HomeMy WebLinkAbout101107285 - Permitcity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana CA127O2 Building
Permit Counter: (714) 647-5800 lnspection Requests: (7'l4l667-2738 in.p""to, Sectron (714) 647-5853
Permit #: 1lJ11lJ7245
Pin #: 53091
,ilProject Address: 1105 N Gates St
Assessor's Parcel 198-331-12 Lol 32
Unit Bldg: Address Range Surte Range:
Zoning RlBlock NA Tract 1944 Hrstoric: No
Building Use: Single Family Dwelling Occupancy: R-3, U 1st FL Area: Patao:
Job Type: Rsroof Constr Type: V B 2nd FL Area: T.l.Area:
Natureof Work: Reroof code: cBc 2019 other Areasr yards Req,d:
Existing Bldg. & Use: SFD ddet Garage Flood Zone: A-0602320143J
Garage Area: Valuation: S9,000.00
Proposed Use: # of Stories:
Total:
Description of Work: Tear off exiating roof material and install new comp shingle roof material. Owner-authorization form on file. Handout given.
Planning Conditions:
Owner:
Address
Phone:
tTenant:
Conlractor
Address:
Owner-Builder
Engineer
Address:
Phone:
License #
Tung Ho
1105 N. Gates Sl.
Santa Ana, CA 92703
(714) 360-9924 Phone;
Stale Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policy #:
Expires:
Archilect /
Desiener:
Address:
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp Req'd:
PWA lnsp. Req'd:
Planning lnsp. Req'dl
Landscaping lnsp. Req'd
lvlartin, Eric
Chavez. Dave
Oale 0711912021
Date:
Oate 0711912021
Subject lo Fieldl
)?Q.
Misc Receipl
Misc Receipt
Misc. Receipt
57607
57770
57672
57600
57607
0777600 2
07776002
0177600 2
07776002
0777600 2
$345.28
$4.05
$1.00
$23.79
$59.30
Permil Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
Fire Insp. Req'd:
Police lnsp. Req'd
Flood Zone Cert Req'd: No
Every pemit issuod shall become nvalid unless the wolr( oa the site authoized by
such pe',nl s commenced wthin 3 days aftet ls tssuance.otil the wo* authonzed
on the sile by such pemt $ suspohded or abandoned tor a peiod gl 360 daysaftet
the ttme the wotk is cofimencecl
No
No
No
No
No
No Account#Total
$433.42
$0.00
i433.42
lnspector MID#: 202'l-'167503
01 1 16002 51600
011 16002 5160'1
01116002 51612
01116002 57770
$23.79
$404.58
$1.00
$4.05
Phone:
License #:
Fee Totall
Paid to Date:
Balance Due:
BUILDING- INSPECTOR RECORD
SITE-WORK DATE IDiSIG.COMMENTS OllllFA AUIDEN DELCAR TION
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llE F)Fny qho hu <! d rtm6 rllc'^ !d wls dEi sh vit tirrclf d lEEl, d lht[at hn r hd ow..npl.F6.
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ani hn6rincdL Tt Cont{of s Li(n* h* d6 n .pply lo !. owmr of rrcrsl, *ho t uildr or tmllots rh.rn n.
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I c.dili rhar itr rh. FnnnmE..rrh. *ort ror whi.h rhis Frnln ,s i$kd. I shall not.nphyany ttron rn sy mnBr
q' r k, h.(m suhFr t, rh. w6 ..s &ntt.sio. Lw( olcal,fomi!. ud n8E rhd ia I ih{B trrotu $bFr'6 ilE
worta(.rrBEEri)nphyisi'ns.fSd1tr'n.!ruofrh.htnrCodt,Iihrll.fdhsirhdtr{ilt*nhllreJ'nrtirions
WARNINC Friturc b sm url.( .oqE e'hn or.B$ t unl,w6,l. .d rE ll \uhF! d drpbFr b cimiMl FEIiB r,t
cill fir.\ rI) !i oi. huidrud rhau{i dollrn lsl(x).lxt)r. r !dd[(,n lo lh.T"t 'f;1r*"*"*"* ""'",".,'ullgpl
IIDIIIB{IIIA
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nMd (sN.3097. civ c )
Lc.dcr'r Num
-
ATTII!]ANI.DES.ASAIII]N
ltud'rrlimu j.i Fnulr, otpdlury.B orttf, r(nbrinS d..l0r.lt'n\
Dcmn n,n Pcrmir\ A\l8los N.rincdion lidcrdl RdBUldi'.\ (Tnb,atr Pd6)
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4tnili rh"r I h"r ."d rhis a])plilrhl std s,r. rhfl th. dh,E inrod ion ,i or.crl. I rga I
onlmn(r !'rl Siar. ttr!\ n'hrine ixl .,n hcEty &uhnrc rcrmc txt!or
dnlc nrnrnrrcd ,,n{.ny nt
Appll.rnt o. AS6l Si,rn6ltrE (
P*rt- -,.,,'ino, X rir o co,rply q(t rll CiyrndC'6ury
rh'(C y.nd coMry r. mrd uF,nrlr
^,.. t4t!(zt
Set Backs
FormsiSteel/Holdowns
Ereclion Pads
UFER Ground
SLAB Floor
Roo{ Sheathinq il/6/zt rtD(?4 )
Shear Wall
Framing
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Beport
Engineer Final Report
Flood Zone Certif
FINAL 6/sl/zt fzr.r( 91
Certificate of Occu anc
Notes, Remarks, Etc
Bev.08-07 2015
Subf loor/VenVlnsulation
f------r-----
Planning & Building Agency
Building Safety Division
20 Civic Center Pl za ,
P.O. Box 1988 (M-19)
Santa Ana, CA 92702
(714) 647-s800
www.santa-ana.org
APP-13 CBC 2016
NOTICE TO PROPERTY OWNER
Dear Property Owner:
An apolication for a buildinq permit has been submitted in vour name listinq yourself as the builder of the property improvements
sp""ified at ll d ( -^i (L* , <r qtuitft1 ,crti A' 'e4 42*O 2
-rWe 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 AN D VERIFICATION OF INFORMATON
D/RECI/OIVS: Read and initial each statement below to signify you understand or verify this information.
Itt r . f 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 lo 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.
nd-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.
-\tt , , understand as an 'Owner-Builded' 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.
f,1-+. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers
on permits and contracts.
1k{ S. 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.
"T
-lS-O t 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 flnancial risk.
lfl , , understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential
structures cannot legally build them with the intent to otfer 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.
I f( A. 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-
cial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workman-
ship or materials.
rfi g. f understand I may obtain more information regarding my obligations as an "employe/'from the lnternal Revenue Ser-
vibe, the United States Small Business Administration, the California Degartme?t 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 -800-
321-CSLB (2752) or www.cslb.ca.qov for more information about licensed contractors.
lh-f o I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the
party le
dress:
gally 9rd\o Nfina al resp onsible proposed construction activity at the following ad-
3-r',. I agree that. as the party legally and financially responsible for this proposed construction activrty, I wall abide by all
applicable laws and requirements that govern Owner-Builders as well as employers.
!-a, I agree to notify the issuer of this form immediately of any addations, deletions, or changes to any of the anformation 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 veritication acceptable to the aqency is required to be presented when the permit is issued to verify the
W 0 elotl t-rSignature of Property Owner Date
-Juxa p,o
7/1.,/
Print name of Owner
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)
0{Ft.'ln
Address of Authorized Agent t\{*t 0,otc}- friud . wosl nunster Aktt6gz
(
Phone Number of Authorized Agent O 7-2.
I declare under penalty of per.lury that I am the property owner for the address listed above and I personally filled out the above
information and certify its accuracy
Property Owneis Signature Date 7()
Print Name of Owner '\tl,'te ft o
Note: A copy of the ownet's dliver's license, form nota zation, 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. /Vofe: A copv of the oropertv ownet's driver's license, form notariza-
propeftv owner's si(lnatu re.
Project Location or Address:
Name of Authorized Agent:
Planning & Building Agency Smoke & CO
Alarm Affidavit
20 Civic C6ntor Plaza Ross Annex
P.O. Box 1988 (M.19)
Santa Ana, C492702
(714) 647-s800
www.santa-a na.orq
rNSP-02 2013 CRC
This document moy be found at.,.http://www.santa-ana.orq/pba/
(Please use a black or blue ink ball-point pen)
Project Address:llO.f r..l €,rlo^ "f et *^r,.
Permit Number:tottDT 29{
Property Owner:Tu(A +{O
Contractor:License #:
State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential
buildings.
California Residential Code (CRC) Section R314.1 and R315.2 states in part that existing dwellings be
"retrofitted with smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R314.3.3 define
the required locations.
A"o,n boxes below must be checked:
El Carbon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of
bedrooms and also on each level of the dwelling. Alarms are required in bedrooms with gas-fired
appliances (i.e. hot water heater, cooktop, furnace) or a fireplace.
El smoke alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping
room, and on each level of the dwelling.
Retrofitted detectors may be battery-operated for buildings where no interior alterations are
performed. Combination Smoke/CO alarms must comply with all applicable standards and be approved
by the State Fire Marshall (SFM). Battery life must be 10 years.
I hereby certify that I am the contractor or the property owner of the above project. I further certify
that smoke alarms and carbon monoxide alarms have been installed in compliance with the governing
Codes and have been tested to be functional. l, also, hereby certify that I will retest the alarms per the
ma nufactu rer's inst u ctio n
lcheck onel Licensed Contractor Property Owner
NoTE: Ihis se/f-cenificotion is only used for projeds thot olfed the ExTERtoR of the strudure. This
process is applicoble ONLY to ptoieds where access to the inteiot ol the dwelling by a Sdnta Ano
lnspectot is not required.
Signoture .h oslnlzt
Have this completed form and the job-card readily available on final inspectionl
t
Pl r\\l\t,
\tt\(\
Date: