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Home My WebLink About20171717 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CAq27O2 Electrical Permit Counter: (714) 647-5800 lnspectaon Requestsr (714) 667-2738 lnspector Section: (714) 647-5853 Permit #: 20171717I Pin #: 78O5G Proiect Address: 721 N Linwood Ave Unil: Block: NA Bldg: Tracl: 1285 Address Range: Historic: No Suiie Range: Zoning: RlAssessor'sParcel: 398-061-23 Lot: 14 Owner: Address: Joaquin Castorena 721 N Linwood Ave Santa Ana, CA 92701 (7141 474-1910 011 16002 51603 011 16002 51600 011 16002 s1603 011 16002 57770 Fee Typo Serv Meter General Plan Update lssuance Microfilm Records Amount 57 .40 23.79 59.30 4.05 Qtr 100 100 100 100 Fee $57.40 $23.79 $59.30 $4.05 Phone: Tenant Name: Conlraclor Address: Owner-Builder Phone I State Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance; Canier: Policy #: Expires: Building Use: Job Type: Nature ot Work Single Famaly DrYelling Miscellaneous Service meter Occupancy: Constr Type Code: R-3, U VB cEc 2019 Notes Meter upgrade. Handout provided Planning Conditions: Plannang Approval By Date Date Date lvlisc. Receipt: Misc. Receipt: Misc. Receiptl Total Plan Checked By Permit lssued By Subject to Field: Building Permit # Amsden, Julie o4t20t2020 Account# Ewry p6mil issued shall become invalid unloss the wo* on the stte autltotized by such peinit is cofimenced wihh 360 days dftet its issuanco, ot if the wo* authoized on lhe sile by such pemit is suspended or abandoned fot a penod ot 360 days afret lhe time lhe wo ts commoncod. $144.54 $0.00 s144.54 lnspector MID#: 2020-160962 01 1 16002 51600 01 1 16002 51603 01116002 57770 $23.79 $116.70 $4.05 Fee Total: Paid lo Date: Balance Due: (X APPROVALS DATE ID/SIG, Site-Work Un derground Pole Bases !!ght Standards Spas, Pool, Fountains Signs (monument) Life Safety /Low Vol tage Fire Alarm / Dampers Communications Cable Building Under Slab / Floor Bonding i Groundinq / UFER Translormers Torqueing Sub-Panels Air Conditioners Roof Top Equipment factory Wired Unit Walls (Conduit ) Walls (Rough) Ceilings (Hard & Soffit Rou gh Ceilings (T-Bar Rough) Meter Release Rou gh tNotesRemarksEtc. 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Cdv.d .\pplnant orrtrdr shEru Zo Zt Z-{,, I Rev- 08 07-201I) ELECTRICAL.INSPECTOR BECORD COMMENTS I I I I I Service Meter I l.'nr[zJ l- /(-*a- Planning & Buildlng 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-I3 CBC 2016 NOTICE TO PROPERTY OWNER Dear Property Owner An applicati specified at on for a build permit has een submitbd ao v vncc (/ Ai our n amflisting yoursglf as t )Ay:.'l r llr4 heb roft e ro improvements IA I 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, initjaled 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 VERIFICATION OF INFORMATON DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. 1 . I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Buildei' build- rmit that enoneously 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 unllcensed 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. 3. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect elf from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my 4 I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers its and contracts. 5. I understand if I employ or otheMise engage any persons, other than California licensed Contractors, and the total of my construction is at least flve hundred dollars ($500), including labor and materials, I may be considered an ployer" under state and federal law 6. Iunderstand if Iam considered an "employer" under state and Federal law, I must register with the state and federal rnment, 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. 7. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential ctures 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 Contraclor. 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- r personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the workman- S or materials ( \l Z f understand buildrng permits are not required to be signed by property owners unless they are responsible for the bllstruction and are not hinng a licensed Contractor to assume this responsability. L l understand I may obtain more information regarding my obligations as an "employer" from the lnternal Revenue Ser- , the United States Small Business Administration, the California Department of Benefit Payments, and the California Divi- sion of lndustrial Accidents. lalso 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. 10. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the legally and financially responsible for proposed construction activity at the following ad- d ress I NJ f f I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all lUr{icable laws and requirements that govern Owner-Builders as well as employers. n JN_llz I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I hur/ 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 flnancial loss you may sustain as a result of a complalnt. 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. 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 pe rmit. /Vote: A copv of the propertv owner's driver's license, form notariza- tion, or other verification acceDtable to the aqencv is required to be presented when the permit is issued to verify the propeftv owner's sionature.1 lr,lSignature of Property Owner ?J/\rLr*-Date (Lo Zo Print name of Owner e shrz.t AUTHORIZATI 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 Date Print Name of Owner: Note: A copy of the owner's driver's license, form notarization, ot other verification acceptable to the agency is re- quired to be presented when the pemit is issued to verily the property owner's signature.