HomeMy WebLinkAboutB ST S 130 12/17/2018CITY OF TUSTIN
Community Development Department - Building Division
300 Centennial Way, Tustin CA 92780
Building Counter (714) 573-3131- Inspection Recorder (77.4) 573-3141
BUILDING PERMIT NUMBER:
BR -2018-00505
ADDRESS: 130 B ST
ASSESSOR'S PARCEL NUMBER
ISSUED BY: ROBERT DIAZ
DEVELOPMENT AREA:
DATE ISSUED: 12/17/2018
PROPERtI '.GWNER'
CHERIEMULLS
130SBST
TUSTIN, CA 92780
APPLICANT
CONTRACTOR
RICHARD GONZALEZ
FORTIFIED ROOFING INC
13463. ESCADERA ST, VICTORVILLE,
CA 92392
13463 ESCADERA ST, VICTORVILLE, CA 92392
JOB DESCRIPTION: REMOVE EXISTING ROOF LAYERS, INSTALL HOT MOP OVER INSULATION. PITCH AREA INSTALL 30 YR CLASS A
SHINGLE, SYNTHETIC FELT (INST ULATTON WILL STAY) CAR PORT REROOF OVER WITH HOT MOP
OCCUPANTLOAD:
O.C.F.A Number
CONSTRUCTION TYPE:
RESIDENTIAL SQXT:
OCCUPANY GROUP:
INDUSTRIAL SQ.FT. 0
GARAGE SQ FT:
0 COMMERCIAL SQ FT:
0 WAREHOUSE SQ FT: 0
ROOF SQ FT:
0 OFFICE SQ FT:
0 CBC EDITION: 2016
NUMBER OF UNI'T'S:
TENANT IMPR. SQ FT.
0 BUILDER VALUATION:
NUMBF9 OF, SEATS:
NUMBER OF STORIES:
VALUATION: $15,000.00
BUILDING -PERMIT FEE $200.33 PERMIT ISSUANCE. FEF - $35.00 PLANNING INSPECTION FEE - $40.07
BUILDING BUILDING
SB1473 CITY FEE $0.10 SEISMIC STRUCTURAL FEE - $1.95 STATE BUILDING 1473 FEE $0.90
.. ... _ RESIDF.NTYAT,
WRRP APPLICATION FEE $50.00
TOTAL FEES: $27835
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 my license
LICENSE NUMBER 1039300 LICENSE CLASS: C39 -Roofing Contractor
Expires Date: 11/30/2020
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 703 1.5, 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 orimprovement 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).
_ I; 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 puts uam to the Contractor's License Law).
—I am exempt under Section Business & Professions Code for the following reason(s):
WORI(EWS 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.
_ I have and will maintain Workers 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: 9240968 COMPANY: STATE COMPENSATION INSURA
(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 California, and I agree that if I should become subject to the Workers Compensation provisions of Section 3700 of the Labor
Cade, I shall forthwith comply with those provisions.
WARNING: Failure to secure Workers 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 hornless 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 until 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 Suite laws relating to the building
construction, and hereby authorize representative of the City to enter upon the above mentioned property for inspection purposes.
Signature of Owner. Contractor. or Authorized Apert Date
"""BUILDING PERMITS ARE SUBJECT TO EXPIRATION IF WORK IS NOT COMMENCF,D WITHIN 180 DAYS AFTER DATE
OF ISSUANCE OR IF WORK IS SUSPENDED FOR 180 DAYS""*
12/17/2018
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APPROVED
COMMUNITY DEVELOPMENT DEPT
DEC 17 2018
PLAN ING DIVI "I
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