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Home My WebLink About101105975 - PermitProject Address: 4914 W Flioht Ave Assessor's Parcel 108-365-06 Lol 23 Bldg: Address Range Suite Range: Zoning: R1Tract: 3652 city of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA\27O2 Building Permit Counter: (714) 647-5800 lnspection Requesls: (714) 667-2738 lnspector Section: (714) 647-5853 Permit#: {O{{05975 Pin #: 29915ht Building Use: Single Family Dwelling Occupancy: R-3, U lst FL Area: Patio: Job Type: Reroof Constr Type: V B 2nd FL Area: T.l.Area: Nature ofwork: Reroof code: cBc 2019 other Areas: yards Req,d: Existing Bldg. & Use: Std Watt garage Flood Zone: X-0602320256J Garage Area: Valuation: $10,000.00 Proposed Use: # of Stories: Total: Description of Work: Reroof houss & attached garage - remove existing, replace any damaged sheathing, install comp shinoles. Handout8 given. Planning Conditions: Owner: Address: Phone: Tenant: Chi Diep 491/t W Flight Ave Santa Ana, CA 92704 (7141232-3624 Owner-Builder Engineer Address Phone: State Lic #: Lic Type: Bus. Lic #; Workers' Compensalion lnsurance Carrier: Policy #: Expires: Phone: License # Archilect / Desiqner: Address: Phone: License #: Planning Approval By: Plan Checked tr, , .. Permil lssued By: \ Graham, Jeffery en, Julie Oale: 0212512021 Dalel Dale 0212512021 Subjecl to Field: Misc. Receipt Misc. Receipl Misc. Receipt 07776002 07776002 077760 02 0777600 2 07776002 57607 57770 576 72 57600 57607 $345.28 s4.05 $1.00 $23.79 $s9.30 Permit Fee Microfilm Records Bldg. Stds. Revolving General Plan Update lssuanceNPDES lnsp. Req'dl PWA lnsp. Req'd: Planning lnsp. Req'd o No No No Fire lnsp. Req'd: Police lnsp. Req'd No No Account#Total Landscaping lnsp Req'd Flood Zone Cert. Req'dr No Every pe nit issued shall become invalid unless lhe evo.r( on the slte authorized by such pemit is commencod wtthth360 ddys after its issuâ‚¬nce.ot it the wod< authoized on the site by such permit ts suspended ot abdndoned lot a pedod ol,360 days after the tirfie the wofu is commenced lnspector 01 I 16002 51600 01116002 51501 01 1 '16002 51612 01 1 16002 57770 $23.79 $404.58 $1.00 s4.05 Fee Total: Paid to Date: Balance Due: $433.42 $0.00 $433.42 Block: NA Historic: No Unit: Contractor; Address: .a: ) MtD#. 2021-164532 BUILDING. INSPECTOR RECORD SITE-WOBK DATE ID/SIG.COMMENTS olrNEL EUlt-llEl. DEI-catATloN I hcr.hy ll,irh uRl.r flnrxy tn Frjury rhrr I rm .rcmfl In,nr rh. 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Lath Brown Coat Masonry Pool Fence T-Bar Handicap Req Deputy Final Report Enqineer Final Report Flood Zone Certif I FINAL 7-tf4(/ac /,*Jf-4Av?ry Certilicate ot Occupancy Notes, Remarks, Etc I I l.trrn\ ('l,i$ aPP-13 CBC 2016 Dear Property Owner: An application for a buil din specified at NOTICE TO PROPERTY OWNER has bee submitted in yo rna listing rself as the bu ilder of the property improvementsq)g o/uL 5/t ht< We are providing you with an Owner-Builder Acknowledqment 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 ACKNOWLEGMENT AND VERIFICATION OF INFORMATON DIRECIIO/VS; Read and initial each statement below to signify you understand or verify this information. ',P 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Buildei' 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 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. 1( N' 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 responslbility. 6 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. -At O tunderstand Contractors are required by law to be licensed and bonded in Californla and to list their license numbers on permits and contracts. 14) S. t 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 "employer" under state and federal law. WA. I understand if I am considered an "employel' under state and Federal law, I must register with the state and federal government, withhold payroll taxes, provide worksrs' 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 flnancial risk- ('Ul t. I understand under California Contractors' State License Law, an Owner-Builder who builds singleJamily residential sArlctures 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)-U. t understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any finan- o-ral or personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the workman- ship or materials. Planning & Building Agency Building Safety Division 20 Civic Center Plaza P.O. Box 1988 (M-19) Santa Ana, CA 92702 (714) 647-s800 www.santa-ana.org U I S. 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 Benefit Payments, and the California Divi- sion of lndustrial Accidents. lalso 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. AL10. I am aware of and consent to an Owner-Builder 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: Lnl// ll.l agree that, as the party legally and financially responsible for thas proposed construction activity, I will abide by all applicable laws and requirements that govern Owner-Builders as well as employers. ,.. /fu:rlZ I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I \na!e 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 p ermit, /Vofe. A copv of the prepefttt oulner's driver's license, form notariza- tion. or other verification acceDtable to the adencv is reou re d to be presented when the permif is issued to verifv the proDertv ow ner's sion atu re. Signature of Property Owner l/tdttnr/tz;:,{Date-fz Print name of owner ( 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 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 re- quired to be presented when the permit is issued to verify the property owner's signature. I