HomeMy WebLinkAbout10194632 - Permitcity 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 #: {O{94632
Pin #: 95920
qProject Address: 804 W Washinqton Ave
Assessor's Parcel 398-531-08 Lot. NA
Lln il Bldg: Address Range
Block: NA Tract NA Hrsloflc No
Building Use: Multi-Family (5 or more units) Occupancy: R-2 1st FL Area:
Job Type: Seismlc Rehab Constr Type: V B 2nd FL Area
Nature of Work: Seismic Upgrades Code CBC 2015 Other Areas:
Existing Bldg. & Use: Apartments Flood Zone: X-06023201rt4J
Garage Area
Proposed Use: # of Stories:
Total:
Description of Work: Voluntary saismic upgrados. new shear walls and hold downs in front of existing garages.
Planning Conditions:
Patio:
T.l.Area.
Yards Req'd:
Valuation: t12,000.00
0
Owner:
Address
Phone:
Tenant
Contractor
Address:
Owner-Builder
Engineer
Address.
Mark Allen
1057 Civic Center Dr.
Santa Ana, CA 92706
(714) 450-2816 Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policy #:
Expires:
Phone
License #
Archilect /
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
Orozco, lvan
Heidari Fred
\$Hernanoe,. xatnv
Dale 1013112017
Dale: 1112012017
Date:1112812017
Subject to Field:
Misc. Receipt
Misc. Receipt
Misc. Receipt
077 76002
07776002
07776002
0I90700 7
o7776002
0 711600 2
07776002
5 7601
5 3600
57770
24000
5 7672
57600
57607
Permit Fee
Plan Check'Fee
Microfilm Records
SMIP - Category 1
Bldg. Stds Revolving
General Plan Update
lssuance
No
No
No
No
Fire lnsp Req'dl
Police lnsp. Req'd ffi Account#
70223
Total
$154.26
$213.86
$32.58
$1 .56
$1 00
$21 .25
$52.98
Flood Zone Cert. Req'd: No
Every pemit issued shall bocomo invalid unloss tho work on the ste aulhonzed by
such permit is commenced wilhin 180days aftet ils issuance.or illhe wotk authonzed
on the sile by such pemit ts suspended or abandoned fot a peiod o1,180 days aftet
the lime lhe work is cotfirnenced .
51600
51601
51612
57770
24000
$21 .25
$207 24
$1 00
$32.s8
$1 56
$477 49
$213 86
s263.63
lnspector MID#: 2017-139652
0'1116002
01116002
0'1 I 16002
01 116002
08901001
Fee Tolall
Paid lo Date:
Balance Due:
Suite Range:
Zoning: R2
BUILDING- INSPECTOR RECORD
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Set Backs )
Forms/Steel/Holdowns I -#yr )
Erection Pads L
UFER Ground
SLAB Floor
Subf loor/Vent/l nsulation
Roof Sheathing
Shear Wall
F ramrng
lnsulation/Energy
Drywall
Ext./lnt. Lath L/t \, r3L!k
Brown Coat ,-,L/a t a: *: *7
lo+asonap it4-kAr* L/t -^ t /-<1]+4,
Pool Fence
T-Bar
Handicap Req
Deputy Flnal Report
Engineer Final Beport
Flood Zone Certif
/l \
FINAL ,tN>ll,ll
Certif icate of Occu an
Noteg, Reparks,E\c,,''7\
I
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L4,',
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MAYOR
Miguel A. Pulido
MAYOR PRO TEM
Michele Martinez
COUNCILMEMBERS
P. David Benavides
Vicente Sarmiento
Jose Solorio
Sal Tinajero
Juan Villegas
INTERIM CITY MANAGER
Cynthia J. Kurt2
CITY ATTORNEY
Sonia R. Ca.valho
CLERK OF THE COUNCIL
Maria O. Huizar
CITY OF SANTA ANA
PLANNING & BUILDING AGENCY
20 Civi( Center Plaza
P.O. Box I 988 . Santa Ana. California 92702
www.santa-ana.orq Dba
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 Wa<h'^0 +0V1
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
D/RECI/O/VS: Read and initial each statement below to signify you underctand or verify this information.
t"y
,', i | 1 . I understand a trequent practice of unlicensed persons is to have the prop erty 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 financial risk for any injuries sustained by an unlicensed person and his or her
employees while working on my property. [4y homeowner's insurance may not 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.
,)."
J)-L Z. , understand building permits are not required to be signed by property owners unless they are responsible for the
'constructionandarenothiringalicensedContractortoassumethisresponsibility.
'))1d_!L3. 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.
,4,
'/ / / 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.
,/!t 1s. t understand if I employ or otherwise engage any persons, otherthan Califomia licensed Contractors, and the total value of
my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state
and federal law.
)1
,4 / I A. I u ndersland if I am considered an "employer" under state and Federal law, I must register with the state and federal
government, withhold payrolltaxes, 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 financial risk.
)t
-/t : l. I understand under California Contractors' State License Law, an Owner-Builder who builds singleJamily 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
geTral building Contractor.
, /11 h. I understand asan Owner-Builder if lsell the property for which this permitis 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
mourrdolosanIa-ana oro
Mayd Pro Te6 Ward 2
n madrnez6sanra ana.oro vsam e.To6sanla ana o.o Ed!!!@!l!E:@i.9t9
P Dav,d Benaedes
dbsaudes@sanra-ana oro Mlleoas@sanl6-sn3 0ro slrnaero@sa.l6 ana oro
,,
,1 1: 9 I understand I may obtain more information regarding my obligalions 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 understand I may contact the Calirornia Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or
for more information about licensed contractors
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 and flna re ble for pro ction acti the followingconsoonstw
":-rb,,,;
. I agree that, as the party legally and llnancially responsible for this proposed construction activity, I will abide by all
le laws and requirements that govem Owner-Builders as well as employers.
. JilZ. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have' 6rovided on thrs 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.
Youronly 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 flrm is injured while working on your property, you may be held iiable for damages. lfyou
obtain a permit as Owner-Builder and wish to hire Contactors, you will be responsible for verirying 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 retumed to the
agency responsible for issuing the permil. ,Vole: A coov of the propertv owner's driver's license, torm notarization, or other
able to the nc to be
sionature.7')
)lt ?B l7Signature of Property Owner (.//^-Date
Print name of Owner lrnolrE A\\"V1
AUTHORIZATION OF AGENT TO AC 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 Project (or Description of Work)
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 filled out the above
information and certif,/ its accuracy.
Property Owner's Signature Date
Print Name of Owner
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 permil rs issued to verify the propefty owner's signature.
PL nk.\'\'P51 C,-,u.:,rrAci'\'ily Ass!.n-l,r)'B:s l.l:,i c! io Pra i,c:l',/ Fr.Ilr
SANTA ANA CITY COUNCIL
m.ulido6santa-ana oro
vrcenle Sam enlo
Earp,enlolAsanta ana oro solono@santa-sna oo
P. Oaed B€.audes
dbenavrdes@sanla a.a.oro /rreoas6 sa.la a_. o o sl laF'oAsa'ra.raa o (
i*chele Mad'n€z
l&yo. Pro Tem, Ward 2
m'marl ne26sanla ana o.o