HomeMy WebLinkAbout102105823 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA\27O2 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714\ 667-2738 lnspector Section: (714) 647-5853
Permit #: {O2t05823
Pin #: 86499h\
Proiect Address: 2028 S Oranoe Ave
Assessor's Parcel:403-162-07 Lot POR 12
Unrt Bldg: Address Range Suite Range:
Zoning: RlTract: 284 Histonc: No
Building Use: Single Family Owelling Occupancy: R-3, U 1st FL Area: Patio:
Job Type: Alteration Consk Type: V B 2nd FL Area: T.l.Area:
Nature of Work: N/V - Garage Code: cBc 2019 Other Areas: yards Req,d
Existing Bldg. & Use 2 SFDs w/det Garage Flood Zone: X-0602320276J
Garage Area: Valuation: S2,500.00
Proposed Use. # of Stories: Total: O
Description of Work: Remove all unpermitted work within garage to convert back to original permitted use. Frame in unpermittod wlndows, remove
unpermitt6d paftitions, remove unpermitted patio cover.
Planning Conditions:
Owner:
Address
Phone
Tenant
CCJH INVESTMENT CORP attn: HL
13081 Stantor
Santa Ana, CA 92705
4\7141744-6991
Contractor
Addressl
Owner-Bualder
Engineer
Address
Phone:
State Lic #:
Lic Type:
8sF! Lic #.
.U\blters' Compensation lnsurance
Carrier:
Policy #:
Expires:
Phone:
License #
Architect /
Desiqner:
Address
Phone:
License #
Planning Approval By: Enriquez, Gissel
Plan Checked By:
Permit lssued By: Chavez, Dave
NPDES lnsp. Req'd: No <?'
Oale: O2lO4l2O21
Date:
Dale 021041202'l
SubJecl to Field
Misc Receipt
[Iisc. Receipt
IrIisc. Receipt
0777600 2
0 777600 2
07776002
07776002
07776002
07776002
o7776002
Permil Fee
Microfilm Records
lnvestigation
Penalty
Bldg. Slds. Revolving
General Plan Update
lssuanceTotal
57601
57770
57607
57607
57672
57600
57607
$172.64
$4 05
$ 104.26
$261.96
$1 00
$23.79
$59.30
PWA lnsp. Req'd: No
Planning lnsp. Req'd: No
Fire lnsp. Req'd:
Police lnsp. Req'd ffi Account#
Landscaping lnsp. Req'd: No Flood Zone Cert. Req'd: No
Every permit issued shall become nvalid unless the wo* on the sle authonzed by
sl.]d,h pennit ts commenced withn 360 days aftet s issuance.ot tf the wod< authonzed
on the site by such peftni is suspended ot abandoned tor a petiod ot 360 days aftet
the tine the woak is commenced
lnspector MtD#" 2021-164087
01116002 51600
01116002 51601
01116002 51612
01116002 57770
$23.79
$598 16
$1 00
$4.05 Fee Totall
Paid to Date:
Balance Oue:
$627 00
s0 00
$627.00
Block E
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BUILDING- INSPECTOR RECORD
SITE.WORK DATE ID/SIG.OWNER BUII,DIiR DEI,CARATI0N
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Erection Pads
UFER Ground
Subf loor/VenVl nsulation
Rool Sheathinq
Shear Wall
Framinq
lnsu lation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enoineer Final Report
Flood Zone Certif .
t I
FINAL 111,1,a MIPK''
Certif icate of Occupancy
Notes, Remarks, Etc
4z
COMMENTS
. ),/4 />t
,,",., - A//s t
(-onlnclor-
Set Backs
SLAB Floor
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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 application for a burlding permit has been submitted In vour name listing yourself as the burlder of the property rmprovements
specitreo at ;-o:-A2 i' f )r,r-t+, AV< '-rr.,-i^ ,lr ^ <i' *>1" 7[ '/
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 atour offlcial address indicated, An agent of the owner cannot execute th is notice unless you, the property owne r,
obtain the prior approval of the permitting authority.
OWNER'S ACKNOWLEGMENT AND VERIFICATION OF INFORMATON
DIRECTIONS: Read and initial each statement below to signity you understand or verify this information
tt't. 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.
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.
,h'f 't 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 flnancial risk by hiring a licensed Contractor and having the permit flled in his or her name instead of my
own-
I
fu-o. , understand Contractors are required by law to be licensed and bonded in California and to list their license numbers
on permits 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 flve hundred dollars ($500), including labor and materials, I may be considered an
"employe/' under state and federal law.
),ry:_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 to serious financial risk.
7tz-r. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential
structures 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.
8. I understand as an Owner-Builder if I sell the property for which this permlt is issued, I may be held liable for any finan-47/_L
cial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workman-
ship or materials.
)--]
V-2_5. I understand I may obtain more information regarding my obligations as an "employer" from the lnternal Revenue Ser-
' vice, the United States Small Business Adminiskation. the Californaa Departm'erit of Benefit Payments, and the California Divi-
sion of lndustrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1 -800-
32'l-CSLB (2752) or www.cslb.ca.qov for more information about licensed contractors.
4V, ,o I am aware/-oartv leoallv and finan
dres's: - ')-r))f,
of and consent to an Owner-Builder bualding permit applied for in my name, and understand that I am the
d-cially sponsible r proposed co nstru ion activity at th e followin a{
/17 t
applica
1. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
ble laws and requirements that govern Owner-Builders as well as employers.
zttl,/r/t '?' 12. I 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 flnancial 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
whelher or not those Contractors are properly llcensed 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. ,Vote.' A copy gtlhe praperty owner's driver's license, form notariza-
tion, or other verification acceptable to the aaencv is reouired to be presented when the permit is issued to verifv the
Bropedy owner's siqnatu re.
;/4,/t1Sagnature of Property Owner Date
,4utrla /t ,,t
AUTHORIZATION OF AGENT TO ACT ON PROPERry OWNER'S BEHALF
Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, lhereby 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)
Project Location 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
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.
Print name of Owner
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