HomeMy WebLinkAbout101103934 - PermitProject Address: 4521W Oakfield Ave
Assessor's Parcel 100414-05 Lot 44
Unrt Bldg: Address Range Suite Range
Zoning: R1Block NA Tract 2191 Historic: No
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, cA92702 Bu ild ing
Permit Counte| (714) 647-5800 lnspection Requests. (7141667-?738 lnspector Section: (714) 647-5853 w
Permit#: lOll03934
Pin #: 51534
Building Use:
Job Type:
Nature of Work
Existing Bldg. & Use
Proposed Use:
Single Family Dwelling
Addition
Addition
Sfd w/att garage
R.3, U
VB
cBc 20't 9
A-0602320143J
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area:
Total:
Patio:
T.l.Area:
Yards Req'd:
Valuation: $45,000.00
Occupancy:
Constr Type
Code:
Flood Zone:
# of Stories:
't44
144
Description of Work: Add a new dining room, expand (2) bathrooms and remodel kitchen
Planning Conditions:
Ownerl
Address
Phone:
Tenant:
John & Erika Saucedo
4521 W Oakfield Avenue
Santa Ana, CA 92703
Cont.actor
Address
Engineer
Address
Phone:
Stale Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policy *:
Expires:
Phone
Lrcense #
Archilecl /
Desiqner.
Address:
Phone:
License #
Planning Approval By
Plan Checked By:
Permit lssued Byl
NPDES lnsp. Req'd:
PWA lnsp. Req'd. No
Planning Insp Req'd. No
Enriquez, Gissel
Scott Fazekas & Assoc.
*o
tnu'"t' *"<k
Dale:0612512020
Date. 1012012020
Dale 11lO3l2O2O
Subject to Field.
077 76002
07776002
07776002
0I907007
0 7776002
o7775002
0 77 76002
57607
53600
57770
24000
57672
57600
57607
Permit Fee
Plan Check Fee
Microtilm Records
SMIP - Category 1
Bldq. Stds. Revolving
General Plan Update
lssuance
Misc. Receipt
Misc Receipt
Misc. Receipt
74521
Total
$300.00
$300.00
$8.10
$5.8s
$2.00
$23 79
$59 30
Fire lnsp. Req'd:
Police lnsp. Req'd
NoNo Account#
Landscaping lnsp. Req'd: No Flood Zone Cert. Req'd: No
Every pem issuect shall become nvahd unless lhe wolk on lhe srle authonzed by
such pormt 6 cofifienced wlhin 360 days after ls issuance.ot tt lhe work authonzed
on tho s/te by such pez,ill's suspencled ot abandoned fot a penod ol 360 daysafter
lhe tine the wo* is cofimenced
lnspector MID#: 2020-159035
51600
51601
5161 2
57770
24000
s23.79
$359.30
$2.00
$8 10
$s.85
Fee Total.
Paid to Date:
Balance Due:
$699 04
$300 00
$399.04
01 116002
0'1 1 16002
01 1 16002
01116002
08901001
Owner-Builder
Cheryl Oemerco
Cheryl Oemarco
912l Atlanta #826
Huntington 8each, CA 92646
(7141173-6623
c23965
BUILDING- INSPECTOR RECOHD
SITE-WORK DATE ID/SIG.COMMENTS OWNER BUIt,Dl:N DEI,( RATION
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""-,u*
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Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Sublloor/VenVl nsulation
Roof Sheathinq
Shear Wall
Framino
lnsulationi Energy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
EnOineer Final Report
FINAL t{64 tL Cte alz-et<-dZry
Certificate ol Occupancy
Notes, Remarks, Etc
--+
Bev.0B 07 2015
Set Backs
Flood Zone Certif .
Planning & Building Agency
Building Safety Division
20 Civic CenterPlaza '
P.O. Box 1988 (M-19)
Santa Ana, CA 92702
(714) 647-s800
www.santa-ana.org
APP-13 CBC 2016
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 improvements
specified at
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 permrt 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 offlcial 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 ACKNOWLEGMENT AND VERIFICATION OF INFORMATON
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" 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 financial risk for any injuries sustained by an unlicensed person and
his or her employees while working on my prope(y. 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.
, , Z. t understand building 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-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.
. . 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers
6frlEmits and contracts.
, 5. I understand if I employ 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
"employei' under state and federal law.
'-r. 6. I understand if I am considered an "employel' under state and Federal law, Imust 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 subiect me to serious financial risk,
! 7. 1understand underCalifornia Contractors' State License Law, an Owner-Builder who builds single-family residential
slructures cannot legally build them with the intent to offer them for sale, unless a// 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.
-il-a. f understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any finan-
ciirl or personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the workman-
ship or materials.
'. L l understand I mav obtain more information regarding my obligations as an "employel'from the lnternal Revenue Ser-
vice, the Unrted States Small Business Administlation, the California Department of Ee-;refit Payments, and the California Divi-
sion of lndustrial Accidents. lalso understand lmaycontactthe California Contractors' State License Board (CSLB) atl-800-
321-CSLB (2752) or www.cslb.ca.qov for more information about licensed contractors.
. ' 10. I am aware of and consent to an Owner-Bu ilder building permit applied for in my name, and understand that I am the
party legally and financially responsible for proposed construction activity at the following ad-
dress LI tF- r-r I'U (ll^ac, . c (L7L3
\ y
f f. 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 govern Owner-Builders as well as employers.
-, 'l)'. lZ. t agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information l
fiave 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 coov of the proDeftv owner's driver's license, form notariza-
tion, or other veritication acceptable to the asencv is required to be presented when the permit is issued fo verily the
Signature of Property Owner
Print name of Owner
!IL U)\
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 flle the documents necessary to obtain an Owner-Builder
Permit for my project.
Scope of Construction Project (or Description of Work)
Project Locataon or Address
Name of Authorized Agent
Address 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
Print Name of Owner
Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is re-
quired to be presented when the permit is issued to verify the property owner's signature.
propeftv owner's siqnatu re.
Date:
Phone Number of Authorlzed Agent
nrto
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