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Home My WebLink AboutPASADENA AVE 265 01/10/2018CITY OF TUSTIN PAID ' Community Development Department — Building Division 300 Centennial Way, Tustin CA 92780 Building Counter (714) 573-3131 — Inspection Recorder (714) 573-3141 JAN 10 2018 CITY OF TUSTIN BUILDING PERMIT NUMBER: C2017-0472 ADDRESS: 265 PASADENA AV TUST SUQASHIER �' ,..a„ ASSESSORS PARCEL NUMB ER� 1 W, SUITE NUMBER...: LOT NUMBER .........................:at TRACT NUMBER.: —�—�—IF .�L.vi ✓� ISSUED BY .............: DEVELOPMENT f :.............. MUMawMMMc Q jDT DATE ISSUED.......: 01/10/2018 PROPERTY 0�UPTE-1l r> n xlCueur� 1Fr CON/WONG MICHELLE JANETTE Tin g4aIapp OOIpMngiprMWMMyMI CppM MnpMYMMMMMMip MW WdM, i ypMiMMtM, TgprppMMM. �.d� a S*Wwy~ow MMMIM ***MMMar CwwYMd Cut" MMMMMM "Mwn My dw&A. TM P.ft bh&Mwd TAM *WMV M/m M*"In r.Ma MppN"Ma pWdq. MMMM. M4, MMpar, pWmpM. awY 4*&p copy JOB DESCRIPTION. Aypro•.eJ .,v DEL, REMOVE LyyIOlAD�i BEARING WALL _ D.M: l �V.�_la OCCUPANT LOAD: RESIDENTIAL SQ.FT: GARAGE SQ FT: ROOF SQ IT: NUMBER OF UNITS: NUMBER OF SEATS: 0 0 0 0 1 0 O.C. A Number.........: OCCUPANCY GROUP: COMMERCIAL SQ IT: OFFICE SQ FT: TENANT IMPR SQ IT: NUMBER OF STORIES: VALUATION...: 0 0 0 0 $0.00 CONSTRUCTION TYPE.: INDUSTRIAL SQ FT: 0 WAREHOUSE SQ FT: 0 OTHER SQ. FT: 0 CBC EDITION: 2016 BUILDER VALUATION:$30,000.00 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: LICENSE CLASS: Expires DATE: 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 or counTy wbieb. requires a pens 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 Contractors License L 3 of the Business & Professions codel 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 sr 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, Busi 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 improvemen 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). I, as owner of the property, 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 contractors) license pursuant to the Contractor's License Law). I am exempt fraler Section Business & Professions Code for thefollowingreason(s): Date. (/i or// 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 forby 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 permit is issued. Number are: POLICY NUMBER: COMPANY: (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 Workers Compensa subject to the Workers Compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signuture - 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 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 applicati benefit work is performed under or ptusuam to any permit issues as a result of this application agrees to, and shall, indemnify and hold harmless the City of Tustin, its officers, ager Chapter 2 of the Uniform Administrative Cade. I agree not to occupy or allow occupancy of any building authorised by this permit until final inspection has been received. I certify information is correct. I agree to comply with all City and State laws relating to the building construction, and hereby authorize represenmtive of the City to enter upon the above a m Coufra for or Aulbori_ed A \�-' f /— ✓ Date /�p� 9 PERMITS ARE SUBJECT TO EXP TI [FWORK W COMMENCED W1T'HIN 180 AYS AFTER DATE OF ISSUANCE OR IF WORK IS SUSPENDED FOR 180 DAYS" FEE SUMMARY PLAN CHECK $246.24 BUILDING PERMIT: $386.77 PLN INSP.: $70.35 MECH PERMIT: $0.00 PLUMBING PERMIT: $50.02 ELEC PERMIT: $66.10 SIGN PERMIT: $0.00 GRADING PERMIT: $0.00 PRIVATE IIIvv1PR $0.00 NEW DEV. TAX: $0.00 TSIP ZONE A FEE: $0.00 TSIP ZONE B FEE: $0.00 SMIPFEE: $3.90 MICROFILM FEE: $12.15 OCFAFEE: $0.00 PENALTY FEE.: $0.00 REFUNDABLE BOND: $0.00 MISCELLANEOUS: $0.00 PLN REVIEW: $49.25 TOTAL FEES: $886.78 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: LICENSE CLASS: Expires DATE: 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 or counTy wbieb. requires a pens 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 Contractors License L 3 of the Business & Professions codel 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 sr 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, Busi 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 improvemen 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). I, as owner of the property, 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 contractors) license pursuant to the Contractor's License Law). I am exempt fraler Section Business & Professions Code for thefollowingreason(s): Date. (/i or// 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 forby 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 permit is issued. Number are: POLICY NUMBER: COMPANY: (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 Workers Compensa subject to the Workers Compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signuture - 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 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 applicati benefit work is performed under or ptusuam to any permit issues as a result of this application agrees to, and shall, indemnify and hold harmless the City of Tustin, its officers, ager Chapter 2 of the Uniform Administrative Cade. I agree not to occupy or allow occupancy of any building authorised by this permit until final inspection has been received. I certify information is correct. I agree to comply with all City and State laws relating to the building construction, and hereby authorize represenmtive of the City to enter upon the above a m Coufra for or Aulbori_ed A \�-' f /— ✓ Date /�p� 9 PERMITS ARE SUBJECT TO EXP TI [FWORK W COMMENCED W1T'HIN 180 AYS AFTER DATE OF ISSUANCE OR IF WORK IS SUSPENDED FOR 180 DAYS"