HomeMy WebLinkAbout10194372 - PermitE
Assessor's Parcel: 008-092-03 Lot: 11
Unit Bldg: Address Range: 1210-1242
Tract: ROBINSON AOD Historic: No
Suile Range:
Zoning: R2Block. B
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 #: 10194372
Pin #: 2378s
Building Use:
Job Type:
Nature of Work:
Existing Bldg. & Use:
Proposed Use:
Single Family Dwelling
Alteration
Windows
SFO
R-3
SPK
cBc 2016
x-0602320257J
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area
Total:
Patio:
T.l.Area:
Yards Req'd:
Valuation:$5,500.00
Description of Work: Change out existing windows. Auth on file.
Planning Conditions: Vinyl sliders W grid. Trim to be added.
Contractor
Address;
Engineer
Addressl
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Architect /
Desiqner:
Address:
Phone:
License #
Phone:
License #
Planning Approval By:
Plan Checked 8y:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp. Req'd:
Planning lnsp. Req'd:
Landscaping lnsp. Req'd
Kelaher, Selena
Zuniga, Allissa
Date: 10/03/2017
Date:
Oale 1010312017
Subject to Field.
Misc. Receipt
Misc. Receipt
Misc. Receipt
$154.26
$1.00
$21 .25
$s2.98
07776002 57601 Petmil Fee
07776002 57672 Bld9. Stds Revolving
07776002 51600 Genetal Plan Update
07716002 51601 lssuance
No
No
No
No
Fire lnsp. Req'd:
Police lnsp. Req'd
No
No Account#Total
Flood Zone Cert. Req'd: No
Every pemit issued shall become invalid unless the wo* on the sito authonzed by
such pennit is comnenced within 180 days after its issuance ot tf lhe wotu authonzed
on the site by such pennit is suspended ot abandoned lor a period of 180 days after
lhe time lhe wo* ts cofifienced.
lnspector MID#: 2017-139098
01 1 16002 51600
01 1 16002 51601
0'1 116002 51612
$21 .25
$207 .24
$1.00
Fee Total
Paid to Oate:
Balance Due
$229.49
$0.00
$229.49
Project Address: 1240 W Third St
Occupancy:
Constr Type:
Code:
Flood Zone:
# of Stories:
Owner: Maria Alejos
Address: 1240 W 3rd St
Santa Ana, CA 927033827
Phone: 17141 454-7221
. Tenant:
Owner-Builder
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS OIINER BUILDAR DET,'ARITION
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Bdi.6 ot P6f*on (ql.) A.,(ny or Coud, *hrh r.qur, p<mn ro co.rtud, rh6, ih,rcvc d.molirh or r+lrn.n\
rtudu.. Ftu 'o
ns eft., rlo r.qun6 rh. g,PlEd tor sr.h rEm o fil. ! sfun.d srrlddl rhal h. or th. B hatd purtn
ro rh. Flbio6 ol dr corkddi Li.aEol btr {(lrFd 9. Commfti.8 $nh s..rn n 7000 or Divirion I of lhc Eurins .nd
PmfsioB ( od.) or lh, lE or slE i .xm[, rhdcfion Ei ih. t8i! aor rh. .lk+.d .tdF ion Any viol.rior.tsBlirn 70ll ! hy lnt
4'plic$t fo, . Fnil et!.t1s llE ol,li(or ro r or il p.Mhy ol ml mo.. thD fit. hun&td dolld lttm)
L a .wffi of $. F)Fn!. m mt €nph)6 *nh $+6 B
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$k mmFMior. $ <h'n snit !d rrE lt,Ere ! hr
inrddcd or offs.d tu d. (5{.704.4, BcitB &d Pror6shB coda'llk coddd J Li@ l^ &,6 (n q,?b b u otrk ot
lhc F.raly who tril& or Ep.oE [Eotr r *hd.tE uh mrt h'rell.r lEslf or rhmqh hit.r hs.M dipl]d,
Fovid.d rhd o.h 'mF{\grdrGmr idanbltrofiqd tu uL l[ lEE6.llE buiLlins or irrrcrstEr i' $ld wihii oE ]aofcoqrli,'. ilE ()*G hl'rd trdl h.* rh. hEdn of Flri,A rhn hc or sh. drl b| hdd n nqm( rh. FEFry tu. lll pa,Fe.a
l. 6 0$6 of th. F!n6rv. m.\cGn.ly c..ir-1!u [nh licdsd conrxlGle co rn.i r psF ls< 7041. t!Gm6
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Ilh.r arL, fo. ih. Ffomm. ol rh. rorl for $ h'.h rh. pdfrn ! eu.n
. I h.E.rd \ iU tui .h 10.16 coEFBdirr iGIlJItr., . r.su'En b! S*itn l70o 6f ilE bboi Co&, aor ih. Ffomln . or
rh. srl lor whth lhir pd6n n is.d Mt $dt6 onpaurirn a6urB.6i, -d Folt, nmbd G
Icd!'rylh.r inrh.p<folrrldcotrt trorlrortrn{trhsFn'r,iirud.Ieh.llmrdpLy.nyF$.'.anynmG
$ c to lE .m rut .d ro rh. $$rt6'6np.d hn l,ss of c.lifomia r.d 4r lhd if I .holld tE(otr sbiN' lo lh.
worl6 cohD.Nlior Dilr irioB of S.clio. 170( ol rh. tlbor Code I slull. adhqnh onply r th lhos Dror 6nr6
WARNINC: Fliluc lo ku. rorl6 snFBni'n covmsc i urlartul. syi nall lbj.rl d drphy( l. oiotul Fuhi* dd
.r'l lin.\ trt, r,'.nc hunlr.(l rl'.r\itri [n. d.nqr* 6 l,o\xkJ htr tht
sclirn \r7a otrh.l-,tu coll. 'ni66r
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of lh.Itum6 Md l\ofdi.N C.&. lrl mr lk* ir in tull fore,n dld
CONSTRUCTION LENDINC A(;EN(1
I hg.t'y .lIm un&r rEuh] of Fjury rhri rhs. i! ! .ott(rudnn Endins rs6q for lh. Ffolr@.. of rh. $nll f.r \rhi.h rhh rErfrit L
is.d lS< 1097,Crv ( )
AIIIIIAXLDECIJSAIIOX
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. R.itutrld ldt6of Noliftdir.
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_pmh*..r.{prrno: (..- .,// A T/ lf,.
L.
L
(7 /ctos;,. lolBlt-lefcios
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loor/VenVlnsulation
Roof Sheathing
Shear Wall
Framing
lnsu lation/Ene rg y
Drywall
,w.ahk 7 ,Fl
Brown Coai
Masonry
Pool Fence
T-Bar
Ha ndicap Req.
Deputy Final Report
Engineer Final Report
Flood Zone Certif
/
FINAL %:/t//Lr ?/Lt>*,'6L-/
Certificate of Occu pancy t
Notes, Remarks, Etc
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MAYOR
Miquel A. Pulido
MAYOR PRO TEi/ll
Michele Ma.tinez
COUNCILMEMBERS
P. David Benavides
Vicente Sarmiento
Jose Solorio
SalTinajero
Juan Villegas
men
INTERIM CITY I,IANAGER
Cynthia J. KurE
CITY ATTORNEY
Sonia R. Carvalho
CLERK OF THE COUNCIL
N4aria D. Huizar
CITY OF SANTA ANA
PI.ANNING & BUILDING AGENCY
20 Civi. Center Plaza
P.O. Box 1988 . Santa Ana, California 92702
www.Santa ana.orq.rgba
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
q ts soecified aL- I ,tU 'ay-d st c-fr qef 0
WeareprovidingyoUWithantomakeyoUawareof
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 veify this information.
fA--At , understand a frequent practice of unlicensed persons is to have the property owner obtain an 'Owner-Builder" building
permifthat 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 prope(y. My 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.
.44tAr. I understand building permits are not required to be signed by property owners unless they are responsible for the
construction and are not hiring a licensed Contractor to assume this responsibility.
,'tl, Ag t understand as an "Owner-Buildel' l am the responsible party of record on the permit. lunderstand that lmayprotect myself
from botential financial risk by hiring a licensed Contractor and having the permit Illed in his or her name instead of my own.
/1 ^tLl. 4l I understand Contractors are required by law to be licensed and bonded in Califomia and to list their license numbers on
permits and contracts.
AA h/ V I t /+ 5. I understand if I employ or otherwise engage any persons, other than Ca lifornia lic ensed 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 lalY.
4l-4U , undersland if I am considered an "employer" under state and Federal law, I must register wath the state and federal
government, wilhhold 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 Ilnancial risk.
Ai A
/l/ l. .+7 . I understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential
structures cannot legally build them with the intent to offer them for sale, unless ail work is performed by licensed subcontractors and
the number of structures does not exceed four within any calendar years, or all of the \,vork is performed under contract with a licensed
general building Contractor.
tLlA, 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
mpur doaAsanta-Ena do
Mayo. Pro Tem Ward 2
m man'.qosanla ana oro sam enrcA sanra-ana oro 6olcro@sa.€ ana oro dbenavrdes@ssnl3-a.a oro iv'llecas@sa.l3-ana oro slrnareroiAsanla.a.a orq
l\1, \5. I undersland I may oblain more information regarding my obligations as an "employer" from the lnternal Revenue Service, the
United States Small Busrness Administration, the Califomia Departmeht of Benefil Payments, and the California Division of lndustrial
Accidents. I also understand I may contact the California Contractors' Siate License Board (CSLB) at 1-800-321-CSLB (2752) or
www.cslb.ca.qov for more information about licensed contractors
AI-L
legally
'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
and fi stru on acti t the llowing
address 'ffe-'ergl':CA 2:o
lLt--A't't.I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
applicable iaws and requirements that govem Owner-Builders as well as employers.
'LL 4,lZ.l 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. lfyou 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 of that individual or firm is injured while working on your property, you may be held liable for damag es. lf you
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 returned to the
agency responsible for issuing the permit. rvote.' A copv of the propertv owner's driver's license. form notarization, or other
uerificatien acceptable to the aqency is required to be presented when the permit is issued to verify the propefty owner's
sionaturc.
Signature of Property
Print name of Owner
Owner
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
project.
Scope of Construction Project (or Description of Work)
Project Location or Address
/C Date; l0 0a
aLa L. 0/c.t o s
Name of Authorized Agent
Phone Number ol 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
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 lo
be presented when the permit is issued to verify the property owner's signature.
SANTA ANA CITY COUNCIL
mpuhdo@santaina do
Msyor fto Tefi WErd 2
m'@n'06:@s6nr,-ana do
Ve.re $mrenro
EtIEE!f9@!ed!:e!!-aA lsdo.06sanla-ana oro
P DaMd B6.sMdes
dbensvdes@sanla-Eoa oro villeoas@sa.la ana oro stinaBo@snra-en. do
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Address of Authorized Agent: