HomeMy WebLinkAbout101105501 - PermitProject Address: 1318 E Fourteenth St
Assessor's Parcel 400-233-07 Lot 18
Unit Bldg: Address Range:Suite Range
Zoning: RlBlock NA Tract. '1533 Hastoric 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
Permit #: { O{ I O55O{
Pin #: 47330
Building Use Single Family Dwelling Occupancy: R-3, U ' tlt FL'Area:
'
o Patro
Planning Conditions: Reroof to match addition.
9s0,000.00
Owner:
Address
Phone;
Tenant:
Contractor
Address:
Owner-Builder
Address
Lydia Richards
1318 E 14th Street
Santa Ana, CA 92701
(7'r4) 402-6093 Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policy #:
Expires:
Phone:
License #
Architect /
Desiqner:
Address:
Phone:
License #
Planning Approval By:
Plan Checked By;
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp. Req'd:
Planning lnsp. Req'd:
Landscaping lnsp. Req'd
Graham, Jeffery
Verduzco, Violet
Dale. 1212112O2O
Date:
Dale 1212112020
Subject to Field:
Misc. Receipl
t/isc. Receipt
Misc. ReceiptJ.l
0777600 2
07776002
07776002
07776002
07776002
57607
57770
57672
57600
57607
$690.56
$4.05
$2.00
$23.79
$59.30
Permit Fee
Microlilm Records
Bldg. Stds. Revolving
General Plan Updale
lssuanceNo
No
No
No
Fire lnsp. Req'd:
Police lnsp. Req'd
No
No Account#Total
Flood Zone Cert Req'd: No
Every pemil issued shall become invalid unless the work on the site aulhorized by
such pemit is cammenced within 360 days aket its issuance.or if the wotk authonzed
on the sito by such pemit is suspended or abandoned for a penod of 360 ddys after
the time the wo* is cornmenced
lnspector MID#: 2019-156643
01116002 51600
01116002 5'1601
01't 16002 sl612
01',t16002 57770
$23.79
$749.86
$2.00
$4.05 Fee Total:
Paid lo Date:
Balance Due:
$779.70
$0.00
$779.70
Job Type: Reroof Constr Type: VB 2nd FLArea: O T.l.Area:
Nature of Work: Reroof/Drywall/lnsullation Code: CBC 2019 Other Areas: o yards Req,d:
Existing Bldg. & Use: Sfd w/att garage Flood Zone: X-0602320163J carage Area: Valuation:
Proposed Use: # of Stories: Totat: O
Deacription of Work: Tear off comp and apply comp to sxisting sfd and garags. Replace drywall and add insullation to existing sfd.
Engineer
BUILDING- INSPECTOR RECORD
SITE-WOBK DATE ID/SIG.COMMENTS OlVNER AUILDER Dl:I,CAI{ATION
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IIECIAMITON
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appli(.nl or A!.nl Si(rul!,,," rTlztlzozo
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Sublloor/VenVlnsulation
Rool Sheathlng Blallao 0tuba at{
Shear Wall
Framing
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certil.
lr
FINAL w? l/bt Ltflh\ib
Certificate ot Occupancy
Notes, Remarks, Etc
I
T-- - T----
Planning & Building Agency
Building Safety Division
20 Civic Center Plaza
P.O. Box 1988 {M-19)
Santa Ana, CA 92702
(714) 647-s800
www.santa-ana.org
APP-13 CBC 2015
NOTICE TO PROPERW OWNER
Dear Property Owner
An applcahon for a building perqrit has been submifted in your name listing yourself as the builder of the property improvements
specified at \3\8 E.. \q+5 5\v{--l , g-.A^ {\v-.-.. q>-.ro \
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 underctand or verify this information.
/XL_I I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" build-
ind 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 injurles sustained by an unlicensed person and
his or her employees while working on my property. i/y 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 buildin g permits are not required to be signed by property owners unless they are responsible for the
construction an d 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 financial 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 re quired by law to be licensed and bonded in California and to list their license numbers
on permits and contracts
&E-U. 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
"employef' under state and federal law.
6. I understand if I am considered an "em ployer" under state and Federal law, I must register with the state and federal
government, wit hhold 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 flnancial risk
7. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential
S uctures 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 does not exceed four within any calendar years, or all of the work is performed under contract
with a licensed general building Contractor.
or
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-
personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the workman-
ship or materials
9. I understand I may obtain more information regarding my obligatjons as an "employer" from the lnternal Revenue Ser-
, the United States Small Business Administration. the California Department of Benefat 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-
32i-CSLB (2752) or www.cslb.ca.qov for more infoimation about licensed contractors.
kQ n I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the
' pbrty legally and financially responsible for proposed construction activity at the following ad-
dreis: - r3 \s E. ' I.-\)5 S\- s.,i.*-l^ s'--. 1-rro
.XL:,.1 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 a$ee to notify the issuer of th is form immediately of any additions, deletions, or changes to any of the information I
ave 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 financlal loss you may sustain as a result of
a complajnt. 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 in.iured while working on your property, you may be held
liable for damages. lf you obtain a permit as Owner-Bullder 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.
table to the a ,s uired to be ented when
p ropertv owner's s i gn atu re.
Signature of Property Owner Date rzlztlzozo
Print name of Owner L R.'o\.., \s
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 responsibality, 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.
Properly 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 properv 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, Note: A copv of the propeftv owner's driver's license. form notariza-