HomeMy WebLinkAboutA ST S 302 09/02/2015gay of f~
CMMawda 1 110
M " VMOhbr Mft tAl, �fr011�11M Dp 11N�10 1�1
M1/ UIINIYIN Mrk
(� 1MO�dPoudwaYaodNNMtrMwk*Y��
airwrda, M sppll�aYb. '
(� t►r PMPMd W t deo M.aa» 1~60 aMliwrl�Ml�ar
Ow�Md Cdrrdl Naairaw MwM M irrut
tSt sh. wuvo.W wrnc
Epvrow1aornea ofnrlyddl wb atw Me�R ilp/a�lata nar
�rw or amara M Nwirwraa.rwh�h„rorw ana wr.riw�h+r»
Awround" araft
am S 0-,/1 S-
230 S. A Street
Reroof of barn garage with brown shingle to match existing.
I
CITY SUSTIN
Community Development Department — Building Division PAIS
300 Centennial Way, Tustin CA 92780
Building Counter (714) 573-3131 — Inspection Recorder (714) 573-31 4
SEP 022015!
BUILDING PERMIT NUMBER: B2015-0413 ADDRESS: 302 S A ST TUST S&M OF TUSTIN
ASSESSOR'S PARCEL NUMBER: 401-363-01 SUITE NUMBER...: CASHIER
LOT NUMBER ................................: TRACT NUMBER.:
DEVELOPMENT AREA ................: TUSTIN ISSUED BY.............:
:
PROPERTY OWNER ......................: HAYWARD HELEN M DATE ISSUED.......09/02/2015
302 SOUTH A ST
TUSTIN CA 92780-3629
CONTRACTOR ARCHITECT
ORANGE COUNTY ROOFING
735 FARAD STREET
COSTA MESA, CA 92627
949)548-0680
0
JOB DESCRIPTION: REROOF; REMOVE EXISTIN, INSTALL OWENS CORNING COMP SHINGLES, HOUSE AND DEA -1
ER2453-01/ESR1372
LICENSED CONTRACTOR DECLARATION
I hereby affimt that 1 am a licensed Contractor under the provisions of chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code, and my license
LICENSE NUMBER: 784622 LICENSE CLASS: C39
Expires DATE:09/30/2016
OWNER BUILDER DECLARATION:
I hereby aft -inn that 1 am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business Professions Code: Any City or county which requires a peen
structure, prior to its issuance, also requires the applicant for such permit to file a sighed statement that he or she is licensed pursuant to the provisions of the Contractor's License L
3 of the Business & Professions code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a pennil a
hundred dollars ($500.00).
I as owner of the property, or my employees with wages as their sole compensation, will do the work and the structure is not intended or oflered for sale (Section 7044, Busi
not apply to an owner of propeny who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvcntcm
building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or site did not build or improve for purposes of sale).
1, as owner of the properly, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business & Professions Code: The Contractor's Lice
or improves thereon, and who contracts for such projects with a contractor(s) license pursuant to the Contractor's License Lav).
I am exempt under Section , Business & Professions Code for the following reason(s):
Owner Signature: Date:
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the w(
I have and will maintain Worker's Compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this pennil is issued.
Number are:
POLICY NUMBER: 9074951 COMPANY: STATE FUND
(This section need not be completed if the permit is for one hundred dollars ($100) or less).
certify that in a performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensal
subject t he W 's orr�pertsafton provisions of Section 3700 of the Labor Code, 1 shall fo hwith cora 1 with those provisions.
Signator
N'ARN(�G: Failure to secure or is ompensation coverage is unlawful, and shall subjcet an entpbyer to cnmmal penalties and civil fines up to one hundred thousand dollars ('
as provJ d form Section (3700) o the Labor Code, interest and attorney fees.
IMPORTANT:
Application is hereby made to the Building Official for a permit subject to the conditions and restrictions set forth on this application. Each person upon whose behalf this applicati(
benefit work is performed under or pursuant to any permit issues as a result of this application agrees to, and shall, indemnity and hold harmless the City of Tustin, its offices, ager
Chapter 2 of the Uniform Administrative Code. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection has been received. I certify
infomtation is correct. I agree to comply with all City and State lay relating to the building construction, and hereby authorize representative of the City to enter upon the above in
—BUILDING PERMITS ARE SUBJECT TO FF R�ATI POPO
_OF ISSUANCE OR IF WORK IS
NOT COMMENCED WITHIN 180 DAYS AFTER DATE
FOR 180 DAYS—
O.C.F.A. Number.........:
OCCUPANT LOAD:
0
OCCUPANCY GROUP:
R
CONSTRUCTION TYPE.:
RESIDENTIAL SQ.FT:
0
COMMERCIAL SQ FT:
0
INDUSTRIAL SQ FT: 0
GARAGE SQ FT:
0
OFFICE SQ FT:
0
WAREHOUSE SQ FT: 0
ROOF SQ FT:
3400
TENANT IMPR. SQ FT:
0
OTHER SQ. FT: 0
NUMBER OF UNIT'S:
I
NUMBER OF STORIES:
0
CBC EDITION: 2013
NUMBER OF SEATS:
0
VALUATION...:
$8,500.00
BUILDER VALUATION:$11,000.00
FEE SUMMARY
PLAN CHECK
$0.00
BUILDING PERMIT:
$245.77 PLN INSP.:
$0.00
MECH PERMIT:
$0.00
PLUMBING PERMIT:
$0.00 ELEC PERMIT:
$0,00
SIGN PERMIT:
$0.00
GRADING PERMIT:
$0.00 PRIVATE IMPR:
$0.00
NEW DEV. TAX:
$0.00
TSIP ZONE A FEE:
$0.00 TSIP ZONE B FEE:
$0.00
SMTP FEE:
$1.43
MICROFILM FEE:
$4.05 OCFA FEE:
$0.00
PENALTY FEE.:
$0.00
REFUNDABLE BOND:
$0.00 MISCELLANEOUS:
$0.00
PLN REVIEW:
$0.00
TOTAL FEES:
$252.25
LICENSED CONTRACTOR DECLARATION
I hereby affimt that 1 am a licensed Contractor under the provisions of chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code, and my license
LICENSE NUMBER: 784622 LICENSE CLASS: C39
Expires DATE:09/30/2016
OWNER BUILDER DECLARATION:
I hereby aft -inn that 1 am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business Professions Code: Any City or county which requires a peen
structure, prior to its issuance, also requires the applicant for such permit to file a sighed statement that he or she is licensed pursuant to the provisions of the Contractor's License L
3 of the Business & Professions code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a pennil a
hundred dollars ($500.00).
I as owner of the property, or my employees with wages as their sole compensation, will do the work and the structure is not intended or oflered for sale (Section 7044, Busi
not apply to an owner of propeny who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvcntcm
building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or site did not build or improve for purposes of sale).
1, as owner of the properly, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business & Professions Code: The Contractor's Lice
or improves thereon, and who contracts for such projects with a contractor(s) license pursuant to the Contractor's License Lav).
I am exempt under Section , Business & Professions Code for the following reason(s):
Owner Signature: Date:
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the w(
I have and will maintain Worker's Compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this pennil is issued.
Number are:
POLICY NUMBER: 9074951 COMPANY: STATE FUND
(This section need not be completed if the permit is for one hundred dollars ($100) or less).
certify that in a performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensal
subject t he W 's orr�pertsafton provisions of Section 3700 of the Labor Code, 1 shall fo hwith cora 1 with those provisions.
Signator
N'ARN(�G: Failure to secure or is ompensation coverage is unlawful, and shall subjcet an entpbyer to cnmmal penalties and civil fines up to one hundred thousand dollars ('
as provJ d form Section (3700) o the Labor Code, interest and attorney fees.
IMPORTANT:
Application is hereby made to the Building Official for a permit subject to the conditions and restrictions set forth on this application. Each person upon whose behalf this applicati(
benefit work is performed under or pursuant to any permit issues as a result of this application agrees to, and shall, indemnity and hold harmless the City of Tustin, its offices, ager
Chapter 2 of the Uniform Administrative Code. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection has been received. I certify
infomtation is correct. I agree to comply with all City and State lay relating to the building construction, and hereby authorize representative of the City to enter upon the above in
—BUILDING PERMITS ARE SUBJECT TO FF R�ATI POPO
_OF ISSUANCE OR IF WORK IS
NOT COMMENCED WITHIN 180 DAYS AFTER DATE
FOR 180 DAYS—