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Home My WebLink About20173255 - PermitCity of Santa Ana 20 crvic Center Piaza (M-19), Santa Ana, CAg27o2 Electrical Permit Counter (714) 647-5800 lnspectron Reque:ts (714\ 667-2738 lnspector Section (714) 647-5853 Permit #: 20173255 Pin #: 87919 Project Address : 1210 N Daisv /ive Unrt; Block Bldgl Tract: 1899 Address Range Histoflc; No Suite Range: Zoning: Rl â‚¬! Assessor'sParcel: 405-103-08 Lot.3 Owner Address: Ezequiel Torres t2IO N OAISY AVE Santa Ana, CA 92703 1714177O-7226 Amount 57 40 23.79 59.30 4.05 Feâ‚¬ $57.40 $23.79 $s9.30 $4 05 >w 0'1 1 16002 5160: 01 1 16002 5160C 01 1 16002 5160: 01116002 5777t Phone: Tenant Name; Contractor Address: Owner-Builder Phone State Lic #: Lic Type: Bus. Lic il: Workers' Compensation lnsurance 3arrier: Policy #: Expires: Building Use: Job Type: Nature of Work Single Family Dwelling Miscellaneous Service Meter Occupancy Conslr Type Code: R-3 VB cEc 2019 Notes. Service meter fcr main house. Hand out given Planning Conditions: Planning Approval By Plan Checked By. Permit lssued By: Subject to Field: Building Permil #: Misc. Receiptl Misc. Receipt: Misc. Receipt: Total Zuniga. Allssa ost0712021 Account# Every pemil Bsued shall become hvahd unless the work o, lhe Site authonzed by sucb permtt 6 commenced \ttthn360days after lts issuance. ot tf lhe work authoxzed on the stte by such pemtt ts suspenclecl or abandoned lor a ponod of360 days aflet lhe hme the work ts commenced $144 54 $0.00 $144.54 lnspector MID#: 2021-163572 011 16002 51600 01 116002 51603 011 16002 57770 $23.79 $116.70 $4 05 Fee Total Pard to Date Balance Due: -/ Fee Type SeN lvleler General Plan Update lssuance Microtilm Records Qly 1.00 1.00 1.00 1.00 v3:l: Date ELECTBICAL-INSPECTOB RECOBD APPROVALS DATE ID/SIG.COMMENTS Site-Work Underground Pole Bases Llght Standards Spas, Pool, Founlains Siqns (monument) Life Safety /Low Vollage Fire Alarm / Dampers Building ^/Bondinq i Groundino i UFER 7XN wth 'typ Transformers Torqueino Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Bough) Ceilings (Hard & Soffit Rough Ceilings (T-Bar Rouoh)t^..t-AI Ar0lhttMeter Release b/JI U&e Rough I t_nl .t A Service Meter I 7t7ar l WU{/U WVs- FINAL 8/ n/a/ffia Notes owirDra BUtabEi Di:LcA& rloN I n rh, trmrfr uid.r p.ndh, o, ttrrlry ihd I m .x.nrr rn,m th. c(rdm(oB LE.n$ Llw ln rlE nnbuinS r.arr (S< ,l)r l 5 Bu\in.sr !d Prrn sn. 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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 buildin g permit has been submitted in your name listing yourself as the builder of the property improvements specified a -L\:\ We are providing you with an Owner-Builder Acknowledqment and lnformation Veriflcatjon Form to make you aware of your responsibilities and possible risk you may ancur 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 agentofthe 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. Y_fl_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. \]l-f. 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. \-i-$_+. I understand Contractors are required by taw to be licensed and bonded in California and to lrst their license numbers on permits and contracts. ..l 1f 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 "employer" under state and federal law. I at6 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. Y-r:fZ t 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. f-Lt6 f understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any finan- EiEi-6i personal injuries sustained by any subsequent owne(si that result from any lalent construction defects in the workman- ship or materials. \ \ 1-\ t. t 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 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. \ l+;9 I undersland I may obtain more information regJrding my obligations as an "employer" from the lnternal Revenue Ser- United States Small Business Administration, the'Galifornia Department of Benefit Payments, and the California Divi- dustrial Accidents. I also understand I may contact ttie California Contractors' State License Board (CSLB) at 1 -800- vice.the sion of ln 321-CSL B (2752)or www.cslb.ca.qov for more informataon about licensed contractors r.1 k.l lO. I am aware of and consent to an Owner-Bu ilder building permit applied for in my name, and understand that I am the party dress legal financiall y reFponsible for proposed construction activityv and,\2 \Dw Y).. at the following ad- c5 { *', ', I agree that, as the party legally and flnancially responsible for this proposed construction activaty, I will abide by all applicable laws and requirements that govern Owner-Builders as well as employers. \r*,| 112. 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 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. tion, or other verification acceptable to the aqency is required to be presented when the permit is issued to verify the property ow ner's siq natu re. Signature of Property Owner Date 5 1 7r t^1-+r.' r -1Print name of Owner vlc,n^i 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 pro]ect. 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 fllled out the above information and certify its accuracy. Print Name of Owner Note: A copy ol 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. / 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 copv ofthe propertv owner's driver's license. form notariza- V Property Owner's Signature:Date: