HomeMy WebLinkAbout40132672 - PermitProject Address: 3635 Westminster Ave
Assessor'sParcel: 198-081-27 Lot NA
Unit:
Block; NA
Bldg:
Tract NA
AddressRange: 3628-3636.
Historic: No
Suite Range:
Zoning: SP2
q
City of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, C492702
lnspection Requests: (7 1 41 667-27 38 lnspector Section: (714) 647-5853
Mec ha n ica I Permit #: 40132672
Pin #: 18255
Phone:
Tenant Name:
Contractor:
Address:
AV Property Managemenl Enterprlse Ll
3636 WestminEter Ave
Santa Ana, CA 927031,145
(714) 936{692
College of Physical Arts, Language & T
Orvner-Builder
Fee Type Amount Qty Fee
01116002 51604 Wall Heater/Floor Furna 65.57 3.00 $196.71
01 1 '16002 5160C Gsneral Plan Update 22.08 1.00 $22.08
01116002 51604 lssuance 55.04 1.00 555.04
80tch+:46233 - 10/3/2018 I0: ccuEr'l-AF
office: CTYH Tronsi: 53 I oi I
Acctc: Ref+: 4t113267:
Rcpti:Q2405984 - 10/3/201.9 1l:12 An
Tnonsoct ion Totol t27J.8J
AV Properts llonogerent EnterPrPhone
Slate Lic #:
Lic Type:
Bus. Lic #
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
ltech on i co I
0ll 16(12- 5160,t000-
Geierol Plon lledote Fee
0l u6m2- 516@0flF
llosten CordCCi:firftflfirrrt675
i251.7t
t22.rls
r2?3.83
Arthg!04681C
Building Use:
Job Type:
Nature of Work
Commercial
Tenant lmprovement
TI
Occupancy:
Constr Type:
Code:
B
V B, SPK
cMc 2016
Notes: Auth on file.
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By: Zuniga, Allissa
Subject to Field:
Buildins Permit f: 10195064
Ewry pemit issued shall beco,7,o invald unless the wo on the site
autlloizod by such pemil is commenced within 1 80 doys affet its
issuanc.p, ot if lhe work auttlotizod on lha site by such pemil is suspendcd
or abandoned tor a padd o1180 days afrer the timo the wo* is
commer@d.
lnspector MID#: 20'16-13'1245
't 0/03/2018
Account#
01116002 51600
01 1 16002 51604
Fee Total
Paid to Date:
Balanco Due:
Date:
Date:
Date:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
$22.08
$251.75
$273.83
$0.00
s273.83
Owner:
Address:
MECHANICAL.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS orr\|r Bl .trtR t)tt r \R\ll0\
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l).mhion PrrmirrArtEslN Norif*'r.n l.drdl RcsoLrion. (Til. ilo. Prn6r
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onl, rn.r. inJ Srr( lnq\r(1,'rtr'!
.boE riri'En Frr.nr l',
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;,,:')J l''il'?
Appliances
Metal Fire Place
Evaporative Cooler
Furnace
Compressor
fvlisc. Equipment
Duct Work
Pre-lnsulation
lnsulation
Smoke Detectors lnstalled
Rouqh Ductwork
Vents
Toilet Room / Clothes Dryer
Residential Banqe
Other
Hood
Type I Hood
Type ll Hood
Grease Duct
Fire Damper
Openinqs
lnstallation
F.D. Drop Test
Above Hard Lid
Above T-Bar
Rouqh Mech.
Meler Release
FINAL /0 t0.R afrr,ry
Notes, Remarks, Etc.
;iop[r
vL '1./
w-'
Final Test
MAYOR
[4iguelA. Pulido
MAYOR PRO TEM
Michele Martinez
COUNCILI\,4EMBERS
P. David Benavides
Vicente Sarmiento
Jose Solorio
Sal Tinajero
Juan Villegas CITY OF SANTA ANA
PLANNINC & EUILDINC ACENCY
20 Civic Center Plaza
P.O. Box I988 . Santa Ana. California 92702
www.santa ana.orgr 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
- Snnri-A /<niA Cfr (J7d.
CITY MANAGER
Raul Godinez ll
CITY ATTORNEY
Sonia R. Carvalho
CLERK OF THE COUNCIL
Mana D. Huizar
)t>p-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 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 verify this information.
N t-1. I understand a frequent practice of unlicensed persons is to have the property 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 sub.iect 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.t"l ,I \ V 2. I understand building permits are not required to be signed by property owners unless they are responsible for
the construction and are not h'iring a licensed Contractor to assume this responsibility.
It!-jla 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.
t{- /o I understand Contractors are required by law to be licensed and bonded in California and to list their license
nf6Eers on permits and contracts.*l tl\\ \'/ 5. lunderstand if I em ploy or otherwise 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
I
"employer" under state and federal law.
f,-/ U I understand if I am considered an "employer" under state and Federal law, I must register with the state and
federal government, withhold payroll taxes, provide workers' com pensation disability insurancel 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.
fNL 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
SANTA ANA CITY COUNCIL
nouldo@ssnra-ana do
llayot Pra 1em, wad 2
mrt]la(ne2@santa.ana.orq 6crono@sa.ra-anaora dbensvdesrosanrs-anaoro rvill&as@sa.ta ana tro sl naiero@santa-ana orq
improvements specified at -at
licensed subcontractors and the number of structures does not exceed four within any calendar years, or all of the work is
peformed under contract with a licensed general building Contractor.LIn{./t \/ 8. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any
finaic-ial or personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the
manship or materials
9. I understand I may obtain more information regarding my obligations as an "employer'from the lnternal Revenue
Service, the United States Small Business Administration, the California Department of Benefit Payments, and the
California Division of lndustrial Accidents. I also understand I may contact the California Contractors' State License Board
(CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.oov for more information about licensed contractors.il,'
t/ f O. I am aware of and consent tqan Owner-Builder building permit applied for in my name, and understand that I am
the party I '\',aw""i'::iy_ffitr1:w r proposed construction activity at the following
work
N/
aqdress:
1-1' tt I agree that, as the party legally and financially responsible for this proposed construction activity, lwill abide by
all.Fpplicable laws and requirements that govern Owner-Builders as well as employers.)\\\1 e.I 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. 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 will
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 the agency responsible for issuing the permit. /Vote.' A copv of the propertv owner's driver's license.
form notarization, or other verification acceptable to the aoe nc v is reouired to be oresented when the permit is
issued fo verifu the owner's sidnature
olglag(>
Printnameofowner Arr.,Gr Lr I! A vo
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
project.
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 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 propedy owner's signature.
SANTA ANA CITY COUNCIL
mour do@sa.ra-ana o.o
Mayor Pro Tem. Wa.d 2
m na.lhez@sanra-6na.do vsamenloasa.ra-ana oro 6.lo.ro@s.nla€na do
P Daud Beruud6
dbeiaudes@sanla-ane oro M reas@sant3-.n5 do st naEroAsa.ta-ana orc
Signature of Prop ery owner (-4-i- {At-J oarc:
Address of Authorized Agent;