HomeMy WebLinkAbout3RD ST W 530 09/12/2018BUILDING PERMIT NUMBER:
ASSESSOR'S PARCEL NUMBER:
DEVELOPMENT AREA:
PROPERTY OWNER
CITY OF TUSTIN
Community Development Department - Building Division
300 Centennial Way, Tustin CA 92780
_ Building Counter (714) 573-3131 - Inspection Recorder (714) 573-3141
BR -2018-00324 ADDRESS: 530 THIRD ST
401-364-03 ISSUED BY: ROBERT CHAVEZ
NO COMMERCIAL DISTRIC DATEISSUED: 09/12/2018
CONTRACTOR
FAIRWEATHER.ROOFING INC
1212 E ASA, FULLERTON, CA 92831
(714)997-9449
SOB DESCRIPTION: TEAR OFF OLD ROOF,
REPLACE WITH COMP SHINGLE "CHARCOAL"
OCCUPANT LOAD:
OC.F.ANumbei
CONSTRUCTION TYPE:
RESIDENTIAI. SOFT:' -
OCCUPANY GROUP:
INDUSTRIAL, SQ.FT:
0
GARAGE SQ FT: 0
COMMERCIAL SQ FT:
0 WAREHOUSE SQ IT:
0
ROOF.SQ FT: 0
OFFICE SQ FT:
0 CBC EDITION:
2013
NUMBER OF UNITS:
TENANT IMPR SQ FT:
0 BUILDER VALUATION:
NUMBER OF SEATS:
NUMBER OF STORIES:
VALUATION:
$7,250.00
FEE SUMMARY
BUILDING PERMIT - DIGITIZING /
$4.05 BUILDING PERMIT FEE
$144.00 PERMIT ISSUANCE FEE -
$35.00
SCANNINGFEE
BUILDING
PLANNING INSPECTION FEE-
$28.80 SB1473 CITY FEE
$0.10 SEISMIC STRUCTURAL FEE-
$0.95
BUILDING
RESIDENTIAL
STATE BUILDING 1473 FEE-
$0.90
TOTAL FEES:.
$213.80
LICENSED CONTRACTOR DECLARATION:
I hereby affirm that I am a licensed Contractor under the provisions of chapter 9 (commencing with Section 7000) of Division 3 of the Business
& Professions Code, and myticense
LICENSE NUMBER: 770565
LICENSE CLASS: C39 - Roofing Contractor
Expires Date: 10/31/2019
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business Professions Code: Any City of county
which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a
signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) of Division 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 permit subjects the applicant to a civil penalty of not more than five 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 offered for sale
(Section 7044, Business & Professions Code: the Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does
such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the
building or improvement is sold within one year of completion, the owner -budder will have the burden of proving that he or she did not build or improve for
purposes of sale).
_ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business & Professions Code: The
Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s)
license pursuant to the Contractor's License Law).
__ I am exempt under Section Business & Professions Code for the following reasimus):
Owner Signature: .Date:.__ _.
WORKER'S COMPENSATION DECLARATION:
_ I have and will maintain a certificate of consent to self -insure for Workers Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
_ f 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
permit is issued. My Worker's Compensation insurance carrier and Policy Number are:
POLICY NUMBER: WC018971701 COMPANY: EMPLOYEE SERVICE GROUP
(This section need not be completed if the permit is for one hundred dollars ($100) or less).
_ I certify that in the 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 Compensation laws of Califorrim and I agree that if I should become subject to the Workers Compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions_
WARNING: Failure to secure Worker's Compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred
thousand dollars ($100,000) in addition to the cost of compensation, damages as provided for in Section (3700) of 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 application is made and each person at whose request and for whose benefit work is performed under or pursuant to any permit issues as a result of this
application agrees to, and shall, indemnify and hold harmless the City of Tustin, its officers, agents and employees in accordance with the provisions of Chapter 2
of the Uniform Administrative Code. I agree not to occupy or allow occupancy of any building authorized by this permit and final inspection has been received. I
certify that I have read this application and state that the above information is correct. I agree to comply with all City and State laws relating to the building
construction, and hereby authorize representative of the City to enter upon the above mentioned property for inspection proposes.
Signature of Owner Contractor. or Authorized Agent Date
***BUILDING PERMITS ARE SUBJECT TO EXPIRATION IF WORK IS NOT COMMENCED WITHIN 180 DAYS AFTER DATE
Or ISSUANCE OR IF WORK IS SUSPENDED FOR 180 DAYS***
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