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Home My WebLink About40135821 - PermitProject Address: 2021 W Twelfth St Assessor'sParcel: 00,4-171-15 Lot: 15 Unit: Block: NA Bldg: Tract 1685 Address Range: Historic: No Suite Range: Zoning: R'l city of santa Ana 20 civic center Plaza (M-19), santa Ana, cAg27o2 Mechanical Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: f/14) 647-5853 Permit #: 4fJ135821 Pin #: 50395 Owner: Address Phone: Tenent Name: Contraclor: Address: HENRY DO 2021 w 't2TH ST sanra Ana, cA 927031926 (7141657-2280 Owner-Builder 01 1 16002 51604 01116002 5160C 01116002 51604 01't16002 5777C Amount 97.17 23.79 59.30 4.05 Foo Typo Compressor General Plan Update lssuance Microfilm Records Qty 1.00 1.00 1.00 1.00 Foe $97.17 s23.79 $s9.30 $4.05 Phone State Lic *: Lic Type: Bus. Lic #: Workers' Compensation lnsurance: Carrier: Policy *: Expires: Eotchi:5UJt6 - off ice: CTYH Accta: Fceli:0337722t| Ironsoct ion Tot I0: ovrcLonr( n5i. JReft: 1t11358i 8/ t2/2q2t 8.$ An t433.25 J23.79 3r56-a7 t4.0g t433.25 Autha:06431! HTHhY OO Genenol PIon uldoie 01116002- 51600U0(r- nech6n icol 01116002- 516u4000- nicrof ilr A Docurenl 0t 1161102- 57770000- U isoBuilding Use: Job Type: Nalure of Work Single Family Owelling Alteratlon AC Compressol Occupancy: Constr Type: Code: R.3, U VB c tc 2019 Notes lnstall an compressor ln rear yard. Planninq Condations: Planning Approval By: Marlin, Eric Plan Checked By Permit lssued Amsden, Julie Subjecl to Field: Building Permit #: Ewry pemit issuod shall bocgmo invaliT unless the wgd< on lha si?a euitprizad by such Nmil is ctnnoncad wihin 360 deys alter its issuancâ‚¬, ot il tho wod< aullptized on the site by such permil is suspended ot ebatf,onad fot e pctid of36o days aftet A1e lme the wod< is @mnenLed. lnspector MID#: 2021-167993 04t12t2021 Account# 01116002 51600 011,l 6002 51604 01116002 57770 Fee Total Paid to Date: Balance Oue: Date: Date: Date: oana2021 Mlsc. Receipt: Misc. Receipt: Misc. Receipt: Total $23.79 $ 156.47 $4.05 $184.31 $0.00 $r84.31 'tfr MECHANICAL.INSPECTOR RECORD APPROVALS OATE ID/SIG.COMMENTS OWNET II,II,DAT DEI.CARATION I h.Gb, .rm oidd Fdh! ol F irsy $n I 6 cer?r tlh tl8 Cont dB lire La fd tlE iolbeit lgso (Soc-D31,5 BNnEs .d Pmknn C.d.): &y Ciy or Cdmy ehib lrqris t Fii ro @itlirl. rXd, i.pr!v!. 4mlit 6 qt Dy rEurEq Ftu ro Xi iBurm,.L$ njrh!! rlE pplirir tu Mh ps.dl lo 6L. rh..d !ti.r drr lr n 3h.l li@t d P@d io rlE Ftri'lxB ot rtE Cqrrsld! r!n-d ur (ourrd 9. Coifrht di Sdtirn r@ ot Divirion ! ol tb ElriEr.d Ptuli*ioi! Cod.) n drl h 6 .lE it .&npr 0Bton !i lrE hGi lor th. rllctcn .en+io.. A", vbhbn ol Sglbn ?031.5 by .ny 4plio,r fd. Frn obr.<rr dE .pplkir 6 r<id Fetyorer mc ln.n frE holirld &u-! (15&). l{0-r, - .**.rrr. p."pory. n r.'q,btd whh w.&iedlt 5k onpc.4b'!'iulb dErqt.d dE{itrE ii 'brilcrd.d dolf6.d td d. 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(d llE FfdltrE of ttE dt for wtth thn Fdir n i! .d My ffiL6 @np.ddion i@!!e @ir ri ,olty nurt . c: I{-!l *n,r, * t* -r* oru. *dr. rd $t.h ltit F,on h i.$.d,I rhdl Dr.rpbyrly FDn ineyffis atot @r r$Fr ro [E ErI6 or4aEdin Ls olc.[Io i..8n {rE rh{ il| rh.dd b..oc stin loor Mtlq'@rFNrirEptur,li,niofs.dlrnl?ooofrhLrtdCodqlilt[lfiheith@trplywnhU'ospovnbN.. WALNIN(; l.rilu. h {.ur. \rrl.h .fn,|{n\rru, (,(.rr8. i\ u l.,nrul ,n niLll bj.{ d .npbjd lo otnnnd pcrrb ud .Ml fmr up ro oG hunhd rtoEtld dolL,r (!100,m,. h tri.rio'! .LdF. a F irt d ao, rlE Sdron .107(' ol rhc lnhtr Crxl. Ncti rtr(l *", orlrl lr au( IJCIISED,.COAIIACINA DECI.dSAIION I t cbylttun!.da D@.lryof Frju., !r.l I u U..d r&d6 Fl&bnoaclrFa 9 (oiftEiot enl! Scrb. ?m) oloivitlon 3 of rh. Buh.$ r l Potiixu Cod...rn ny lt.c b in tul br rd.ff81. gr![rBlJq[alJ&DnG.acEuqr I hs!b, dlrn urd.r FMlly otF.jury llltr tlE! t . ondiclbr bidiii .8!fty fot llE Ffixlffi of rlE @t tu *ttt riii |Emn i, irtun (s(. 1097. Civ. C,). .IEJCAIIIDSSJAAIII! I Hr.trm u.&r F.!y of F jury oc otttr folb*ir! d..ln tirlr: Dcmlirbn &mne^Osro l*rlfErrir tu6.1 R.auhrbar (Tirl,O, Prr6) -Rcquind Llnd of l*'ritr.Ion -l ccaily r,ur rhc tuda.l cSrLrioa EErding.!6c!tos Emvd E mlopdit bL lo thit ttuixl iltottDrb. ! orel. I ttrE lo orpl, wnh rI cnr st Cd! y tErcbyauhorn crcsiftriw. r'ltht Cily rnd Coulylo.nl6 uFlnllr .boE rdbrEd FoFry 6. Applk d 6 Ared ShDtur: Pcmircc Mrft (Fint):_ Appliances Metal Fire Place Evaporative Cooler Furnace Compressor Misc. Equipment Duct Work Pre-lnsulatron lnsulation Smoke Detectors lnstalled Rough Ductwork Vents Toilet Room / Clothes Dryer Residential Ranqe Other Hood Type I Hood Type ll Hood Grease Duct Fire Damper Openinos lnslallation F.D. Drop Test Above Hard Lid Above T-Bar Rouqh Mech. Final Test Meter Release FINAL 2-tt.u D6& ./lr, Notes, Remarks, Etc. ---------------_ T- T-." avhr-lrorr l}?r,Lt{ fh, tt Planning & Building Agency Building Safety Division 20 Civic Center Plaza P.O. Box 1988 (M-191 Santa Ana, CA 92702 (714) 647-5800 www.santa-ana,org APP-I3 CBC 2016 Dear Property Owner An applicati specified at on for a building permit has b een submitted in yo NOTICE TO PROPERTY OWNER ur name listin f as the builder of the property improvements >(&L 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 offlcial 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 DIRECI/O/VS: 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-Builder" build- ing permit that erroneously implles that the property owner is providing his or her own labor and material personally. l, as an OwnerBuilder, 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 homeowneas insurance may not provide coverage for those injuries. I am wallfully 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. _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 filed in his or her name instead of my own. _4. I understand Contractors are required by la\ to be licensed and bonded rn 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 lotal 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. _6. I understand if I am considered an "employef' 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. _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 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 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. _9. I understand I may obtain more anformation 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 Divi- sion of lndustrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1 -800j 321-CSLB (2752)or wuw.cslb.ca.qov for more information about licensed contractors _10. 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 flnancially responsible for proposed construction activity at the following ad- d ress: _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. _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. 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 orooertv owner's driver's license, form notariza- tion, or other verification acceDtable to the adencv is reouired to be presented when the permit is issued to verifv the property owner's siqnatu re 2//LSignature of Property Owner Date Print name of Owner tt14.rLY W) 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 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 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 lo verify the property owner's signature. 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 Iiable 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. nvlrz /uru fo 6$\N5- t s> s s t'.\+\4 fl o{ ? no N cl n\]N o.(S QA s -l- dI \ ( C ---- t,nEr_t f-s >leF-+<> /)-r ,-l N--S-.- \ -'-\q\\ R/ Cl I T4 .- --II afrII I qt!-.o d Bp g B B ,I v Ia Ia I \ ) I -a tAft. a a L-a,l .a ,aJI)'>ffi r I i:.l I a t ) (a I v )) IJ + I aa,f, h. ' tr I II I I I I 1 frI - ) a I \vI{ OJ {,1 t- -.-L l )r!I -el J C L--1 Il , a rr-II a