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Home My WebLink About102107810 - PermitProiect Address: 5501 W Tamoion Ave Assessor's Parcel 108-526-03 Lot 14 Unil Bldg: Address Range Suite Range ;J Zonang RlBlock: NA f racl. 4024 Hastoric: No city of santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CAq27O2 Building Permit Counter (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853 Permit #: 1O21O7A1O Pin #: 2o495 Building Use: Single Family Dwslling Occupancy: R-3, U 1st FL Area Patio. Job Type: Rsroof Constr Type: V B 2nd FL Area T.l.Area: Nature of Work Reroof code: CBC 2019 other Areas: yards Req,d Existing Bldg. & Use Sfd w/att garage Flood Zoner A-0602320252J Garage Area: Valuation: $12,000.00Proposed Use: # of Stories: Totat Description of Work: Permit tho reroof of a house & attached garage - removed comp, replace any damaged sheathing, install new comp shingles. Handouts given. Planning Conditions: Contractor Add.essl Owner-Builder Engineer Address Phone: State Lic #: Lic Type: Bus. Lic *: Workers' Compensation lnsurance Carrier: Policy #: Expires: Phone: License # Architect / Desiqner: Address: Planning Approval By: Plan Checked By: / Permit lssued By: \ NPOES lnsp. Req'd. PWA lnsp Req'd: Planning lnsp. Req'd: Gomez, Pedro Amsden, Julie Date: 0813012021 Datei Date: 08/30/202'l Subject to Field Misc Receipt Misc. Receipt Misc. Receipt No No No No Fire lnsp. Req'd: Police lnsp Req'd No No Account#Total $345.28 $4.05 $104.26 $261.96 $1.00 $23.79 $59.30 Landscaprng lnsp Req'd Flood Zone Cert. Req'd No Every pemit issued shall become invahd unless lho work on the site authorized by such permit is comnenced wthin 360 days aftet its issuance ot it the wo* authotizad on the site by such peflnit is suspenclec! or abandoned for a period of360 days after tho ttme the wo* ts cofimenced lnspector 01 116002 51600 01116002 5't601 01116002 51612 01116002 57770 $23.79 $770.80 $1.00 $4.05 Fee Total Paid to Date: Balance Due: $799.64 $0.00 $799.64 Owner: David Grice Address: 5501 W Tampaon Ave Santa Ana, CA 927041700 Phone: (714) 380-0000 Tenant Phone: Lrcense # 077t6002 51601 Permil Fee 07775002 57770 Microfitm Records 07775002 51601 lnvesligation 07776002 57607 Penally 07116002 57672 Eldg Stds. Revolving 07776002 51600 General Ptan Update 07776002 51501 lssuance MID#: 2021-168509 BUILDING- INSPECTOR RECORD SITE-WORK DATE ID/SIG.COMMENTS OWNDR EUILDER DE'TAR TION t i6cby r,Itrm u.dd Fdr, of p<rlury lnd I m .r.mF 6sm th. Conlrxlou l-i.w L{* fo. lh. follovinr ,!&n (Se 701 I 5 BEi.6s drri Prcfsion (od.): Ary Cny or Co! y which r.qut6 r Fni lo @ri{tu(. .lrq. impm\q da.oli5fi or rlpan uy strucruc, r,rr lo its isuMc., Als r.!un6 $. applicd lb, such dnir kr il. ! sisnaj lratnnl lhll h. or rhc i! lico*d pcuMl lorn Fori.ioB of fi. Contr.cror's Licmra] L5* (Ch.prs 9, Conmcn.ing wirh Salion 7000 of Divhion 1 olrh. Bain.s ed Pmfsions Cod.) or lhar L d rh. b ddpr rh6.nom dnd rh. bara for $.611.8.n .rdFio. Any lioldiotr of Sdio. 7011.5 by Ey Effi f*:"-:-ffiffiffiil;#*-i*******., rhc ',$psry {ho hril& or m!,!!â‚¬ lh6oG Md wral drE $.h mn [nB.lf or h6daor lhrcush hi! or hd om dplor.6 prord.d lhat such iEFoffilJ e nol i,toxLd or oftsqj lor sL. lt ho*dd, $. buibor or mFov.lMt ir bld *nnin onc t@ ofconpLrbl! rrE ('rr( Bu da will h.E 6c hlda ofF!$g tla h. or rh. did ml hild or imFrw th. FoFry for ll* l! Fe ot l. c o$nd olrh. FoFrr, e crclBn.ll conrd'ns slh licuE d conranos ro cone{d rh. Fo)cl (Sd 7or4, t}Brn6 drj ltllko Codc: Th. ConrGr.. s Li..G. li* do6 frn apply to m o{na of prcpdy sho builds o. mp,o!6 rt6@q rnd sl$ contds for s!.h rmj(ts Rnh a Conr6.lo(s) lrcos.d psudr Io rhr Contacloi! l,i.@ L.w). I dnRcnr!! und6 Sdion- (D.8 3p:'2-L oy, DI]CJ.IAATO! , hsch),llir tr.de Faht of lEju,r_ onc.frhc foll('\'n3 dNl,arD.s I hav. dd will @'nt!in r Ccnifiotc ot Co.gl lo sclt-16urc lor sor td conp.Brrion, s Eovided to, byS4lion 1700 oIrh. lib.r ( od., for rh. FfolrM.. o f rh. woll fo' whi.h rh. pdmir i! ireu.d I h&. .nd *ill h.im6in wod6 comFMrion 'N!rffi.. s r.+ncd by Sclion 1700 ohh. lrbr Cod.. lot $. psfolrla. of rhc *o.l for *hi.h lhie p.nir ir ie.d My *0116 omFMion iNuroc. 6iE sd Dolicy numbd r.: Ekoln\ td n ttt pctlomtu. or (h. wort rur s h tr h rh'r psnir 'r isu.d. I lrulhor dploy .ny FM. ir s., mM6r*-* n t .".. -q-i r. rh. rolld @tr Fuarhn h$s of Crlir6mi,. m.t .sG rhn irl n; haore subirt ro rlr slrrd.onFMi.nFoGio6ofsdion1700ofth.l:huCodeIshrll.,onhq'ilhcoDply$ilh0h*Foririo6. $aRNlNC [ailw ro suc rortd' @mFailion or'6rs. a dla$ful. Md dEll subjd M aploF lo sininol p.ulE ud civil fin* up to on. hundr.d rhousnd doll6 (1100,000), i. rddnio. ro !h. cd of comFn$lion. {h,.as6 G prclid.d fo.lh. DECIJAAIION I hd$, .ffm undE pa,ny oaFrury fid I m ncosl urdd Forirbi otchlptg 9 (@M*ins snh s..lb. 7000) of Dili.ion l of lnc BGhB @d Potdoa Cod., rd my li.ce 6 D tull aoN &rl.lIcl. CAIIIIIJCIIO!.LIIDIIS.&qENCI I hdb, lmm od6 Fnalry ot pdjury lhd rho. s ! conrdrlion kodins i{dcy for lh. FforM(. of rhc *o* for "tr.h $i! Fnn is issu.d (Sr.1097, Civ C ). L..doi N!D.: AIIIfCAIILDECI.{8AITO! I hqlt y dfiim undd F.ax, of pEjury on. ol th. follo*rng ddhrslions: Dâ‚¬rolirion Pd,nn! sb6ror Nolifi.alion F.dGal R.golalions (TitL40, Pint) R.qun.{t lard.lNdifi .rmn Set Backs Forms/Steel/Holdowns Erectron Pads UFER Ground SLAB Floor Subfloor/VenVlnsulation Roof Sheathing I ?+t-zt :hatfi 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 Certif . FINAL kpzt :rL-.9{s Certificate of Occupancy Notes, Remarks, Etc. f I fq.r-A., J.Ea^ e^.-a-,o* f c 3rn- zr Drlrz-rrr.l AID C,s- I -:l) "##idd" "^ ^^IHFrJ.E //,.-rs /z Llcinst'n (oN r R ( rolt li rhd rh. f.n6.l rcgul,rnc Esedh! ct sk* r@oval d. nol alrl(.bL b rhir pn,r(l rlulharcrcalllnsr|]l]h.llum'lsralclh ih.finc 'nn)mriitr)0 hronN Iag&h(!rl)lvn'rhallC()and(qinrt r.r{rsc hns.lrhtr(' } ntrdCounrrro orr urx)nrhc ib.\. nE nrcd propdy \..- "^n*",,onkQ4ilQ J C-11t c ,Af-= zt Planning & Building Agency Building Safety Division 20 Civic Center Plaza P.O. Box 1988 (M-19) Santa Ana, CA 92702 (714) 647-5800 www.santa-ana.org APP-13 CBC 2016 Dear Property Owner: An application for.a specified at NOTICE TO PROPERTY OWNER bu ild in g permit AS sub \tn your na me listi DSy ourself as the b ilder of the prop improvements2o 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 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 understand or verify this information. Ing permr I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Buildel' build- t 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. 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 lu nderstand as an "Owner-Buildel' I am the responsible party of record on the permit. I understand that I may protect potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of mymyself from own.(bt/ _hzk'{ I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers' oh pelmits and contracts. I understand if I employ or otherwise engage any persons, other than California censed 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. 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. 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. ct 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- rsonal injuies sustained by any subsequent owne(s) that result from any latent construction defects in the workma n-or pe ship or materials t- ,/ I understand I may obtain more information regarding my obligations as an "employel'from the lnternal Revenue Ser- vice, the United States Small Business Administration, the California Department of Benefit 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.oov for more information about licensed contractors. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the pa rty dress legally and finan cially responsi for 4oP con tructi n vity at the foll n ad- t_,, app licable I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all laws and requirements that govern Owner-Builders as well as employers. ave pr . I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I ovided on thls form. Licensed contractols 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 Iicensed and the status of thejr workers' compensation insurance coverage. 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 properTv owner's driver's license, form notariza- tion, or other verification acceptable to the aqencv is required to be presented when the permit is issued to verifv the p roDertv own er's s io natu re,p Sagnature of Property Owner Date O Printnameof own"rD.+u) D L, en,L- 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) Name of horized Agent Addr ofAuthorized Agent: I declare under penalty of perjury th I am the property ove and I personally filled out the above information and certify its accura Property Owner's Sig nat 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 property owner's signature. r for the address listed /)d -z l- Proiect Locafn or Address: Phone Number of Authorized Agent: