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Home My WebLink About102104875 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA,27O2 Building Permat Counter: (714) 647- EOO lnspectaon Requests: (714) 667-2738 lnspector Section: (714) 647-5853 A! Permit #: 1O21O4A75 Pin #: 776Al| Project Address: 5114 W Sixteenth St Assessor's Parcel 't00-17042 Lot NA Unit Bldg Address Range: 5114-51'16 Historic: No Suite Range: Zoning: R2Block NA Tract: NA Building Use: Job Type: Nature of Work Existing Bldg. & Use Proposed Use: Single Family Dwelling Alteration N/V - Windows Sfd w/det garage Occupancy: Constr Type Code: Flood Zone: # of Stories: 'l st FL Area: 2nd FL Area: Other Areas: Garage Area Total: Patio: T l.Area: Yards Req'd: Valuataon:s6,000.00 Description of Work: Legalize window change out and demo unpermitt6d patio covsr. Planning Conditions: Owner: Address Phone. Tenant Contractor Address: Engineer Addressl Melissa Pinon 5116 W 16lh Streel Santa Ana, CA 92703 (7141 561-217',| Owner-Builder Phone: State Lic #: Lic Type: Bus. Lic #: Workers' Compensalion lnsurance Carrier: Policy #: Expires: Phone: License #: Archatect / Desiqner: Address: Phone: License # Planning Approval 8y: Plan Checked Byl Permil lssued By: NPDES lnsp. Req'd: PWA lnsp. Req'd: Planning lnsp. Req'd: Landscaping lnsp. Req'd Graham, Jeffery Verduzco, Violet 'l Dale. 1010712020 Date: Dale: 1OlO7l2O2O Subject to Field: Misc Receipt Misc. Receipt Misc. Receipt 0 71760 0 2 0 71150 0 2 07775002 07776002 o7716002 0 7116002 o7716002 5750 7 57770 57607 5760 7 516 72 57 600 57 501 Permil Fee Microfilm Records lnvestigation Penally Bldg. Stds. Revolving General Plan Update lssuance No No No No Account#Total $345.28 $4.05 $ 104.26 $261 .96 $1.00 $23.79 $59.30 Fire lnsp Req'd: No Poljce lnsp. Req'd: No Flood Zone Cerl. Req'd: No Every pemtt issued shall become invalid unless the wo* on lhe site authon2ed by such permit is commenced within360 days after its tssuahce.or t the work authorized on the site by such permtt is suspended or abandonod for a penod o1360 days aftel the hme the work is commenced lnspector 01 1 16002 51600 01 1 16002 51601 01 1 16002 51612 01 116002 57770 $23.79 $770.80 $1.00 $4.05 Fee Total: Paid to Date: Balance Due: $799 64 $0.00 $799.64 R-3 VB cBc 2019 A-0602320143J \ MID#: 2020-161989 BUILDING. INSPECTOR RECORD SITE-WORK DATE tD/stG.COMMENTS OWNF:R AU[,DER DEI.CAI'AIION I l*r.hy .ruu un!.! Fmh, al tcrjury rnd I an c{corrr tr.m rhc Ci,!B&r: l.krn* tjs nr lh. fullowr! rclqr (Scc ?(r]l.t llu$..s r l ltolcsrr C( .)i An, (- y,, Cou.ry *h(h rcqu".1 r Fmi t, nmnul. .lis. mtrorc. &mnAn.r rIEr .n, (orrf.. run, d! a\u4.. ,l{! r.quftr rh. qilllirnr l,r srh |tr rn,l,L a iSrJ {!r.mnt th{ lr {r 6l,(.nql lurrulnr k' rlr ln'vNrns ol rh. (:(mrr(nr'$ I.rctrscd u* (Chali.rrr. 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Lath Brown Coal l\r1aso n ry Pool Fence T-Bar Handicap Req. Deputy Final Report Engineer Final Report Flood Zone Cerlil FINAL 7'lt- z-1 R/<-/t ^Ja-/2.3 *2, Certificate ol Occupancy Notes, Remarks, Etc. I I Forms/Steeli Holdowns I I I ;).3-'J I Planning & Building Agency Building Safety Division 20 Civic Center Plaza P.O. Box 1988 (M-l9) Santa Ana, CA 92702 (714) 647-s800 www.santa-ana.org APP-r3 CBC 2016 Dear Property Owner. NOTICE TO PROPERry OWNER rn your ame listin g you elf a he bu ild the ro improvementsAn applicati specified at on for a buildi has been s b o p We are providing you with an Owner-Builder Acknowledoment 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 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 D/RECIIO/YS: 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-Builde/' build- g 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- ertv. \NJ.)f--]Z t understand burlding 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-Builde/' I am the responsible party of record on the permit. I understand that I may protect myse t from potentral financial risk by hiring a licensed Contractor and having the permlt filed in his or her name instead of my own. \NP\\ -\ 4. I understand Contractors are required by law to be licensed and bonded in Californla and to list their license numbers on permits and contracts. 5. I understand if lemploy or otheMise engage any persons, other than California licensed Contractors, and the total lue of my construct,on is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. -S\ ' understand if I am considered an "employer" under state and Federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment com- pensation of each "employee." I also understand my fallure to ablde by these laws may subject me to serious financial risk. \$V\. l. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family residentialffiIrr"s cannot legally build them with the intent to offer them for sale, unless a// work is performed by iicensed subcontrac- tors and the number of structures does not exceed four within any calendar years, or all of the work is performed under contract with a licensed general buildang Contractor 8. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any finan- bial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workman- ship or materials. . ^ '\t/ \l\e I understand I may obtain more information regarding my obligations as an "employer" from the lnternal Revenue Ser- vice, the United States Small Business Administration, the California Department of Beneflt Payments, and the California DivF sion of lndustrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800- 321-CSLB (2752) or www.cslb.ca.oov for more information about licensed contractors. _^p$" \tO. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party dress legally n ncia ll y res S ro pos c str uAion activtA q"att following ad- \a 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 hav 12. I agree to notify the rssuer of this form immediately of any additions. deletrons, or changes to any of the information I provlded 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. l/ote.'A coDv of the DroDeftv owner's driver's license, form notariza- tion, or other verification acceptable to the aqency is req uired to be Dresented when the Dermit is issued lo verifv the proDertv owne r's sion atu re. Srg nature of Property Owner Date \U Print name of Owner AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of whach 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) Pro.lect Location or Address 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 filled out the above information and certify its accuracy. Property Owneis Sagnature Date Print Name of Owner: Note: A copy ot the owner's driver's license, form notatization, or other verification acceptable to the agency is re- quired to be presented when the permit is issued to verify tho property owner's signature. ( \ Name of Authorized Agent: {bA'D CAE,.r'v'tr DP-nrcal aa 'lr.v up , L\.-i' /, 'v '-l \ \,oV r{r7 ,.^ ..-) I 5\\."'/ I v 6tl"\Nr \," A r-Y4 br$^t*^ APPRO FqA.}(M'r' n_.pan*,.'4 :}LI]IJ [.-rrtV & t15)l^'. 'A8râ‚¬R r , )&-l!1fr r pLA 1.a t t q,a{i TIt \I\' E F] 'Y F t, l{ar(fi-- tt F:]'f,l Ql: ,l -*A o I \L)r{ D.s'\-rxq \ I .r0 ,-tr \ *N\abt'\ \ (tr\'Dtif r\- R( rJ5 t fi.,1-*-r\t-(-rtl'O 11) - .l PLrlJt irj.i t ,JT|J E IEVIS{,]:.rE .. .T TO tillrJ chr (i:D ,.,ND C R rir ',ti I ) IJ rl rJ I lial[ilrl')ll N/ \-dr<A \ \ BeUroow^ )-- L/I \ I\ PERM[TTYPE: MECH tDLtulS 7{ ., CONSTS T'/PE-b Itrt,( t- i,l ( fio lro NO ES NO YES NO