HomeMy WebLinkAbout10193307 - Permitcity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA\27O2 Building
Permit Counter: (714) 647-5800 lnspection Requests: l.714)-667-2738 lnspector Sectaon: (714) 647-5853
Permit #: {O{93307
Pin #: 88891
EProject Address: 2202 1/2 W La Verne Avg
Assessor's Parcel:109-122-21 Lol: 22
U nit Bldg: Address Range
Block NA Tract: 1346 Hislorlc: No
Pla rning Conditions: All materials to match existing . Water heater enclosure
Owner:
Address
Contractor:
Address:
rint of buildin
Engineer:
Address.
Phone:
License #
Donald J lnman & Associates
Donald J lnman
5131 Fox Hilla Avenue
Buena Park, CA 90621
(714) 521-0554
11888
Tran Design lnc
Leon Tran
7332 20th Street, Suite E
Westminster, CA 92683
(714) 418-6604
Phone:
Tenant
Trang Ho
2202 W LA VERNE AVE
Santa Ana, CA 927043510
(714) 726-6040
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #l
Workers' Compensation lnsurance
Cariec
Policy #:
Expires:
Architect /
Desiqner:
Addressi
Phone:
License #
Permit lssued By:
NPDES lnsp. Req
sp Req'd Fire lnsp Req'd
Planning Approval By:
Plan Checked By: \
Mar, Escarl
o,A
Date: 10/'18/2017
Dale 1Ol'1712O17
Dale:1011812017
Subjecl to Field:
No
NIisc. Receipt
[,lisc. Receipt
lvlisc. Receipt
0 7776002
07776002
0 77 76002
i 73 73 002
08907007
01776002
0 77 76002
07776002
5760 7
53 600
57770
57997
24000
5 7672
s7600
57607
Permit Fee
PIan Check Fee
Microfilm Records
Res. Dev. Fee - S/E
SMIP - Category 1
Bldg. Slds. Revolving
General Plan Update
lssuance
$812.40
$1,233.26
$21.72
$5,732.80
$1 1.70
$4.00
$21.25
$52.98
s7.890 11
$1,115.04
$6,775.07
\_
, Teri
Account#
69717
Total
No
No
Planni lnsp YeS nsp.-Ye
Landscaping lnsp. Req'd: No Flood Zone Cert. Req'd: No
Every pemit issued shall bocorne invalid unless the tvor.k o, the srfe authorEed by
such permit $ cofifienced within180 days after tls issuance ot il the work authorized
on the s e by such pefinit is suspended ot abandoned lota peiodof180 days atler
lhe lime the wo* is comfiencecl
lnspector MID#: 2017-136903
011r600251600
01116002 51601
01'1 16002 51612
01116002 57770
08901001 24000
31313002 57991
$21.2s
$€65130-Q!;,.i,1.
s4.00
$21.72
$11.70
55,732.80
Fee Total:
Paid lo Date'
Balance Due
Suite Range:
Zoning: R'l
Building Use: Single Family Dwelling Occupancy: R-3 1st FL Area: 'l'104 Patio. 23O
Job Type: New Constr Type: V B 2nd FL Area: T tArea
Nature of work: 2nd Dwelling uniuPatio cover code: cBc 2016 other Areas: yards Req,d:
Existing Bldg & use: sfd watt garage ' Flood zoner x-0602320257J Garage Area: vatuation: $9o,ooo.ooProposed Use: 2nd Dweling Unit (ADU) # of Stories: , ,oO, lto4 :
Description of Work: New detached 2nd dwelling unit with J-bedrooms, 2-full bathrooms, living room, kitchen, dining room, attached open patio cover, &
water heater enclosure. SAUSD #3946.
BUILDING. INSPECTOR RECORD
SITE.WORK.DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATIoN
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Bu.in6s a Prof6{n c.d.) ny (-ir! or Co!,nr trt(t r.qutr6 t Fmr r..!dM. tllg. iqio\e &nslih or qu$}
srndu.. D.hr to n! N6c.. rleo r.qutrB rhc q,pli..d for 3u.h t flrn kr fik a !'sn.d $dmd rh, h. or nt ir licla.n derr
r. rh. rm\uFd olilE (..LdM r Li.6cl l.r (Chqrq 9. ( nmftm8 trnfi Sdlx). TlnO of oirision r of rht B*indq and !
Pnn6sionr (i'd.) or rhal lE or.hc ir.lrmpl lh.r.n.m ed rh. tsn for rh. d1.1.{.rdBhn An! rhLri{'rnfs<d.nr0ll l b-( r..
!T'r'lica.r ftr r FDn $t ct' rh. rtfli.dnr tr r cn il p..!hy of nor dor. rhd fir. hundrrd dollss i lt00)
LB $n6 of rh. FiFny. or my dplolG *nh tr.*6 s rh.ir sn. (otnFMon, sill& rh.qoll ard rh. ndc. ir fr{
inldxldl or oft .d lor sh (sd 7or,r, Buind Dd PNfei,ni Cod. Tn. (-o r*oi3 I {G lr{ Lh6.d rt'trlv ro d.sffi of
rh. rioltny n no hilds or trrymvB rhm)n, a $h.docsfi$i*h'n3.lforhmlforlhrcusfihtorhdo*nairlq.6.
F.\ klal rhri rurh mF.\.!d! e mr iddrl.d ( ofrqld ftr qk Il hos6t. tlE tlildin8 d nlro\ffi it $ld unhin on.ld
of compld Nn, rh. O*rs Uuik d will ha. fi. hr.&n ofFolins thd iE or sh. dxi mr toild or insro\ c thc FFF) for tlE FrIFx ot
l. so*6oirh. Fqdt, mc\.lusrcly c.dn 1'n! r h l(o*.n .ontradon lo $nslrud lhc F!.d (Sc. 7L\4'1. lt6tds
Md ftDftimtr ( od. lh.(o reror r L ic.n* l-a$ d.6 Nr !I,t'll n, u o* f,d aarf,oFn! s iF blild. or inPrc\ d rh6on.
ud \ho llinrdi aM iu.n l,oldi $nh 6 (i.ne1o(3) hcda.d NuuMr to rhc (nmracttri lj.N t-d\e)
I m .rmpr unrkr S<rFr ("
lt[(r &!-t!]t!
I hd.l,! .mm und6 p.naht of pqjuq olt ,\\
Ihry.Etrillmi.i.m!(Gn'ftdcorcon5r6s.lftcurcfdtr0116'comrdeton,BFtld.dforb)S<tnn1700ofrh.
I lbor codc, fo, rh. pdfomdc. oalfic work ror *hich rh. Frnn ir isu.d
I hav. lnd ulll m.inrrin *0116' romp.Ml bn i6ur!mc. s r.qu .n h\ sd Fr u00 .f lh. l$.r (-o{. foi lh. ncfo.rr@. .l
rt trrt ror*hrhrh.Fmn i3 sEl. Mt sor t6' compdsar hn fturtn.. c.ri6 dd Flq nunhd ftl
l..nit rhd in rh. Frfomsnc€ o I rb. *ort for *h(h rhk Fmi n iisd I lhall mr mploy !nr. p.ren r uvnrE
r, 6 r' b<Lom sbd ro llr urrl6 omFMion L{: ofc:lifonq ard +E rhd i, t lh.uld h6oft .ubj*r ro llE
w.*6 mmp<rdion provr(B ofstrion lT00 of lh. llhr (tde l !rdl, fodh{nhomdys htho.Fnrsil6
ltAiNlN(; Flilu. t1 w $orts' omp.nsnntr cov6.s. ii nnL$ful. sd shrll tubid .n mtloF lo mintl tn$nis md
cie'l nna up 16 on. hun&.d lh's.d
\rrnn 1076.rih. IrlFr (ixL hr6d
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1.."^.r {
I h6.b( a,Iun und6 FEtr) of Fjory lh, I D UEed u,'.Lr F.ri.i'n of (tuFd s (onn@'na rirh sdrcn 7000) orDn!rcn:r
of th. ausinBs ed PrcfssniN Cod.. .nd nry lic.M is in flll forcc drl .fidt
qalslalI:rjatrEriulqlq!!(I
I hd$, lmm undq F hy .f FJu,r_ rhd !h6. i ! codrucrion lcnd'ir a86.y tu ihc psforo.. . f rh. $ ori tor which lhir F nir i!
's!u.d(sd 1097, (-i! ( )
APPLICAIIT Df, CL iAIIOII
| ,@a rrmnundd pcntrlly olrFrury o..orrh.lollosints &(lsdotrs
Domhriin Pdnn$Ash.sror Norin.dh)n F.ddd! R.gul.rions (T[1. 10. tan6)
Rdtuiral L!'q or fhifrdn.
I cqrib rt6 rh. Ldr,l rcsuldoB r.a6drm 6b6lo! rdovtl.r. Rr ttPlictbl.lo lhn ,tilcr
I (drb rhd lt|,11Ed lhtr tpel'(.,hn nrl {0r. rhd rh. itnrc rnlntu'on s !on.d l.srarosmpl}
d k.]\3ld sl|(. I.B d, !E !o h{rlddB c.tuFtr .d hdd} tdlhM. r.F.5d tr 6 ol rhr Cn}
.r$r. Mr tl<l6mFn, ffl rNp.d'on pupo6
nrrn-,-h2-,*. l-.^ Lt lht.
PmkFn.m.rpr,{): lI'I1'lL+!e)>{_
Md ( ount! r. drE !F)nrh.
Set Backs
tto ilt,L
Erection Pads t>/";J-
[JFER Ground
SLAB Floor "/Su bfloor/VenVlnsulation I lr
Roof Sheathing q
Shear Wall +I
,l/rh I Mr
Framing q I K u
lnsulation/Energy t4 +\ll /\,1A -,+d"ii/4 *
Drywall I )
/lnt. Lath rl q r)li1{
Brown Coat I t?l
Masonry lt L I
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
FINAL lyrS\"tt t{,"\)?>
Certificate of Occupancy t-1 U t
.l 18.d5 .z .pJ 0 o NI.
tIt C 1
lr \ 't)
I I
I
Forms/Steel/Holdowns v
)
II
Notgs, Remarks, Etc.I
MAYOR
Miguel A. Pulido
MAYOR PRO TEM
Michele Martinez
COUNCILMEMBERS
P. David Benavides
Vicenle Sarmiento
Jose Solorio
SalTinajero
Juan Villegas
INTERIM CIIY MANAGER
Cynthia J. KurU
CITY ATTORNEY
Sonia R. Carvalho
CLERK OF THE COUNCIL
Maria O. Huizar
CITY OF SANTA ANA
PTANNING & BUILDING AGENCY
20 Civic Center Plaza
P.O. Box I988 . Santa Ana. Californla 92702
www.santa ana.orq/rpba
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
vements s ified at
t|,.
rmpro
;l \el I ,ta.r-4 ge{J-. k s, C,h 'ie?o(
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 buildlng 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
lf+ 2. lunderstand building permits are not required to be signed by property owners unlessthey are responsible for the
construction and are not hiring a licensed Contractor to assume this responsibility.
T l{ 3. I undersland as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect myself
from potentjal financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own.
t* 4. lunderstand Contractors are required bylawto be licensed and bonded in Califomia and to list their license numbers on
permits and contracts.
r{t 5. lunderstand if I employ or otherwise engage any persons, other than 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 "employef und er state
and federal law.
T+t 6. lunderstand if lamconsideredan "employer" understateand Federal law, I must register with the state and federal
government, withhold payroll taxes, provide workers compensation disability insurance, and contribute to unemployment
compensation ofeach employee." I also understand my tailure to abide by these laws may subject me to serious financial risk.
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 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.
Bi- 8. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held lia ble for any financial or
personal injuries sustained by any subsequent owner(s) that result fiom any latent construction defects in the workmanship or
materials.
SANTA ANA CITY COUNCIL
mo!l'do@san€'ana do
lelayq fto Tem, Ward 2
m man ne2,asanta-ana do
vrcenre samienlo
6am'en|oAsanta-ana do Ed9re@ladrillasg !'!e!as@ri!u:a@-e!9 slrnaieroosa.ta-ana orc
DIRECTIONS: Read and initial each statement below to signify you understand or verify this information.
-1ft 1. lunderstand a frequent practice of unlicensed persons isto havethe properly owner obtain an "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 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. 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.
-( 9. I understand I may obtain more information regarding my obligations as an "employer" Irom the lnternal Revenue Service, the
United States Small Business Administration, the California Department of Benefit Payments, and the Califomia Division of lndustrial
Accidents. lalso understand lmayconlactthe Calilornia Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752)or
www.cslb.ca.oov for more information about licensed contractors.
rtf- 10. Iam aware of andconsenttoan Owner-Builder building permit applied forin myname, and understand that Iamthepafty
legally and financially responsible for proposed construclion activity at the following
address:
r t, 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 that govem Owner-Builders as well as employers.
!L12. I agree to notifr/ 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 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 orfirm is injured while working on your property, you may be held liable for damag es. lfyou
obtain a permit as Owner-Builder and wish to hire Contactors, you ,,vill be responsible for verifying whether or not those Contraclors are
properly licensed and the status of their workers' compensation insurance coverage.
Beforo 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 coov of the DroDertv owner's driver's license, form notarization. or other
verification acceDtable to the qencv is reouired lo be oresenled when the Dermit is issue to verify the propertv owner's
siqnature.
Signature of Property owner 1fr"",a tb Date
Print name of Owner -CANa--J]0
Project Location or Address
Address of Authonzed 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 to
be presented when the permit is issued to verify the property owner's signature.
SANTA ANA CITY COUNCIL
mpuhdo@sant -ana.oro
Mayo. Pro Tem Ward 2
mrmEninez@sanlE-aoa do
Vi@.le $mienlo
6emrento@sanla-ana o.o 60lonoasanlaa..oro dbanavrdesaasanla-ana.oro rsl&98@!,a!E:a4a-arq sl'rsrero@sanla ana oro
AUTHORIZATION OF AGENT TO ACT ON PROPERW OWNER'S BEHALF
Excluding the Notice to Property Owner, the execution of which I undeBtand 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
prolect.
ScopeofconstructionProject(orDeScriptionofwork);
Name of Authorized Agent;
Phone Number of Authorized Agent: