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Home My WebLink About102101831 - PermitCfry nf Santa Ana 20 civic center Plaza (M-19), santa Ana., cA927o2 Building Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnsfeclor Section: (714\ 647-5853 Permit#: lO2lOl83l Pin #: 68114Py Project Address: 926 S Garnsey St Assessor's Parcel 010-251-19 Lol: POR 10, POR 11 Block 19 Bldg Address Ra ge TTact: POLYTECHNIC VILLA U|lrt Hrsloflc No Suite Range; Zoning: SD40 Building Use: Single Family Dwsllang Occupancy: R-3, U l st FL Area: Patro: Job Type: Alteration Constr Type: V B 2nd FL Area: T.l.Areal Nature of work. Demo Addn/shed/Repair code: cBc 2016 other Areas. yards Req,d: Exrsting Bldg & Use: Sfd w/att garage Flood Zone: X-0602320257J Garage Area: Valuation: 53,000.00Proposed Use: # of Stories l To,"l Description of Work: Demo unpermitted addn @ rear of garage, Demo (2) sheds @ rear yard, Remove ceiling drywall from garage & return garage to its intended use for parking. Remove outside laundry facilities Planning Conditions: All Repairs To Exterior Wall To Match Existing. No Conduit To Be Erposed. Servico Box To Be Painted To Match House. Owneri Address Plrone Tenant: Maria Galvan 926 S Garnsey St Santa A0a, CA 92701 (7141 329-2501 Conl.actor Address Owner-Builder Engineer Addressl Phone: State Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance Carrier: Policy #: Expires: Phone: Liceose , Planning Approval tsy Plan Checked By: Permlt lssued By: NPDES lnsp. Req PWA lnsp. Req'd Date'10/14/2019 Date: Date 10/14/2019 Subject to Freld. Misc. Receipl Misc. Receipt Misc. Receipt 0 7 7 76002 o7776002 o7775002 017 76002 077 7600 2 o7776002 Permit Fee lnvestigation Penalty Bldg. Stds. Revolving General Plan Update lssuance N be, Jill l-/ 57607 5750 7 5760 7 57672 57600 57607 $166.53 $ 100.57 $252.69 $1.00 $22.95 $57.20 rodowski, Tel1 Planning lr)sp. Req'd Fire lnsp. Req'd: Police lnsp. Req'd Laldscaping lnsp Req'd No No Flood Zone Cert. Req'd: No Every peut l tssuec! shall becone nvahd unless the wor* o, the s,le aulhotized by such pefit t ts cotntnenced w hto 360 days aller ls issuance.or I the work authoized ofi lhe sle by such penn ts suspencled ot abanaloned lot a peroQ! ot360 days aftet the trne the wotk ts cotnnenced No No Account#Total 01 1 16002 5't600 01 1 16002 51601 0't 1 't 6002 5 1 6'1 2 $22.95 $576 99 $1 00 $600.94 $0 00 $600.94 lnspector MrD#: 201e-1 551 od{OTICE OF VIOI.ATION Fee Total Pard to Date. Balance Due Architecl / Desiqner: Address: Phone: License # BUILDING. INSPECTOR RECORD SITE.WORK DATE ID/SIG.COMMENTS Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Subfloor/VenYlnsulation Roof Sheathing Shear Wall Framing lnsulation/Energy Drywall Ext./lnt. Lath Brown Coat Masonry Pool Fence T-Bar Handicap Req Deputy Final Report Enqineer Final Report Flood Zone Certif. FINAL 3'tl -an LUg Ne,ro->-zn Certificate of Occupancy Notes, Remarks, Etc. 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Box 1988 (M-19) santa Ana, cA 92702 (714) 647-s800 www,santa-ana.org APP-'13 CBC 2016 Dear Property An appllcation for a building submitted in ur na s OU f"",*cil#*mentseitSe { \ "Ild 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 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 DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. I I 6 t . t understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" build- ing bermit 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 llable 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. lkq-Z t understand building permits are not required to be signed by property owners unless they are responsible for the con'struction and are not hiring a licensed Contractor to assume this responsibility. Il f-, S. f understand as an "Owner-Builde/ lam 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. I ) 6 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. Nl (Z 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 "employer" under state and federal law. !l1A t understand if lam considered an "employer" understateand Federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disabllity 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. _7 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 structules does not exceed four within any calendar years, or all of the work is performed under contract with a Iicensed general building Contractor. ll4-A I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any f inan- cldl or personal in.iuries sustained by any subsequent owner(s) that result from any latent construction defects in the workman- ship or materials. NOTICE TO PROPERTY OWNER L-..-- \'{ I I \ l,l-,'. g. I understand I may obtain more information regarding my obligations as an "employe/'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. 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. l-1 ., , lO.l 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 flnancially responsible for proposed construction activity at the following ad- dress: U-_11. 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. ME_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 financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Conkactors 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. Ivote.' A copv of the Dropertv owner's driver's license, form notariza- tion, or other verification acceptable to the aoencv is reouired to be Dresented when the permit is issued to verifv the propertv owner's siqnatu re. 2a,.:â‚¬,/'".-Signature of Property Owner Date Print name of owner lLtrro 6q /ro ,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, I hereby authorize the followang 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 Authorlzed Agent: Address of Authorized Agent Phone Number of Authorized Agent: 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 propefty owner's signature. /D ,//4 ,/.tale 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. I (>-- C.)7. I I I \ zo J- 5o lr.o ul C) to z -v