HomeMy WebLinkAbout6TH ST W 365 09/08/2015 (2)CONTRACTOR ARCHITECT
COMMAND AIR CORP
4431 CORPORATE CENTER DRSTE 115
LOS ALAMITOS, CA 90720
714) 952-3900
OB DESCRIPTION:
INSTALL DUCTLESS MINI -SPLIT A/C SYSTEM, 13SEER,
FEE SUMMARY
O.C.F.A. Number.........:
$0.00
BUILDING PERMIT:
$0.00
-
CITY OF TUSTIN
OCCUPANCY GROUP:
R
Community Development Department — Building Division
$0.00
:ESIDENTIAL SQ.FT:
300 Centennial Way, Tustin CA 92780
PAID
0
Building Counter (714) 573-3131 — Inspection Recorder (714) 573-3141
0
1ARAGE SQ FT:
0
SEP - S 2015
IUILDING PERMIT NUMBER: C2015-0620 ADDRESS: 365 W 6TH ST TUST SUITE
CITY OF TUSTIly
0
,,OOF SQ FT:
CASHIER
6SESSOR'S PARCEL NUMBER:
401-372-22 SUITE NUMBER...:
OTHER SQ. FT:
.OT NUMBER ................................:
TRACT NUMBER.:
I
)EVELOPMENT AREA ................:
TUSTIN ISSUED BY .............
CBC EDITION: 2013
$0.00
DATE ISSUED.......: 09/08,2015
0
'ROPERTY OWNER ......................:
BROWN DAVID W & TIFFANY
BUILDER VALUATION:
$0.00
365 W 6TH ST
TUSTIN CA 92781-1224
TOTAL FEES: $105.95
CONTRACTOR ARCHITECT
COMMAND AIR CORP
4431 CORPORATE CENTER DRSTE 115
LOS ALAMITOS, CA 90720
714) 952-3900
OB DESCRIPTION:
INSTALL DUCTLESS MINI -SPLIT A/C SYSTEM, 13SEER,
FEE SUMMARY
O.C.F.A. Number.........:
$0.00
BUILDING PERMIT:
$0.00
)CCUPANT LOAD:
0
OCCUPANCY GROUP:
R
CONSTRUCTION TYPE.:
$0.00
:ESIDENTIAL SQ.FT:
0
COMMERCIAL SQ FT:
0
INDUSTRIAL SQ FT:
0
1ARAGE SQ FT:
0
OFFICE SQ FT:
0
WAREHOUSE SQ FT:
0
,,OOF SQ FT:
0
TENANT IMPR. SQ FT:
0
OTHER SQ. FT:
0
WMBER OF UNITS:
I
NUMBER OF STORIES:
0
CBC EDITION: 2013
$0.00
LUMBER OF SEATS:
0
VALUATION...:
$0.00
BUILDER VALUATION:
$0.00
ICENSED CONTRACTOR DECLARATION:
hereby affirm 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 liceosa
(CENSE NUMBER: 942279 LICENSE CLASS: C20
xpires DATE:01/31/2016
iWNER BUILDER DECLARATION:
hereby aflirn 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 perm
ructure, 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 I_:
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 pennit si
undred dollars ($500.00).
_ 1 as owner of the property, or my employees with wages as their sole compensation, will do die work and the structure is not intended or offered for sale (Section 7044, li—I
n 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!
.hilding or improvement is sold within one year of completion, die 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 die property, am exclusively contracting with licensed contractors to construct die project (Section 7044, Business & Professions Code: The Contractors Lice
improves thereon, and who contracts for such projects with a contractors) license pursuant to the Contractor's License Law).
I am exempt under Section_, Business & Professions Code for the following reason(s):
wrier bignature:
JORKERS' COMPENSATION DECLARATION:
hereby aft rm under penalty of perjury one of the following declarations:
�1 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,
1 have and will maintain Workers Compensation insurance, as required by Section 3700 of the labor Code, for the performance of rte work for which this permit is issued.
amber are:
DLICY NUMBER: SWC1074131 COMPANY: SECURITY
-his 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, 1 shall not employ any person in any Runnier so as to become subject to the Worker's Compens:u
ibjcct to the Worker's Cos perts ' t provisions f S�etie 700 of the labor Code, I shall forthwith c npI ity visions.
Ignature Date: C.�"/ `C� ' -to
'ARNING: Failure t Worker's Compensation coverag� is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ('
provided for in Section (3700) of the Labor Code, interest and attorney fees.
APORTANT:
pplication 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 applicaii�
atetit work is perfornhed hinder 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, ager
hapter 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 eenify
formation is correct. 1 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 in
I>uanhre of wner Contractor or hthorized Agent : (_)1'3Date
'**BUILDING PERMITS AR CT TO EXPIRATION IF WORK IS NOT COMMENCED WITHIN 180 DAYS AFTER DATE
OF ISSUANCE OR IF WORK IS SUSPENDED FOR 180 DAYS***
FEE SUMMARY
LAN CHECK
$0.00
BUILDING PERMIT:
$0.00
PLN INSP.:
$0.00
4ECH PERMIT:
$57.58
PLUMBING PERMIT:
$0.00
ELEC PERMIT:
$44.32
ICN PERMIT:
$0.00
GRADING PERMIT:
$0.00
PRIVATE IMPR:
$0.00
1I- W DEV. TAX:
$0.00
TSIP ZONE A FEE:
$0,00
TSIP ZONE B FEE:
$0.00
MIP FEE:
$0.00
MICROFILM FEE:
$4.05
OCFA FEE:
$0.00
ENALTY FEE.:
$0.00
REFUNDABLE BOND:
$0.00
MISCELLANEOUS:
$0.00
LN REVIEW:
$0.00
TOTAL FEES: $105.95
ICENSED CONTRACTOR DECLARATION:
hereby affirm 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 liceosa
(CENSE NUMBER: 942279 LICENSE CLASS: C20
xpires DATE:01/31/2016
iWNER BUILDER DECLARATION:
hereby aflirn 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 perm
ructure, 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 I_:
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 pennit si
undred dollars ($500.00).
_ 1 as owner of the property, or my employees with wages as their sole compensation, will do die work and the structure is not intended or offered for sale (Section 7044, li—I
n 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!
.hilding or improvement is sold within one year of completion, die 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 die property, am exclusively contracting with licensed contractors to construct die project (Section 7044, Business & Professions Code: The Contractors Lice
improves thereon, and who contracts for such projects with a contractors) license pursuant to the Contractor's License Law).
I am exempt under Section_, Business & Professions Code for the following reason(s):
wrier bignature:
JORKERS' COMPENSATION DECLARATION:
hereby aft rm under penalty of perjury one of the following declarations:
�1 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,
1 have and will maintain Workers Compensation insurance, as required by Section 3700 of the labor Code, for the performance of rte work for which this permit is issued.
amber are:
DLICY NUMBER: SWC1074131 COMPANY: SECURITY
-his 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, 1 shall not employ any person in any Runnier so as to become subject to the Worker's Compens:u
ibjcct to the Worker's Cos perts ' t provisions f S�etie 700 of the labor Code, I shall forthwith c npI ity visions.
Ignature Date: C.�"/ `C� ' -to
'ARNING: Failure t Worker's Compensation coverag� is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ('
provided for in Section (3700) of the Labor Code, interest and attorney fees.
APORTANT:
pplication 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 applicaii�
atetit work is perfornhed hinder 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, ager
hapter 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 eenify
formation is correct. 1 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 in
I>uanhre of wner Contractor or hthorized Agent : (_)1'3Date
'**BUILDING PERMITS AR CT TO EXPIRATION IF WORK IS NOT COMMENCED WITHIN 180 DAYS AFTER DATE
OF ISSUANCE OR IF WORK IS SUSPENDED FOR 180 DAYS***