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Home My WebLink AboutB ST N 168 06/06/2018CITY OF TUSTIN Community Development Department - Building Division 300 Centennial Way, Tustin CA 92780 Building Counter (714) 573-3131 - Inspection Recorder (714) 573-3141 BUILDING PERMIT NUMBER: COMBR-2018-00148 ADDRESS: 168 B ST ASSESSOR'S PARCEL NUMBER: 401-523-26 ISSUED BY: DEVELOPMENT AREA: NO COMMEI W1*WJ4 E, ,,,+y rDATEISSUED: PROPERTY OWNER: BRUCELANE o}4J''lni' SYSTEM ADMINISTRATOR 06/042018 APPLICANT s-; CONTRACTOR IE INC _ . COMPLETE COMFQ,%T HEATING AND AIR 31225 LA BAYA, WESTLAKE VILLAGE, CA'msaaa.? Saul nva tcmaalwT c+a oMil 8:x+f,', JOB DESCRIPTION: NEW A/C UNYA WITH A DISCONNECT SWITCH:.. . . OCCUPANT LOAD: O GF A Number ""CONSTRUCTION TYPE: RESIDENTIAL SOFT: OCCUPANY GROUP. �" ra, IN]bbSTRIAL SQ.FT: 0 GARAGE SQ FT: 0 ' CQNLMERCIALSQFT: . .,nn n+:+eeu.. 0 WAREHOUSE SQ FT: 0 ROOF SQ IT: 0 OFFICE SQ FT *o R"" 0 CBC EDITION: 2013 NUMBER OF UNITS: m erre TENANT IMPR SQ PT 0 B DER VALUATION: vr , NUMBER OF SEATS: NUMBER OF VALUATION: $0.00 FEE SUMMARY PERMIT FEE - MECHANICAL $11.29 PERMIT ISSUANCE FEE ELECTRICAL SEISMIC STRUCTURAL FEE - $0.50 RESIDENTIAL TOTAL FEES: $81.79 $35.00 PERMIT ISSUANCE FEE - $35.00 MECHANICAL 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 license LICENSE NUMBER: 940202 36 LICENSE CLASS: C20 -Warm-Air Heating, Ventilating and Air -Gond Expires Date: 04/302019 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 in the provisions of the Contractors 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 Contractors 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 -builder 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). _ 1 am exempt under Section Business & Professions Code for the following reason(s): Owner Signature: Date: WORKER'S COMPENSATION DECLARATION: _ 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 work for which this permit is issued. _ I have and will maintain Worker's Compensation insurance, is required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers Compensation insurance carrier and Policy Number are: POLICY NUMBER: COMPANY: (This section need not be completed if the permit is for one hundred dollars ($100) or less). _ 1 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 Code, I shall forthwith comply with those provisions. Signature Date: 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 pennit 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 State 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 Agent Date ***BUILDING PERMITS ARE SUBJECT TO EXPIRATION IF WORK IS NOT COMMENCED WITHIN 180 DAYS AFTER DATE OF ISSUANCE OR IF WORK IS SUSPENDED FOR 180 DAYS*** Comrtwuny Devekpnlenl Dapa1Y1NN CMIN�g`b� nW DA�igegynM� A0 v 7MO�bOMMrpkNWsaa N�laYMypb reprNa�arban YIoh101E NOMQI[♦ �Nwaq�y A 110 MYN, Beleheelel smle1, 01 I.1 i / I � 4gMAI bslwd + Crm...ft. 1001.ONCNmhlrlWcrAbpllala DIM"""* aaW dOm nn mar The paopvsi, n., ,nrmwulo me NwdclwCmaaneaatltarre eaayll WMuds. I aMu,. awe The propos., oore turas ml aCsarseiy aheC me Cdera0rlelMarklar Dwunea.: C~O fl"Op whrsn Ino pmol-, Tb p,s ,sed worts la harmoniope wah ..lean, swiwu d&W M la d oppr,11,w.eness of m edala,a dp. Mae. hethl, pbcmne,, aM pee W ecele bind. i0 or nrixmre In relariw Mp Ip ozill g pmimngv and s@pplurtl aM 1M aurtnunding seMnp Approve[ pv - J,�y'v^i'�•v'�'L Date: 9 _ _