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Home My WebLink About40135126 - Permitcity of santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA127O2 Mechanical Permit Counter: f/l4) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: O14) 647-5853 Permit #: 4O135{26 Pin #: 26553 Project Address: 1137 S Shelton St Unil: Block: NA Bldg: Tracl: 557 Address Range: Historic: No Suite Range: Zoning: R1AssessoisParcel: 013-061-12 Lot: 53 Owner: Address: Robert & Laura Monzon 1137 S Shelton Street Santa Ana, CA 92707 (714) 319-6934 Fee Type Amount 01116002 5'1604 Fumace/Comp Combo 136.71 01116002 51600 General Plan Update 23.79 01116002 5'1504 lssuance 59.30 01'116002 57770 Microfilm Records 4.05 Qty 1.00 1.00 1.00 1.00 Fee $ 136.71 $23.79 $59.30 s4.0s Phone: Tenant Namo; Conlraclor Address: Owner-Builder Phone Stale Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance Carrier: Policy #: Expires: Building Use: Job Type: Nature of Work: Single Family Dwelling OccuPancy: Alteration Constr Type Fumace/compre3sor comb&ode: R-3 VB cMc 2019 Notes: Planning Conditions: Planning Approval By Plan Checked 8y: Permit lssued By: Subject to Field: Building Permit #: Guevara, Jerry Date: Date: Date: 't2t0112020 Misc. Receipt: Misc. Receipt: Misc. Receipt: Total VerUuzco, vloei'N 12tO1t2020 Account# Ewry pgmil issued shell become invalid unbss lre worr( o/, lfre srle authodzed by such pemit is commonced ,,tithin 360 days af,er ils or abandoned fot a peiod of360 ddys aflet the lme the wot* is comoprwd. $23.79 $196.01 $4.05 $223.8s $0.00 $223.85 lnspector MID#: 2020-163003 01116002 51600 01116002 51604 01116002 57770 Fee Total: Paid to Date: Balance Due: MECHANICAL.INSPECTOR RECORD APPROVALS DATE to/stG.COMMENTS Appliances Metal Fire Place Evaporative Cooler Furnace Compressor Misc. Equipment Duct Work Pre-lnsulalion lnsulation Smoke Detectors lnstalled Rough Ductwork Vents Toilet Room / Clothes Dryer Residential Range Other Hood Type I Hood Type ll Hood Grease Duct Fire Damper Openings lnstallation F. D. Drop Test Above Hard Lid Above T-Bar Rouqh Mech. Final Test Meter Release FINAL E?FX Lt {lu,u, W\qtrNotes, Remarks, Etc .'-1 I OWNIR AUltl,EI DEI{AR T|ON t ha!t, .lho lttdd Frlty of FiEr ! | a qal?r nd dE consis U..c t3' br llE b[osit 160 (s61l)]1.5 Builo ...1 Polcsior Co<L): Any Chy .r Colny vhi.h r.quia ! Fnh lo @nnru.( .llE. iryort, danolu! ot EF! oy i (tr.. Firb a! bu.E. & G$iq ilErdt d tulEiFEilo fiL.3isn d.rad dl.t dtEilid,ii.n ro rlE Fvibd ol rt Con!*r..i Lko&d t!* (Cll4r6 9. ColtltEEin| *nl Selir 7!@ of Divbbo 3 of dE BGi6 Ed PrcfsbuCod.)dln1ll.dib.irqdgrrhEdldrddEh.tbtutt.ll.8cdaaiFion.AryvioLlbDofs.db.mll.,bye, tppli!, li,. 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FDviLd br b, Sttun 1700 of rl'. Lbd Cod.. fo. lh. F&.EE ol dE Et lm *tin ft. FD! i i$.(I -l llE rd will di i! eorlo oqdrir irdcc. . Fqtlid ty Setb! lrm of dt tlho. Cod.. tu 0E Fft.iEt of rE Nt fa etihrtirpdri i! id MyEta o4dih i'.!E ciir -il poli.y nntd G -l c.rify dla h rh. F6lr't.e of d. *!rt fo. $tth tn pdEn ir isx( I ![.ll mt orploy &y F@ h o, re D Bto b@tr robid lo rhc e!ta'NnFltion bB orcdirortn &d..rc tltd if I tlDuld beon.4bi..1 ro rt 6rld' ol4atdboFwlis oas.dbtr l7m oallE t tn Codq I drlL fdrhlni @npl, Inh tlE FDvilie. 1& nNINC: Fnte to c@ wnia' @nqa'lbo oldr8. ir 6L*tu1 Ed d|ll sbi$ & alpbF ro otuid Fr!i. &d .ivit fn6 up ro d hurt d rlE6-d dolL! llloo.(m). i! ..Bnbn lo lE ..r of oqc6iioa tDa!. - FoviLd fo. d. sdii.. io'76 ofrh. t,lnr (bd. ,nrdddd.nom6.! a6'/'?-o IICIMID-CAIIaAIIITA lECttEArIA! I h6.hy llrtu u.d6 pdulry ol Fjurv lh.l I m li(ar.d unrL. Flvnren of(tuBa 9 (.onMcing R'lh Sdhn ?00o) of Dili.ion i ol rh. &6iIB lhd Pi f*i6B cdj.. rn 'ry ltae t in tull foN dd.If<l aac c1--r}c r,id!6 CO!iIAUCI!0!,EID|!GJCEM] I hd!b,.lT!, uldd Fdy of p.i,ry tt lta! i. odD.ib! blir.arnry tu dE F&l'le! of 0E w.r br etdct tlir FDi i iEGd (s4. lo9?. cir. c. ) a.SluqrNlDElllsA:u0! I hcq .rhf, und6 pa.ht of Fjlrr' m ol llE rolb*ins &L,rri,N Dmolhio. P@iB-Asb6ror Notificlr irr. [.{@l R.suln ion! (TnL ,l{], Pd6) -RaNiEd tirld of firi&rin -l cqtfy ltl lh. &d-.1 Es!&bd Eatdin8 lh.rot tqot'll E !d +dbbL to 6ir Fj<tt. I cdrty rhal I hrv. rdJ rhn 0ppli(rrion ed 3l!1. lher th. rh)(. rnfomdbn B .ond I arra lo omply w h tll ( ny .nd (-ounlv odired sd Sr.l. t!trs Elr !E li' tliLlrc .ododi4 lrr hd.St MlBd. r.Feirn 6 of ihis Cnr" tnd ( ouly lo dnd !F. th .t B cnioo.d FrFry ld Ei9clih ,,tZ-/'-z'o tita7,Gfgw{ ]- I+- I Planning & Building Agency Building Safety Division 20 Civic Center Plaza P.O. Box 1988 (M-19) Santa Ana, CA 92702 (714) 647-5800 www.santaâ‚¬na.org APP-13 CBC 2015 Dear Property Owner: NOTICE TO PROPERW OWNER ermit has been submi tn urn me lis ng y TS AS builder of the property improvementson for a building p We are providing you with an Owner-Builder Acknowledoment and lnformation Verlfication 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 permittang authority. OWNER'S ACKNOWLEGMENT AN VERIFICATION OF INFORMATON DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. M I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Buildei' build-/ ifo permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, 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. l\,4y 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. NU//I , I understand building permits are not required to be signed by property owners unless they are responsible for the ' bonstruclon and are not hiring a licensed Contractor to assume this responsibility. (/fu-t I understand as an "owner-Buildef' I am the responsible party of record on the permit. I understand that I may protect /\mydelf from potential financial risk by hiring a lacensed Contractor and having the permit filed in his or her name instead of my own. U14, I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers / bn permits and contracts. MU I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total/ \alue 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. UMU I understand if I am considered an "employer" under state and Federal law, I must register with the state and federal /\ovdrnment, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment com- pensation of each "employee." I also understand my failure to abade by these laws may subject me to serious financial risk. Afr%r. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential ' ltructures 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.lrilll / \lj 18 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- cial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workman- ship or materials. An applicati specified at %l d ress: 0. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the gally and fi ia lly esp on sib pro d nstruction a ivity at the llowi s ad-2 d Q4,, I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all- >pplicable laws and requirements that govern Owner-Builders as well as employers. @,r l agree to notity the issuer of this form immediately of any additions, deletions, or changes to any of the information I' }lave provided on this form. Licensed contractors are regulated by laws desjgned 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 wrsh 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 acceDtable to the aoencv is reo uired to be presented when the permit is issued to verifv the DroDertv owne r's siq natu re. Sig nature of Property Owner /2 -/ -2o Print name of Owner 7 t' H|N7'ou 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) 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. Property Owner's Signature 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. %-, I understand I may obtain more information regarding my obligataons as an "employei'from the lnternal Revenue Ser-/ \ice, 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. 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 prooe,Tv owner's driver's license, form notariza- Date Date: ir\ r --s\c-At dsr F\ Tc v n ,J.:''4 o d ,{ <) /-Jt + tl JtC Ttn ! E' Eoz s G/)-tm 1 0f- p t' F ,/] ul 6,) 1' r P NI p -(,tt B--{ ml- N+ N/.o Nc ??/ o ,mo U It I B{m I I i. il -1IurtIfim 9; t= '11I P 1 z 9 m f. i a 6.t o 5 I LNJI t/ o =oz otrga oa>zcolo9fr<s -'z:1 ,A EEEI gTt:i Hi?$P6:Ia *g;3Jc, 6= { 2n b =2 _-{o ? 7 n o) 0- J A t roo Y l/m k "t l\.J l-s-\\ ti.','\..Y II (^.1 h 0 Fo -c i-U)6)oo! oZ oul Oo ultllt! ;tllo) ;zulo -a UJ oz a UJ (I 2) LLoE = oz a u, uln Lt t-EulO llizCNo o) Tl. oZ aIJ oo uJzoNooo) z Eou] L! C) L] aloGo ..i _i ulc F crI U, cU r\ Y I u- LUo- s \ oz o & N ul rF =G L o ) A \H (,o)