Loading...
HomeMy WebLinkAbout10294915 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853 Permit #: {02949{5 Pin #: 21994 E ect Address:.217 S Daisv Ave Assessor's Parcel OO7-261-32 Lot 21 Suite Range: Zoningr RlBlock: A f .acl. 233 Hisloric: No Proj Building Use: Job Type: Nature of Work: Existing Bldg. & Use Proposed Use: Single Family Owelling Alteration Alter Sfd W/aft Garage Occupancy: Constr Type Code: Flood Zone: # of Stories: R-3 VB cBc 2016 x-0602320257J 1st FL Area: 2nd FL Area: Other Areas: Garage Area Total: Patio: T.l.Area: Yards Req'd: Valuation:$1,000.00 Description of Work: Remove unpermitted detatched structure from teat yatd. Planning Conditions: Owner: Address: Phone: Tenant Contraclor Address: Owner-Builder Engineer Address: Phone License # Architect / Desiqner: Address: Phone: License # Juan Olvera, Susan Lambaren 217 S Daisy Ave Santa Ana, CA 92703 (7141322-2366 Phone: State Lic #: Lic Type: Bus. Lic #; Workers' Compensation lnsurance Carrier: Policy #: Expires: Planning Approval By:-- Orozco, lvan Plan Checked By: ,' Permit lssued By: l NPDES lnsp. Req'd: PWA lnsp. Req'd; Planning lnsp. Req'd 57 607 57607 57607 5 7672 57600 57607 o77760 0 2 07776002 07776002 o77760 0 2 07776002 07776002 $154.26 $93.17 $234.08 $1.00 $21.25 $52.98 Oale 1112712017 Date: Dale:1112712017 SubJect to Fieldl Misc. Receipt Misc. Receipl Misc. Receipt Permit Fee lnvestigation Penalty Bldg. Stds. Revolving General Plan Update lssuance No No No No Fire lnsp. Req'd: Police lnsp. Req'd No No Account#Total Landscaping lnsp. Req'd Flood Zone Cerl Req'd: No Every pennit issuod shall becone invalid unless the work on the site authorizod by such pornil is cofinenced within 180 days aftot its tssuance.ot if the wo* aulhonzed on lhe site by such parmit is suspended ot abandoned fot a period of180 days aftet lhe time the wo* is cofifienced. $556.74 $0.00 $556.74 lnspector MtD#.2017-139640 01 1 16002 51600 01 1 16002 51601 01 1 16002 51612 $21.25 $534.49 $'1.00 Fee Total: Paid to Date: Balance Due Unit Bldgr Address Range /T e.ra"n, trti" - BUILDING- INSPECTOR RECORD SITE-WORK DATE ID/SIG.COMMENTS Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Subf loor/VenUlnsulation Roof Sheathing Shear Wall Framing lns u lation/Energ y Drywall Ext./lnt. Lath Brown Coat Masonry Pool Fence T-Bar Handicap Req Deputy Final Report Engineer Final Report Flood Zone Certif I nc FINAL Certificate of Occu Notes, Remarks, Etc O\INEN B!II,DIIR Df, LCARATION I h..b .rm und6 FMny of Fjury th, I d .roqjl iln rlE codrdoE Lr6& lr* Lr ih. n\lh$ 3 ltMn (Sa r01l 5 a6i6! .,n Pmrdkr Co&) Any CnJ or count sh(h r.qur6 . pqni lo edrud, d!6, mFo!.. &tuliih 6r EP.n d! rrud@ Finro ii! !lre..,t r.qtiE rh. +pliar for.stFnnh 6t tsb..dfiorM lhn lEot3rrklkaB d PoRdr ro rhc Forsr6 of E (ontrrlq ! Li(t*d tr! I(-rufl6 9, (i!ffihs qnh Sd$. 7000 of Difirhn ! .f lhc &!r ..d Pmfdiorr ('o&) or tn.l lE r dE ir 6otpr rh6.nom id rlE tsir for rht llks.d donprsn An, vioLlionofs..l.nr0lll b !n! applrcdr for r p.r6n rubj<t llE rprlicanl lo.civilp.ullyofnor motthtr livc hun&.n dollsr(!5m) t. ( []. * .'" "..r,r'. p.1.n). n' my.mplot6 *rh s.{6 rhdr slcompnBd'on. {Ill,ll' th.s,Yl Eld rh.eru,ft i! mr '--Adrd or llr.d r,tr ql. ( sd 7oa{. Buin6 Md Pr.rdiorr Codr Th. ( onLt.lor! tjtffi br' &€ nor tpply lo s om6 of thcroF!] who t!n& or imFnv6 llE@l| d who d.E *h *nd hiru.lt n hcll or lrnlush hir or hd otr r .mployG proriddl thi .u.h 6rxorrd! E mt hoxLd $ ofiqd fo' 5t l[ ho*6d, iE hlildIts ot rqnnEFi ir $ld wihin oE ]6 ofo,pHnr llt ()\rG ttuildd $il nrc. rlE hlddl ofForts thi lE or JE dil bl hlild or npmrt,E FsFry k rlr In.Posof L s orffi of rh. Fnldr, e dclGnr[ on6<r'nt rnh l'.d{.r! codrslG ro @ltsru.! ilF tmFt lsc 7(xr, &!i6 rn Fokrh ( o<,c rll.(6 roi!Ltetred(Bmll{t vl.uo]BolF.Fn,thottril&orinprordlh64n. rd sho 6dr&1r rd !o.t FoFr$nh ! Con6do(r) la6a.d puM 'o rh. Cornrdoa. LiN l^) I m.rdnpr trnrld S(rrn ,/*, 1//z 7/r 7 I.IL!LIII.IIID I h€r$y .ttm uida FrXy ofFiury orc of6c aollo*rE &.lraioB: -t h.v. !d *ill rints . cdlifta. of coer lo s.lf-!6c fo( Fdta o[F!rn., t Ford.d f.r b, selbn !700 of llE L.ts Code for rlE Ff.rffi olrlE mt fd *tth rlE Frn a is.d I h.!. rn sil midrin mtld <otrlddioa itlirlue . r.qlird b, 56161 1700 otlhc lrbor ( od.. tu lh. Ftldft. ol rlE El fd whtt thi !-rn ir is,.d My *dl6 ompddbn ilElrc ffi, td Fli, nutubd rc: (m: PolicrNumbg: ExpiB: 1 J4a,-,4,*, . ,n. -n,l1Mc..rth. sort h, qhKhrnt Fnr h ilsEil t slEll nor mploytny Fs. i.eymMrq N 6s 'o bdom !uh,.d ro rlE s 6'snFshn l,q. of ( .lifomir i.d 4r lha if I shuld t com. !!1'j6' lo 'lE$orlc'conndErioDrrnrirnBors<rio.lTmolllELlnr(.&.liElLronhrnhNmrlv$irhthorFort'oE $ARNlNc Frlu. t' <c. (0116 comg.nenn orE rr.6 unb*tuI, tnd srEll3ubr.cl , drLrd ro aidiulFul6 Dd cnrl rm* un r. oft hunddl th.ued &1116 (tlno.llr). m ddnrn io rh. (d of .omFdlh( &tu86 B proril.d for lh. nrad rrd dlon<t ! f6 K,.", I heby sflim undr rsslly or FJury rhd I m li(.nxd undd Foyi!'onorChaprd 9 (.oBmocins silh sc.16.70{0) ofDirnn)n l of rh.BdindanJ lhf*rionr Codc. ad mylrc.* ! 'n fullfor..tnd.ffEl CONS'IIU('TION LENNINC AGf, NCt I hd.try .llm !'xk rEuhy of p.rjuir tht dE. ir r frdtudD. bnns.{*y for rlE Ff(nrrld. oalh. sorl f.. $nth rnn Fmr u B$d(s< 1097, ('iv (' I lodo'! \M( aftll(AtrllrlclJaarla! I hdlat arm undd F8lrt of Frury oE or th. follotr ins drlet' as Dsmhion Pmh}Artad Ndificdnn F.dgll R.8uhinu (rirk40, Pd6) R.qtrn d Ldrd .a trdrfrdir l cdr6 rh, rh. f.J.rrlr.ruLlnN Fsed'.s dhdol,m,'.lu.m' 4plithkrnrhi pn\Fr fLL!cdrry rhd I 16c,..d !h'r.p9l(.rFn art norcrhd fi..h1\c into dionB.odd I rse ro mnpry $llh 'rr ( dr- 'tu1 (t'unrt -md'nlnceedShr.l,*rEldinsrobu'ldrn8coNddrun,irlh6.tyaulhrn..F6ddn6olthi!(iltudCounryloo16urb.lhcolrr!. rn6t ioncd rr{pd y ln arp.d $mri".nr o,,r*-r str,.r,.. (r.mitft m .(pnn'l:L,Ar.1 ([ ". " .'., u/zzlz IaILZi I \F.A I I I MAYOR NriguelA Pulido MAYOR PRO TEM Michele lr4artinez COUNCILMEMBERS P. David Benavides Vicente Sarmiento Jose Solorio Sal Tinajero Juan Vtllegas Dear Property Owner INTERIM CITY MANAGER Cynthia J. KurE CITY ATTORNEY Sonia R. Carvalho CLERK OF IHE COUNCIL Mana D. Huizar CITY OF SANTA ANA PI.ANNING & BUILDING AGENCY 20 Civic Center Plaza P.O. Box I988 . Sanra Ana, Calrfornia 92702 W!!w.santa ana.grqlpba NOTICE TO 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 , /-.-,2. 5 {)ai5u 4^.t/o 4,^-a,. C/e,a gzzo-2, ,/ We are providing you with an 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(n 1.1understandafrequentpracticeofunlicensedpersonsistohavethepropertyownerobtainan"Owner-Builder"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 flnancial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. lr.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. JA 2. I understand building permits are not required to be signed by property owners unless they are responsible for the constructjon and are not hiring a licensed Contractor to assume this responsibility. )O Z. I understand as an "Owner-Builder" I am the responsible party ol 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. d_O 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. )O S. I understand if lemploy or otherwise engage any persons, other than Califomia licensed Contractors, and the total valueof my construction is at least five hundred dollars (5500). including labor and materials, I may be considered an'employer" under state and federal law. IdO 6. I undersland if lamconsideredan "employer' under state and Federal law, I must 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 financial risk. P-1. t understand under California Contractors' Stale License Law, an Owner-Builder who builds single-family residentialii l-tures 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. )ou 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 owne(s) that result from any latent construction defects in the workmanship or materials. SANTA ANA CITY COUNCIL dou dorosanta-ana oro Mayo. Pro Iem Warc 2 m,marnnez,Osanta-6nE.oro vsamenrorasa.la ana orc soloro@sanla 6na oro P OEvLd Benaudes dbenavrde@santa ana.oro vr eoas@s.nta a.a oro strraEro@sanla ane oro leqallv and financiallv responsible for proposed construction activitv at the followingaotriss: 2/7' 9'- Dar','t, 5ot^,/a, ,A-,n.r, Z t4 ?i> oZ' -7 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 lhat govern Owner-Builders as well as employers. llt Z. t 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 flnancial loss you may sustain as a result of a complaint. Youronly remedy against unlicensed Contractors may be in civil court. ltis also important for you to understand that if an unlicensed Contractor or employee ofthat individual orfirm is injured while working on your property, you maybeheld liable fordamages. lf 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 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 ths permit. /Vote: A copv of the Drooertv owner's driver's license. form notarization. or other verification acceotable to the aoencv is reouired to be Drese when the Dermil is issued to verifv the orooeftv owner's sionature- Signature of Property Print name of Owner Date )/1 AUTHORIZATION OF AGENT TO A CT 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 file the documents necessary to obtain an Owner-Builder Permit for my project. Scope of Construction POect (or Description of Work) Project Location or Address Name 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 certify its accuracy. Property Owners Signature Date Print Name of Owner Note: A copy ot 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 propeny owner's signature. ] SANTA ANA CITY COUNCIL moulrdolasanla-Bna do Mayor P.o lem Ward 2 mrMnrnez@sanlE anE do Vicente Samrenro 6amrenro1osa.le{n3 do Eala!@$da:?.!a-o!s P Dav'd Benav,des dbenasdesaA$nt5.n3.do iu re5srAsants ana oro strn.Bo@sanla ana do I b_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 Benefit Payments, and the Califomia Division of lndustrial Accidents. lalso understand lmaycontactthe California Conlractors' Stale License Board (CSLB) at 1-800-321-CSLB (2752)or www.cslb.ca.oov for more information about licensed contractors. It A 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 Address of Authorized Agent: