HomeMy WebLinkAbout10299221 - PermitProject Address: 1018 S Cyoress Ave
Assessor's Parcel 011-061-11 Lot POR 5
Bldg Address Range 1016-1018
Tract R. S. OF MCFADOEN-W1LSON Historic: No
Unrt Surte Range
Zonrng R2Block NA
CitV nf Santa Ana 20 Civrc Center Plaza (M-19)' Santa Ana, cA9?702 Bu ild ing
Permit Counter: (714) 647-5800 lnspection Requests. 1714) 667-2738 lnspector Section: (714) 647-5853 *?
Permit #: 1o299221
Pin #: t4516
Building Use:
Job Type.
Nature of Work.
Existing Bldg & Use
Proposed Use:
Oescription of Work
Single Family Dwelling
Alteration
N/V - Garage Addition
SFD wldet Garage
Occupancy:
Constr Type
Code:
Flood Zone:
# of Stories:
R.3, U
VB
cBc 2016
x-0602320276J
'1 st FL Area:
2nd FL Area:
Other Areas.
Garage Area
Total
Patro
T.l.Area:
Yards Req'd.
Valuation:
252
276 $1,000.00
Legalize addition to rear of garage. Addition shall be used as storage only. Remove unpermltted wall creating a bathroom.
Enclosed patio cover to be opened up and will remain as an open patio cover. Owner-Builder form on file.
Planning Conditions:
Owner
Address
vrcroR culcA
1018 CYPRESS AVE
Santa Ana, CA 927015840
Contractor
Address:
Owner-Builder
Engineer
Address.
Phone
License #
Archilect /
Desiqner:
Address:
Phone:
License #
6en,ral I
l11l6t-Il2
P.u i ld ine
l(\rr Up d(
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensalion lnsurance
Carrier:
Policy f;
Expires:
Planning Approval By: Fregoso, Vince Date: 02/1912019 Misc. Receipt
Plan Checked Byr Scotl Fazekas & Assoc. Dale. 0810512019 Misc Receipt
Permit lssued Byr Chavez, Dave Date: 01/0912020 Misc Receipt
NPDES lnsp. Req'd. No a-d Sublect to Field:
PWA lnsp. Req'dr No Fire lnsp. Req'd: No
Planning lnsp. Req'd: No Police lnsp. Req'd: No A count#-
Landscaping lnsp Req'dr No FloodZone Cert. Req'di No Ot116002 51600
Every perm $sued shallbecome nvahd uhlessthe wo onthes e authotized by 01116002 51601
such pemi $ comnencect wtthn 360 days aftet ts tssuance.or t the work authoraect 91 1 -1999? 1191?
on the sile by such permt $ suspended or abandoned fot a period ol 360 days after 01 1 16002 53600
lhe ume lhe wotk ts commenced
0 77 76002
01776002
0777500 2
017760 0 2
0 717600 2
0777600 2
07776002
$166.53
$230 87
$86 78
$2s2.69
$1.00
$22.95
$57 20
72216
Total
57 607
53600
57607
57607
57672
57600
57607
Permit Fee
Plan Check Fee
lnvestigation
Penalty
Bldg Stds. Revolving
General Plan Update
lssuance
$22.95
$563.20
$1 00
$8.71 Fee Tolal
Paid to Date
Balance Oue
$8'r8.02
$222 t6
$595.86
lnspector IvllD#: 2019-149556
Phone
Tenant:_4
BUILDING- INSPECTOB RECORD
SITE.WORK DATE ID/SIG.COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loorVe nVln su lation
Roof Sheathinq
Shear Wall
Framinq
lns u latio n/ En ero y
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Enqineer Final Report
\I ,l -
FINAL n
Certilicate ol Occupancy I
Notes, Remarks, Etc.
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Flood Zone Certif .
*" . /'?- Lo
,,U'9'2u
,/
lu{\?r
Planning & Building Agency
Building Safety Oivision
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
Dear Property Owner
NOTICE TO PROPERTY OWNER
a building permit has been su bmitted in our name listin o vou
a'r+
rself as the builder of the property improvementsqAn applicati
specified at
on fort()5 -\,'e q (2
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 ACKNOWLEGME NT AND VERIFICATION OF INFORMATON
DTRECTTOIVS.' Read and initial each statement below to signify you underctand or verify this information.
t.V - 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 pelson 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.
\l .-2. I 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.
I
! C S t understand as an 'Owner-Builde/' 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_
,l "\ c_4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers
on permits and contracts.
,t^\i g 5 I understand if I employ or otheMise 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
"employe/' under state and federal law.
, /^\S__6. 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 lo serious financial risk.
.t^\ q_7 I understand under California Contractors' State License Law, an Owner-Builder who builds singleJamily 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.
V C- A. I understand as an Owner-Builder if I sell the property for \uhich 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.
I
.t-\ L g. t understand I may obtain more information regarding my obligations as an "employei'from the lnternal Revenue Ser-
vice, the United States Small Business Administration, the California Department of Benefit Payments, and the California DivF
sion 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.qov for more information about licensed contractors.
.,^
V L 10. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the
pary
dress
legally anciall responsible for propos con ction activit at the followinandCIfled
9
slru
C, l l/
d-
7ccvl
.t-VL 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 govern Owner-Builders as well as employers.
[- f Z. t 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 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 Dropertv owner's driver's license. form notariza-
tion. or other verification acceDtable to the adencv ts reout re d to be presented when the permit is issued to verifv the
propertv ow n e r's s io n atu re.
Signature of Property Owner Date /-?-3b
Print name of Owner V,L,(,-ia',
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Scope of Construction Project (or Description of Work)
Project Location or Address
Name of Authorazed Agent
Address 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 fllled out the above
information and certify its accuracy.
Propedy Owneis Signature Date
Note: A copy of the owner's driver's license, form nota zation, or other verification acceptable to the agency is re-
quired to be presented when the pemit is issued to verify the property owner's signature.
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 obtaln an Owner-Builder
Permit for my proJect.
Print Name of Owner: