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Home My WebLink About10193538 - Permitq Proiect Address: 2021 N Fairview St Assessor's Parcel 399-091-20 Lol NA Unit Bldg Address Ranger 2021 -2025 Historic: No Suite Range: Zoning: R1Block: NA Tract: NA CiQ of Santa Ana Permit Counter: (714) 647-5800 20 Civic Center Plaza (M-19), Santa Ana, C,A'92102 ' . Building lnspection Requests: (714) 667-2738 tn.p""to, Section: (714) 647-5853 Permit #: 1O193538 Pin #: 95847 Building Use: Single Family Dwelling Occupancy: R-3, U . I st FL Area: 745 Patio: 204 Job Typer New Constr Typer V B 2nd FL Area: 455 T.l.Area: Nature of Workr SFD w/att garage Code: CBC 2016 Other Areas: Yards Req'd: Existing Bldg &use: sFD w/det garage Flood zone: x-0602320'l'l4J Garage Area: 467 Vatuation: $156,022.00 Proposed Use: Sfd Watt garage # of Stories: , ,o,",, 'ZOOOescription of Work: New 2-story sfd with 3-bedrooms, 2-112 bathrooms, laundry in kitchen, open patio cover (at rear), front porch (69 sf), & attached 2-car garage. GGUSO #4733. Planning Conditions: Submit Landscape Plan. Owner: Address Phone: Tenant Tan Nguyen 11071 Cottonwood Ave. Garden Grove, cA 92843 (714) 230-9682 Owner-Builder Phone: State Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance Carrier: Poiicy #: Expires: Contractor Address Engineer Address: Justin Vict Nguyen P.E Justin Viet Nguyen 5593 Teakwood StrBet Cypress, CA 90830 (714) 209-396s 68232 Loc Ly Loc Ly 7521 Volga Drlve, #3 Huntington Beach, cA 92647 17't4l 657 -276s Phone: License # Architect / Desiqner: Address: Planning Approval By Guevara, Jerry Plan Checked By: Permit lssued By: NPDES lnsp. R PWA lnsp. Req'd No Planhinq lmp. Re1.d: Y ro ki, Teri 69808 Total 077 7600 2 o7176002 ott tdooiz 08907007 0777600 2 o1176002 o7776002 57607 53600 57770 24000 57612 57600 57607 $1 ,001 20 $3,009.80 s39.82 $20 28 $7 00 $21 25 $141 .32 Dale:1011712017 Oate: O9l1al2017 Oale10/1712017 Subject lo Field [4isc. Receipt [,lisc. Receipt [Iisc. Receipt Permit Fee Plan Check Fee Mkaofilm Records SMIP - Category 1 Bldq Stds Revolvinq General Plan Update lssuance/New Structu Fir lnsp. Req'd ice lnsp. Req'd No Yes-)Account#e Landsctpinii ln-sp REt: -No Tfodazonec eif. Rtq.a : lb Every petmit issued shall become invalid unless lhe wo* on lhe site aulhorized by such pemit $ conmenced wilhih 180 days aftet ils issuance,ot il tho wo* authoized on the sile by such pemit is suspended or abandoned fot a period ol 1 80 days after lhe time lhe wo* is cofimenced lnspector MID#: 2017-13501 1 01 1 16002 01 1 16002 01'116002 01 1 16002 08901001 51600 51601 5161 2 57770 24000 $21.25 $1,142.52 $7.00 $39.82 $20.28 Fee Total: Paid to Date: Balance Due $4.240.67 $3,009 80 $1,230.87 Phone: License #: I\ BUILDII'IG. INSPECTOR RECORD SITE-WORK DATE ID/SIG.boMMENTS (,WN ER BU I I-DER I'I]I,('AIIATION I h6.by imm und6 p...lly or Fl0ry rhal I m dmt)l nom rh. 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L.bo, cdL. aor rh.Ffotu. orrh. *b fo.shthrn Fnd i! isu.rl I r r,o'. ."a " ,lt .",n,!,n " 0r\6 (nmrENr k{ rBute., f,r rqurtd lt s.<r i.. iTOJ .f rh. Lhor (td.- for rh. Ffolrre. ot rh. $crl r.r $hEhrhB Fmir i! sd V, (.116'(.mFlq'rn'^ru'tut.r.n'. in<l Frtr y nu'nt{ d. l.dilt rhd '. rh. p6ao@Nc ofrh. qort lor uhkh rhis Fmi itr i$al l.h.ll mt 6pl'y rn! Fmn h mt mdffi $ lo trmft subjdr k, th. *n.[d comp.r*irn lrs ot Cllifomu. dd lsr thd il I rhould b.(ore lubd lo tlE uo*6' otrp.r!.rion For ilioB of Sdhn ! 7m of rh. lrh6r Codc, I lhrll- follh$ nt coid) tr nh rhots Fo\irh6 WARNING: Fi'lu. ro B@ mrl6 conpi{lon cov.r.s. i! unl.vlul. nd rhrll llhjer M nplord to dihiml paEhid d cnil fin6 tp n 6R hunddd rhousnd dolld (ot.omp.Nr... &ru*6 .s rro\&d tu rh. S(tion :r(116 oirh.l ah! (.Jc 'nr-.3t turi I hcf, .rm und6 Foalry df FJUry thd I m li..rxi unds I'!,l r){connfti.s \irh sdin 7uD).aDnBion I of 'h. u6iR rnJ PDtsirnr Co&- ol m! lt.M i! n tull aor.. sn. CAISIBII(IIONIIIDIIC.AGIICI I hschy a,Im urd6 F$hyof lx juD. lhx th6. i!,.odruc!irn kndin8 rsay lor Ihc rdnrlruc. of th.rork for shichIhir Fnit k 's.d (Sd l0)7, Crv c ) AIILI1SNIDES.A8^Iq! I IEu]* .rlm und6 r6.hr of Fjur! or .l rh! rou{tr Ds dc(l&!t ir.t l)oolirion Pamit*A$6ror Not'n.dhn l;cd6d R.cuLliB (rnt.l0. Pdn6) Rqutcd l.lin olNoli6carhn or lEm\.| r. mt @lr.bL h lha Frt< lE rto\r inltrtuhtr ir (n!.t I .grc 16 @opry *nh .ll Cn! rnd Countr tukl hd.by .urhori,. rqr6d6r1r6 o f rht ( ir v ind (i 1* tfiot, lU t7 // Set Backs \ Forms/Steel/Holdowns Erection Pads ,l.t,a \^1\ UFER Ground ) SLAB Floor 7 SubfloorA/enVlnsulation ( Roof Sheathin /rl & Shear Wall rl Framing /.8 t lnsulation/Ene rgy D itg zEil.Mt. tajl S tsArz n Ju4.a3+ 'Bi5wn-foat dt.<'le -96? [,4ason rY Pool Fence T-Bar l[4dicap Req Dep11!y Final Report En gineer Final Report Flood Zone Certif FINAL z 1?-/9 t I Certificate of Occu pancy Notes, Remarks , Etc, t hvL I I /t--,- I /V"\-,- [,4AYOR [4i9uelA. Pulido MAYOR PRO TEI\,,I l\4ichele Martinez COUNCILMEMEERS P. Oavid Benavides Vicente Sarmiento Jose Solorio SalTinajero Juan Villegas INTERIM CITY MANAGER Cynthia J. KurE CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar CITY OF SANTA ANA Dear Property Owner An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specifie a 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 bujlding 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. (on OWNER'S ACKNOW ED GMENT AND VERIFICATION OF INFORMATON DIRECTIONS: Read and initial each statemenf below to signify you understand or veify this information. tM , , understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" bualding p*mit that erroneously impliesthatthe property owner is providing hisorherown laborand material personally. l,asan 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 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. { , , understand building permits are not required to be signed by property owners unless they are responsible for the 6nstruction and are not hiring a licensed Contractor to assume this responsibility. lN L l understand as an 'Owner-Builde/ l am the responsible party of record on the permit. I understand that I may protect myself f(om potential flnancial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. PO,understandContraclorsarerequiredbylawtobelicensedandbondedinCalifomiaandtolisttheirlicensenumberson +rmits and contracts. tl Y" s t understand if I employ or otheMise engage any persons, other than California licensed Contractors, and the total value of ty construction is al leasl flve hundred dollars ($500). including labor and materials, I may be considered an'employer" under state lnd federal law. TU ,undersland if I am considered an 'employer" under state and Federal law, I must register with the state and federal qpvernment, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment Compensation of each 'employee. l also understand my failure to abide by these laws may subject me to serious financial risk. '1 , , undersland under California Contractors' State License Law, an Owner-Builder who builds single-family residential st(uctures 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. Y4 , 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 prrsonal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or nlaterials. SANTA ANA CITY COUNCIL L Mayor Pro Ted Wad 2 mrmanrnez sanl.-am oro Earmienloasanla anz cro Eds@ll!!a{E g9 P Daud Ben:v'des dLEnav'desOsa.ta lna do M eoas@s.ra'a.a do PI.ANNING & BUILDINC AGENCY 20 Civrc Center Plaza P.O. Box I988. Santa Ana. California 92702 www.Santa-ana.orq /oba NOTICE TO PROPERTY OWNER .4N I t g. t understand lmay obtain more information regarding my obligations as an'employer" from the lnlernal Revenue Service, the Urlted States Small Business Administralion, the Califomia Department of Benefit Payments, and the California Division of lndustrial Accidents. lalso understand lmaycontactthe Calilornia Contraclors' State License Board (CSLB) at 1-800-321-CSLB (2752) or slb.c:,for more information about licensed contractors ally '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 aid financially responsible for proposed construction activity at the following address Y f f . I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all arplicable laws and requirements that govem Owner-Builders as well as employers. Mr., agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have ovided on this form. Licensed contractors are regulated by laws designed to protect the public. lfyou contract with someone who does not havea license. lhe 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 of that individual or flrm is injured while working on your property, you may be held 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 the permit, /Vote.' A coDv of the ,roDeftv owner's d ver's license, form notarization. or other ted when rmil is issued to veri lhe owner's siqnature. Signature of Property Owner Date: /'0 /tt /2.a/ 7T77- Print name of 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 file the documents necessary to obtain an Owner-Builder Permit for my prolect. Scope of Construction Project (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 filled out the above information and certify its accuracy. Property Owneas Signature Date Print Name oI Owner: Note: A copy of the owner's driver's license, form notarization, or other yerification 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@sa.ta-ana do llayor Pro Tem, Ward 2 m ma.!nez@sa.ta-.^a do V ce.le Samrenlo emâ‚¬.to@snta{na do Bolond@s3nla-ana do P Oavld Benavdes dbâ‚¬naedesdsanta-ana oro MlleoasAsanlr-ana oro st na'e.o@sanla..na oro l Address of Authorized Agent: