HomeMy WebLinkAbout101106029 - PermitFlProject Address:1210 XzN Daisv Ave
Assessor's Parcel:405-103-08 Lotr 3
Unit Bldg: Address Range Suite Range:
Zoning: R1Block: NA Tract: 1899 Historic: No
city of Santa Ana 20 civic center Plaza (M-19), santa Ana, cA 92702 Building
Permit Counter: (714) 647-5800 lnspection Requests: (.714) 667-2738 lnspector Section: (714) 647-5853
Building Use: Accessory Dwelling Unit-Oetachec Occupancy: R-3
Job Type: New Constr Type: V B
Natureof Work: New Detached ADU Code: CBC 2019
Existing Bldg. & Use: 5pp vy1211 gxl3gg Flood Zone: X-06023201.14J
Proposed Use: # of Stories:
Desciiption of Work: New 404 sq ft detached ADU with (1) bedroom, (1) bathroom, kitchen,
file.
Planning Conditions:
1st FL Area: 4OG Patio:
2nd FL Area: T.l.Area:
OtherAreas: . Yards Req'd:
Garage Area: Valuation: $62,000.00
Total: 406
living room, washer & dryer. SAUSD 114099 Letter of auth on
Owner:
Address:
Phone:
Tenant
Contractor
Address:
Engineer
Address
€zequiel Torres
,I210 N DAISY AVE
Santa Ana, CA 927032023
17141770-7226
Owner-Builder
Phone:
Stale Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier;
Policy #:
Expires:
OGI Oes(rna
lgnacio Garcia Ochoa
8191 Kingsdale Drive
Huntington Beach, CA 92646
(714) 9044823
35217
A & A Draftinq
Al Maciel
2017 W Alco Avenue
Santa Ana, CA 92703
?141a3s-1424
Phone:
License #
Architect /
Desiqner:
Address;
Phone:
License #
Planning Approval By; Orozco, lvan
Plan Checked By: Le. Tung
Permit Issued By Chavez, Dave .
NPDES lnsp. Req'd: No \7: '
07776002
07776002
01776002
o8 9 070 07
0 7776002
0 77 76002
01776002
57607
5i600
57770
2400 0
5 7612
57600
57607
$450.00
$550.00
$60.75
$8.06
$3.00
$23.79
$158.15
Date: 03/15/2021
Dale. 0311312021
Dale 0312512021
Subject to Freld:
N,4isc Receipt
Nrlisc. Receipt
Mrsc Receipt
75294
Total
Permit Fee
Plan Check Fee
Microfilm Records
SMIP - Category 1
Bldg. Stds. Revolving
General Plan Update
lssuance/New Structu
PWA lnsp. Req'd: No
Planning lnsp. Req'd: Yes
Fire lnsp. Req'd:
Police lnsp Req'd
Noyes Account#
Landscaping lnsp. Req'd: No Flood Zone Cert. Req'd: No
Evary porml issued sha becofie invalid unless lhe work ol| lhe srle authonzed by
such pemit is commenced withn 360 days aftet ls tssuance.or if lhe wo* authoizec!
on the site by such permil ts suspended or abandoned for a period of 360 daysafter
lhe time lhe wo* is connenced
lnspector MID#: 2021-164105
011 16002
01 1 16002
01 1 16002
01 '1 16002
08901001
51600
51601
51612
57770
24000
$23.79
$608.15
$3.00
$60.75
$8.06
Fee Total:
Paid to Date:
Balance Due
$1,253 75
$550 00
$703.75
Permit#: {O{{06029
Pin #: 14357
BUILDING- INSPECTOR RECORD
SITE-WORK DATE OWNER BU II,DER T'F:LCARATION
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Tla ry hn0h 14G 6l2d'at
FINAL U t717Dl Wlthfr.tEo,tro
Certificate of Occupancy
es,ar
--t
tD/stG.COMMENTS
I
\ttln+rt @tir6tdt ' ard
Pl.nning & Buildlng AgoncY
Bullding S.f.ty Divl.ion
20 Clvic Contcr Pl.z. . .
P.O. Box 1988 (M-10)
s.nta Ana, cA 92702
(714) 647-5800
www.Santt-ana,olg
APP,13 CAC 2016
NOTICE TO PROPERTY OWNER
Oear Propeo Owner
An applcation for a buildi rmit has been submitted in your n listing yourself as the builder of the property improvements
specified at
WeareprovldlngyouwlthantomakeyoUawareofyour
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 retumed this
form to us at our otficial address indicated. An agent ofthe owner cannot execute this notice unless you, lhe property owner,
obtain the prior approval of the permitting authority.
OWNER'S ACKNOWLEGMENT AND VERIFICATION OF INFORMATON
DIRECTIONS: Roed and initial each statament balow to signity you understand or verify thts lntomation.
ft
:-.l-!_1. I understand a frequent practice o, unlicensed p€rsons is to have the property owner obtain an 'Owner-Builder' build-
ing p€rmit that erroneously implies that the property owner is providing his or her own labor and matsrial personally. l, as an
Oflner-Builder, may be held hable and subject to serious tinancial risk for any injuries suslained by an unlicensed pe6on and
his or her employees while working on my property. My homeowner's insurance may not provade coverage for those iniuries. 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.
t-{-2. I understand buildrng 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 thrs responsibility.
E ! g. , understand as an "OwnerBuildef I am the responsible party of record on the permit. I understand that I may protect
myself lrom rctential financial risk by hiring a licensed Contraclor and having the permit filed in his or her name instead of my
own.
.\
-L-Ll f understand Contractors are required by law to be licensed and bonded in Califomia and to list their license numberS
on permils and contracts.
+. . \-. I undersland if I employ or otheMise engage any persons, other than Califomia licensed Confactors, and lhe total
value of my construction is at least five hundred dollars ($500). including labor and materials. I may be considered an
'employe/ under state and federal law.
-f 'tO f understand if I am considered an "employer" under state and Federal law, I must rogister wilh the state and federal
govemment, withhold payroll taxes, provide workers' compensation disability insurance, and contribut6 to unemployment com-
pensatron ol each "omployee." I also undersland my lailure to abide by these laws may subjoct me to senous financial risk.
E .\ 7. I understand under Califomia Contractors' State License Law, an Owner-Builder who builds singlejamily residential
structures cannot legally build them with the intent to offer them for sale. unless a/l work is performed by licensed subcontrac-
tors and the number of structures do€s not exceed four within any calendar years, or all of the work as performed under contract
with a licensed general building Contractor.
&-A I understand as an Owner-Builder i, I sell the property for which this permal as issued, I may be held laable for any tanan-
cial or personal injuries sustrained by any subsequent owner(s) that result from any latent construction defects in the workman-
ship or malerials.
c r 9. I understand I may obtain more rnformation regardrng my obftgalions as an "employer" from the lnternal Revenue Ser-
vic., the Unrted Strtes Small Business Admrnrstration. the Californra Dep4.tmeIt gf Benefit Payments. and the Califomia DivF
sioh of lndustrial Accidents. I also understand I may contact the Califomia Contractors' State License Board (CSLB) at 1-800-
321-CSLB (27s2)or www.cslb ca ov for more rnformatron about lcensed contractors
E't-10. I am aware of and consent to an Owner-Burlder burldrng permrt apphed for rn my name. and understand that I am the
party legally and financially responsible for proposed construction activity at the followrng ad-
dress
\:_l_1 1. I agree that, as the party legally and financrally responsrble for thrs proposed construction activity. I wrll abrde by all
applicable laws and requrrements that govern O\uner-Builders as well as employers.
f-\ Z f agree to notify the issuerotthis form rmmedrately of any additrons, deletions, or changes to any of the information I
have provided on this form
Ltcensed contractors are regulated by laws desrgned to protect the public. lf you contract wth someone who does not have a
license, the Contractors' State License Board may be unable to assist you with any financial loss you may suslain 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 rndrvidual or firm is injured while working on your property. you may be held
liable for damages, lf you obtain a permjt as OwnerBuilder 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.
Botoro a building permit can be issuod, this form must be completed and signed by the property owner and returnod
to the agoncy rasponsiblo for issuing the psrmit. /Vote; A coov of ahe prooetTv owner's driver's license. form notari2a-
tion. or other verification acceptable to the aaencv is reouired to be prasented when the pamit is issued to verifv the
proDedv owner's sionature.
(Signature of Property Own '4 ^0",". \-LV -'z r
/Pflnt name of Owner
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Excluding lhe Notce to Property Owner, the executron of which I understand rs my personal responsibrlty, I hereby authonze
the bllowing person(s) to act as my agent(s) to apply for. sign, and file the documents necessary to obtain an Owner-Bualder
Permit for my project.
Scope of Construction Project (or Des cnptr:;n olWoill.4ob.'(, r-!A+ 4e?-1, \.
Project Location or Address
Name of Authonze d Agent. \^t lla.L'f T>F+E >,
Address ot Authorized Agent k-a L
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 cedity its accuracy
{Property Ownels Sig
1->2
nalrJ--L
,trL
()
9
)(-Date 1Zc-1
xPnnt Name of Owner.Z tr LL
Note: A coPy ot the ownet's drivor's license, torm notarization, or othor vgrification acceptable to tha agency is re-
quired to be prcsented whan the permit is issued to vetify the propefty owner's signature.
Phone Number of Authonzed Agenr *l +f aa t - +t< c.l