of Stories: Totalt 340
Oescription of Work: Add 340 sq ft to expand family room, 6ntry, and kitchen. Remodel kitchon, living room and dining room/add 30 sq foot front porch
\
Planning conditions:
Owner:
Address
Phone:
Tenant:
Zeferino & Maria Jimenez
2337 S Lowell St
Santa Ana, CA 927073156
(714) 966-5327
Contractor
Address:
Owner-Builder
Address
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensalion lnsurance:
Carrier:
Policy #:
Expires:
Phone:
License #
Architect /
Desiqner:
Address:
Phone:
License #
Planning Approval By
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp. Req'd: No
Planning lnsp. Req'd: No
Orozco, lvan
. Mazatji, Zac
$
Hernanoez. xatnv
0 7776002
0 777600 2
0777600 2
o777600 2
0177600 2
0777600 2
57 607
si600
57770
57572
5760 0
57607
Dale: O7lO7l2O17
Oale. Ogl12l2017
Dale: Ogl12l2017
Subject lo Field:
Misc. Receipt
Misc. Receipt
Misc. Receipt
69786
Total
Permit Fee
Plan Check Fee
Microlilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
$503.60
$517.00
$28 96
$2.00
$52.98
$1 ,125.79
$517.00
$608.79
Fire lnsp. Req'd:
Police lnsp. Req'd
No
No Account#
Landscaping lnsp. Req'd: No Flood Zone Cert. Req'd: No
Every pennit issued shall bgcoma invalid unloss the wo* on the sile aulhonzed by
such pemil is commencod wlhin 180 days aftet ils issuance.ot il tho work authonzed
on tho sile by such pemit is suspended or abandonod fot a peiod of180 days after
the time lhe wotk is commenced
lnspector MID#: 2017-137273
01 1 '16002 51600
0'1116002 51601
01 1 16002 51612
01 115002 57770
$21.2s
$s56.s8
$2.00
$28.s6
Suite Range:
Zoning: Rl
Engineer:
Fee Total:
Paid to Date:
Balance Due:
BUILDING- INSPECTOR RECORD
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SLAB Floor
Subf loor/VenUl nsulation
Roof Sheathing 12-1't7 V*J,A
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Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
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FINAL Vl*lr0,r f-*t tt *It)
Certificate of Occu pancy
Notes, Remarks, Etc
Erection Pads
I\,1AYOR
[4iguelA. Pulido
MAYOR PRO TEM
Michele Martinez
COUNCILMEMBERS
P. David Benavides
Vicente Sarmienlo
Jose Solorio
SalTinajero
Juan Mllegas
INTERII\,4 CITY MANAGER
Cynthia J. KurE
CITY ATTORNEY
Sonia R. Carvalho
CLERK OF THE COUNCIL
Mana D. Huizar
CITY OF SANTA ANA
PI.ANNINC & BUILDING ACENCY
20 Civac Center Plaza
P.O. Box 1988 . Santa Ana, Calfonia92702
www.santa ana.orq/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
tm ments s
1r--. s"pecified at L-,eas--rr,t4-X{ <\
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 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.
L-L1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" building
permat that enoneously 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 properly. My homeowner's insurance may not provide coverage for those injuries. lam willfully acting
as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property.
z-) 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.
^ -_:-
/), 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 Conlractor and having the permit filed in his or her name instead of my own.z14. I understand Contractors are required by law to be licensed and bonded in Califomia and to list their license numbers on
permits and contracts.
I , \5. I understand if I employ or otherwise engage any persons, other than California licensed Contraclors, and the total value of
my construclion is at least five hundred dollars ($500), including labor and materials. I may be considered an 'employer" und er state
and federal law.
-)tZ:-26. I understand if I am considered an 'employer" under state and Federal law, I must register with the state and federal
-gorernrent,
withhold payroll taxes, provide workeri' compensalion disability insurance, and cdntribute to unemptoyment
compensation of each 'employee.' I also understand my failure to abide by these laws may subject me to serious financial risk.
-----i.'' | ' 7. I understand under California Contractors Stale License Law. an Owner-Builder who builds single-family residential
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.
a \ L l 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 owne(s)that result from any latent construction defects in the workmanship or
materials.
SANTA ANA CITY COUNCIL
Mayor Pro T6m, Ward 2
mrmaa'nezOssnta-ana.oro \Bamienro@sanla-?na do 6clonc@santa ae o.r dbenatrdsas8nra.ana -o lvilleas@snla .ns do snnaerc,asama'.na domourrdo@sanra-ana do
E-).-
d. I g. t 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 Benefit Payments, and the Califomia Division of lndustrial
Accidents. I also undersland I may 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.4 '10. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party
legally an
address:
d fina c !lv resoonsibz- s.le for proposed co stru ron at th followin s
,Z -/ 1l.lagree that, as the party legally and rinancially responsible for this proposed construction activity, lwill abidebyall
aO-plicable laws and requirements that govern Owner-Builders as well as employers.
-.(1)2. t agree to notify the issuer of this form immediately of any additions. deletions, or changes to any of the informalion 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 result of a com plaint.
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 ofthat individual or firm isinjured while working on your property, you maybeheld liable fordamages. 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 bo issued, this form must be completed and signed by the property owner and returned to the
agency responsible for issuing the permit.
^rofe:
A copv of the oropeftv owner's driver's license. lorm notarization. or other
verificalion acceptable to the y is required to be Dresented when lhe permit is issued to verifv the DroDertv owner's
9!Snature.
Signature of Property Owner
-2-
Z-d Y- <\ -c-{.\a_9_j-1 Date 7rl2. \Q
Print name of Owner
AUTHORIZATION OF AGENT TO AC T 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
project.
Scope of Construction Project (or Description of Work)
Project Location or Address
Name of Authorized Agent
Address of Authorized Agent
I declare under penalty of perjury 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
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 verily the property owner's signature.
SANTA ANA CITY COUNCIL
moul'do@sanla-a.a.oro
Illat$r Pro Tem. Ward 2
mrman ne2@sanla'ana oro
Vrcenle Samiento
Bamrnlorasanta ana do 60rono@s.nta-ana oro
P. Daed B€naMdes
,.os!!vlc!!@!rd!=l!!.![g rs eoasAsanla-ana orc snna€rd@sanL-ane do
Phone Number of Authorized Agent:
Print Name of Owner: