The URL can be used to link to this page

Home My WebLink About30138677 - PermitProject Address: 402 W Fourth St Assesso/sParcel: 398-593-05 Lot: POR 35, POR 37 Unit: Block: NA Bldg: Address Range: 402408 Tracl: BIRCH ADD Historic: Yea Suite Range: Zoning: SD84 E @ city of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA,27O2 Plumbing Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Sectlon: C/14) 647-5853 Permit #: 30{ 3E677 Pin #: 3,44lD1 Owner: Address: Phone: Tenant Nam6: Contraclor Address; Broadway lmprovement 129 W Wllson Sto #100 Costa Mesa, CA 92627 19491722-7400 The Comb Salon Fee Type Amount Sink '12.23 Clotheswasher 13.45 Sewer Alter/Repair 42.85 Wtr Htr (Comm up to 50 21.42 Water Piping (Each 100 42.85 General Plan Update 21.25 lssuance 52.98 Foe $48.92 $13.45 $42.85 $21 .42 $42.85 $21.2s $52.98 Owner-Builder Phone State Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance: Carrier: Policy #: Expires: i. Refi: io/?017 a I drt 'enero0l1ll Plurb Suilding Use: Job Type: N.ature ot Work Planning Conditions: Commorclal Tenant lmprovement Plumbing B VB cPc 2016 10130t2017 Account# 01 1 't6002 51600 01 I 16002 51602 $21.25 $222.47 Notes; lnstall new slnks, wrrhfi, ,ltcr salxer llne, water heater and new water piping. Auth on tile. M Date: Date: Date: Misc. Receipt: Misc. Receipt: Misc. Receipt: Total Zuniga, Allis Every pomit issued shall becone invalid unloss tha wod on the site aulhoized by such pennit is comnoncrd within 180 days afrer its issuanci, ot it the wo* authodzed on lhe &te by such pomit is s!*onded or abandoned lot a poiod of 1 80 days after the time the wo* is connen@d. lnspector MID#: 2017-139648 $243.72 $0.00 $243.72 011 16002 51602 01116002 5'1602 01116002 51602 01 t16002 5'1602 011 16002 51602 01116002 51600 0'l 1 16002 5't602 Qty 4.00 1.00 1.00 1.00 1.00 1.00 1.00 Planning Approval By: Plan Checked By: Permit lssued By: Subject to Field: Building Permit #; Occupancl: Constr Type: Code: Fee Total: Paid to Oate: Balance Due: PLUMBING.INSPECTOB RECORD APPROVALS DATE ID/SIG.COMMENTS UNDEB GROUND Waste & Vent Water-Under floor Gas-Underfloor Building Sewer Area/Storm Drain lnterceptor/ Clarif ier TOP OUT Waste & Vent Water Piping Gas Piping Rool Drain Tub/Shower Test Rough Water Heater POOL/SPA P-trap/Drain Line Marn Drain/Pool Pipinq Fill Line/Back Flow Pool Heater/Gas Line Miscellaneous Gas Service Water Service Lawn Sprinkler Sanitary Sewer/Cap Back Flow Device Rough Plumbinq Final Gas Test Meter Release FINAL /-?-tc {/zSa <zt Notes Remarks Etc. l.r!!s'r,$lrtr.tlotxd!.n'n'\.nllt,lNrtr [s.'!.',nrlrtr r,l (onrttn\ rnr.(rr,k,rrr'nL rlrlrotNr!rlr'linl([ur ii,nt!rlhuJrl(h,(lt-{f,h(,trt1'ntr\ll,ilx1!]l,irhn{'rl,htrtrlr,'ntt.r!,r,,,.. /;/ii I lr'.n! !lrnnr uftlr t(nnlrr "r r\r,ur oft rr f, l('ll( ljh{ (irl.. r'n rl* trrkrnurx, ol rl{ s'!l l,n nIilr rli |iitrxr trNnkrl _llurctr'rl{illnsn !i,,sol L\rt'rl ll\ SLari,' r:ir,.'lrli'l.nrr(iNL 1,rrlr ri,i,nEmof rh qo'l r{n }hi.h rhn tf,rn'ir ir n{irl ltly qo't.'! (,tr,{xtr\,ritr' nn 'x'rr lJir rrlF,li r Nn'lr, tr. \iir rrrnri rlr'lnh,r GlL. i r,f{ rl-T ,,,,," c I of tl/ t? 4'!'rr l'.'ri,r !!t,{rrr tr 'r s rh \.rir 'io, ilhnirnl !!r:!rx[-uu\u !!lx!_]!l:}!t I !.n'l\ rlli rI h1L',n '.rul,iD,\ 'rrinh,,r Jn\ n,- ', rt,,]lr. 'ii .'r,|tlk 'l,l r' rl'^ r,,r, Irorn'rr!(,.irl|r,,](,nilr,'/e'!tr(\nr.i r\!{rl'tri ,irrr,{ 1' , r.r uF'nrlE \IPli'.' r !tr \rd'r \r!ri i3 eoa:"'; r,fz"f ,7 II lt-r----t--- I MAYOR Miguel A Pulido MAYOR PRO TEM Vincent F. Sarmiento COUNCILMEMBERS Anggllca Amezcua P. David Benavidos Mrchâ‚¬la Maninez Roman Reyna SalTrnalero CITY OF SANTA ANA PLANNING & BUILDINC AGENCY 20 Crvrc Center Plaza P.O. Box I988 . sanra Ana, Calrfornia 92702 www.santa-ana.org 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,*r:r"l*,. specified ^, ,lr, Z w Llh ,iV<â‚¬T 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 nottce unless you, the property owner. obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF I NFORMATON DIRECTIONS: Read and initial each statement below to signify you understand or verify this information 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" building permit that enoneously amplies that the property owner is providing his or her own labor and material personally. I 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. My homeowner's insurance may not provide coverage for those iniuries. 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. U-Z I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hinng a licensed Contractor to assume this responsibility. Qt. 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 haring a licensed Contractor and having the permit filed in his or her name instead of my own. *O I understand Contractors are requrred by law to be licensed and bonded in California and to list their license numbers on permits and contracts. 4U. I understand if I employ or orherwise engage any persons, other than California 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 "employea' under state and federal law. 4U I understand if I am considered an "employer" under state and Federal law. I must register with lhe 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. '& 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 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. SANTA ANA CITY COUNCIL A^gdrca &rP-:@ MAn'doio.rnra-3na do vrrcar F 5â‚¬m6do Mavo, Pro I.n' Wao i Vsâ‚¬me.lott5a.rr.!@ dc rrqralFozae.ta .na do C{TY I\IANAGER Davrd Cavazos CITY ATTORNEY Sonra R Carvalho CLERK OF THE COUNCIL Mafla D. Hupar AAhacu.@sanra'ana do O8.nay6â‚¬s6,sanb.ana d. RR.faO3anra-sna d! Sl6!soos!nr.{.6 yo -4,, I am aware of and consent to an Owner-Builder bullding permit applied for in my name, and understand that I am the party legally and frnancially responsible for proposed construction activity at the followingaddress: 4a Z ut ''t n srruzcr ''"'" -runderstand 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 owhe(s) that result from any lalent construction defects in the workmanship or materials. -/9-' _9 I understand I may obtain more information regarding my obligations as an "employer" from the lnternal Revenue Service, the Unrted States Small Business Administration. the California Depanment of Benefit Payments, and the California Division of lndustrial Accidents. I also understand I may contact lhe Californra Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752)or www.cslb.ca.oov for more information about Iicensed contractors -4-9-- 11.1 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. -&r 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. Lrcensed 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 complaint. 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 damages. lf you obtain a permit as Owner-Builder and wish to hire Contactors, you wil be responsible for verifying whether or not those Contractors are properly Iicensed 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 theagency responsible for issuing the permit. A/ofe: A coDv ofthe Dropeftv owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permil is issued to verify the propedy owner's sianature. Signature of Property Owner Print name of Owner Date: i Zui -7 AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Properly Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to acl as my agent(s) to apply for, sign. and file the documents necessary to obtain an Owner-Buiider Permit for my project. LJ A'nlScope of Constructron Pro,ect (or Description of Work)A s l.) ,L 0 (e<-'^Y S Pro,ect Location or Address 4aLu.t 4fi srz<er Name of Authorized Agent:-7Wf Bepoo,.-.t Address of Authorized Agent:129 ut, Nt t-s(r\t 9lv--e I declare under penalty of perjury that I am the propâ‚¬rty owner for the address listed above and I personally filled out the above information and certify its accuracy Property Owner's Signature Print Name of Owner:lR -. a"', (),t'"-,rs,- Date: lO 2 'Zbl Note; A copy of the owner's drlver's licensa, form nolarization, or other yerlfication acceptable lo the agsncy is required to be presented when lhe permil is issued to verify the property owner's signaturc. SANTA ANA CITY COUNCIL t?16t, Pio 'Idr lryaro r vslmrlo6.rll.iâ‚¬ o.a Mm!cu.@sr. s^. @ P Oad B.ruuda DE&.$d6o.ar!tr-r.a orc ST'EcorOe.t 'an. oE 4'/<- RRe6r@sml..ena o.o Phone Number of Authorized Agent.