HomeMy WebLinkAbout101105211 - PermitPermitCounter (714)647-5800 lnspection Requests i.714) 667-2738 lnspector Section: (714) 647-5853
Proj ect Address: 1221 E Warner Ave Unrt
Assessor'sParcel: 016-12048 Lol NA Block F Tract 696 Hisloric: No
Suite Range:
Zoning: Ml
City of Santa Ana 20 civic center Plaza (M-19), santa Ana. c492702 Bu ilding Permit #: 1O1105211
Pin #: 33952
Building Use.
Job Type:
Nature of Work:
Existing Bldg. & Use
Proposed Use:
Commercial
Alteration
Car Lifts
Commercial
Occupancy:
Constr Type:
Code:
Flood Zone:
# of Stories:
F-l
V B, SPK
cBc 2019
x-0602320278J
1st FL Area
2nd FL Area
Other Areas:
Garage Area:
Total
Patiol
T.l.Area:
Yards Req'd
Valuation: $20,000.00
0
Planning Conditions:
Owner:
Address
Contractor
Address:
Owner-Builder
Engineer:
Address.
Phone:
License #
Architecl /
Desiqner:
Address:
Phone
License #
Auto Collision Group
1221 E Warner Ave
Santa Ana, CA 92705
(562) 884-8134
Aulo Collision Group
EJD Engineering lnc
Ernest De Leon
14726 Ramona Ave (Suite 410-W1)
Chino, CA 91710
(909) 517-2lr51
67755
Phone:
Tenant
Phone:
Stale Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Polacy #:
Expires:
Planning Approval By:
Plan Checked Byl
Permit Issued By:
NPOES lnsp. Req'd: No
PWA lnsp Req'd: No
Planning lnsp. Req'd: No
Landscaping lnsp. Req'dr No
0 711600 2
0 7 7 76002
0 7 7 75002
017 760 0 2
07716002
0 77760 0 2
$172.64
$478.68
$8 10
$1 .00
$23.79
$59.30
Graham. Jefferv /
so, Anson N1
Zunrga. Atlissa \
Oale 1111212020
Dale.0212412021
Dale 03104/2021
Subject to Field
No Account#
74943
Total
Misc. Receipt
lvlisc Receapt
Misc. Receipt
5760 7
5i600
57770
s7672
5 7600
57607
Permit Fee
Plan Check Fee
Microfilm Records
BIdg. Stds. Revolving
General Plan Updale
lssuanceFire lnsp. Req'd:
Police lnsp. Req'd No
Flood Zone Cert. Req'd: No
Every pemit issued shall becone hvalid unless lhe wolk on lhe s/le aulhonzed by
such parmit is commenced wilhin360 days after ils tssuance.ot I the work aulhonzed
on the sle by such pemil,s suspendecl or abandgned lot a penod 01360 days aftet
the tlme the wotk ts commenced
lnspector MtD# 2020-162725
011't6002 5't600
01116002 s1601
01116002 51612
01116002 57770
$23.79
$231.94
$1.00
$8.10 Fee Total
Paid to Dale:
Balance Due
$743 51
$478.68
$264.83
Bldgi Address Range
Description of Work: Legalize 4 car lifts. Auth on file.
BUILDING- INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS
Set Backs
UFER Ground
SLAB Floor
Subf loor/VenVl nsulalion
Roof Sheathinq
Shear Wall
Framing
lnsu lation/Eneroy
Drywall
Ext./lnt. Lath
Brown Coat
I\/asonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Enqineer Final Report
Flood Zone Certil.
ll
FINAL ltt5tu Dkkt
Certilicate ol Occupancy
Notes, Remarks, Etc
OWNI]R BUII-DAR I)EL('^f, ATION
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issu.d(Se.. .lu)?, Civ. C )
APPLICANr DECLAR TION
I hr.tt rflirm okl.r Jrinihy ol Frlury onc ol rh.li)11,,*rn-! dcrhnrnrr
rxmnr$n llcrmir+ \l)cio\ N{tirrrrnr lcJcral R.atlarfn\ fl,rL il1r, P,n6)
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\Dpli(,nl or Ax$l SillNlu
Forms/Steeli Holdowns
Erection Pads
,
D.l.<'\
Planning & Building Agency
Building Safety Division
20 Civic Center Plaza
P.O. Box 1988 (M-19)
Santa Ana, CA 92702
(714) 647-5800
www.santa-ana.org
aPP-13 CBC 2016
NOTICE TO PROPERTY OWNER
Dear Property Owner:
An applicatio uil permit has been bmitted in your name listing yourself as the builder of the property improvementss
specified at
We are providing you with an Owner-Builder Acknowledqment and lnformation Veriflcation 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 agentofthe owner cannot execute this notice unlessyou, the property owner,
obtain the prior approval of the permitting authority.
OWNER'S ACKNOWLEGMENT AND VERIFICATION OF INFORMATON
D/RECI/O/VS: Read and initiat each statement below to signify you understand or verify this information.
Q, I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" build-
-ing 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 flnancial 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 prop-
erty.
/ob-Z I understand buildrng 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.
3. I understand as an "Owner-Buildei' I am the responsible party of record on the permit. I understand that I may protect
myself from potential financaal risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my
own
,/
n permr
I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers
ts and contracts.
.1,2
IZLS I understand if I employ or otheMise engage any persons, other than Calafornia licensed Contractors, and the total
-value of my construchon is at least five hundred dollars ($500), including labor and materials, I may be considered an
"employer" under state and federal law.
Za
,22A. 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' compensation disability insurance, and contribute to unemployment com-
pensation of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk.
G, I understand under California Contractors' State License Law, an Owner-Builder who builds single{amily residential
-structures cannot legally build them with the intent to offer them for sale, unless a/l work is performed by licensed subcontrac-
tors 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.
,/),)(-a 1.
/ .- ,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 finan-
-cial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workman-
ship or materials.
zLzl
br. I understand I may obtain more information regarding my obligataons as an "employei from the lnternal Revenue Ser-
"vice, the United States Small Business Administration, the California Department of Benefit Payments, and the California Divi-
sion of lndustrial Accidents. I also understand I may contact the Caiifornia Contractors' State License Board (CSLB) at 1-800-
321-CSLB (2752)or www.cslb.ca.qov for more information about licensed contractors
I,Q(1'> lO I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the
X*.*nr,,{UUf "EtW;"r"P}fopp;oooseo construction activity at the following ad-
27?ll I agree that, as the party legally and flnancially responsible for this proposed construction activity, I will abide by all
Yipplicable laws and requirements that govern Owner-Builders as well as employers.
6
h ave
12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I
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 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 DroDertv owner's driver's license, form notariza-
tion. or other verification acceDtable to the aaencv is reouired to be presented when the permit is issued fo verify the
p rope t7v ow ne r's s io n atu re.
Sagnature of Property Owner Date 9 z/
Print name of Owner {r..,
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)S11r Vlts
Pro.iect Location or Address 1Zz/ f zuLatt-u.tz evL./6u4 7s hr
Name of Authorized Agent
--<
-"-).)P,>y-- (', , o
Address of Authorized Agent 122( € Lut a,1,wv 4",- S'."wt- Z-. C-t+- '?t1-r-
Phone Number of Authorized Agent jCt - 6/5
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 '/" 1' '
Print Name of Owner .v)* 1t---
Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is re-
guired to be presented when the permit is issued to verify the property owner's signature.
...-._.>