HomeMy WebLinkAboutEL CAMINO REAL 434 11/19/2015CITY OF TUSTIN
COMMUNITY DEVEDEPARTMENT
PERMIT APPLICATION 7141573-3i3lor7141573-3132LOPMENT PAX:71415?13125
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PLAN CHECK# 9
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PROJECT ADDRESS 434 E L P4 VALUATION OF PROJECT A
**DESCRIBE WORK TO BE DONE 1110PLAtre-W& 00V W& StW ?AkJE[
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APPLICANT (contact) NAME: V
I am the: Phone No.
0 Property Owner 13 Architect
13 Contractor s C3 Engineer
Employee of the
QOwnar (3 Contractor (vwowtm atctx*w,
6-P. R*f1w),
CONTRACTOR:, Co, Name
Addr(
State License # Class
Address:
I., TV
PWO-d Work:
-*SUB-CONTRACTOR: 13 YES
0 No
Email
ARCHITECT: Co. Name
State License# Class
ENGINEER: Co. Name
State Registration 9 --Class — Exp. -_)(Thftuw
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PROPERTY VMER: (required) 41
Name - Lo's 4k
Addt*ss
PhoneNtmbit! 6U-2669-7777
Email Address - 0 @
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.'Itntant
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appropriatenes I to, PI r4i y" of a new
Room addition/Alteration sq. ft.. h11ddi4,;j ==J =18i NO=
Garage !urfou
g wall (x) max. 6'-13" high
light -frame —Sq. ft., kit x; Liq aacfeet of Wood -fence (x) max. high
masonry sq.
'Pl-
Proposed Roofing Material Patio enclosure sq. ft.
ICC ER# of roofing Patio cover sq, ft.
Roof area sq. ft. Pool & Spa —sq. ft.
Y70)& a 6mdo? 4 A. p%llAprduidAJouciuralanaw,byae"01'. gigh
5.3.z> sq.
Demolition sq. ft. Skylight sq. ft. Fire sprinklers _ _
New Building Area sq. ft,
Tenant Improvement sq. ft.
For All waste. eallection hies or roll Off boxes, it is mandatory to
APPLICANT SIGNATURE:
Grading area sq. ft.
Class Construction Type
City's franchist waste hauler. 1'ru3tin Code Section 4321- Ord, N.o. 132.5)
DATE:
- CITY OF TUSTIN PAID
Community Development Department — Building Division NOV 19 2015
300 Centennial Way, Tustin CA 92780
Building Counter (714) 573-3131 — Inspection Recorder (714) 573-3141 CM OF TUSTIN
CASHIER
BUILDING PERMIT NUMBER: S2015-0074 ADDRESS: 434 EL CAMINO REAL TUST SUITE
ASSESSOR'S PARCEL NUMBER: 401-622-08
LOT NUMBER ................................:
DEVELOPMENT AREA ................: TUSTIN
PROPERTY OWNER ......................: POTTENGER MARGARET E
PO BOX 1946,
TUSTIN CA 92781
CONTRACTOR
JOB DESCRIPTION: FACE CHANGE "ZAMA TEA"
O.C.F.A. Number.........:??
SUITE NUMBER...:
TRACT NUMBER.:
ISSUED BY .............:
DATE ISSUED.......: 11/19/2015
ARCHITECT
OCCUPANT LOAD:
0
OCCUPANCY GROUP:
FEE SUMMARY
CONSTRUCTION TYPE.:
PLAN CHECK
RESIDENTIAL SQ.FT:
0
COMMERCIAL SQ FT:
0
INDUSTRIAL SQ FT:
0
GARAGE SQ FT:
0
OFFICE SQ FT:
0
WAREHOUSE SQ FT:
0
ROOF SQ FT:
0
TENANT IMPR. SQ FT:
0
OTHER SQ. FT:
0
NUMBER OF UNITS:
0
NUMBER OF STORIES:
0
CBC EDITION: 2013
SMTP FEE:
NUMBER OF SEATS:
??
VALUATION...:
$0.00
BUILDER VALUATION:
$0.00
LICENSED CONTRACTOR DECLARATION:
1 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 which requires a perm
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 G
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 st
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 improvemern
building or improvement is sold within one ear 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 ex ively contracting with licensed contractors to construct the project (Section 7044, Business & Professions Code: The Contractor's Lice:
or improves thereon, and who contracts f such pr ects with a contractor(s) license pursuant to the Contractor's License Law).
I am exeippt under Section Ausiness & Professions Code for the following reason(s):
Owner Signature . Date:
WORKERS' CO N Tl
I hereby affirm under penalty of p ury on of the ollowing declarations:
I have and will maintain certific to of co sent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the we
1 have and will maintain Worker' 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).
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 Compensat
subject to the Worker's Compensation provisions of Section 3700 of the Labor Code, l 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 ('
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 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, agen
Chapter 2 of the Uniform Administrative Code. I agree not to occupy or allow oc upancy of any building authorized 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 t the bt)iding construction, and hereby authorize representative of the City to enter upon the above in
***BUILDING PERMITS ARE SUBJECT TO EXPIRATION IFWO S N07COMMENCED WITHIN 180 DAYA AFTER DATE
OF ISSUANCE OR IF WORK IS SUSPEN D FO 180 DAYS***
FEE SUMMARY
PLAN CHECK
$0.00
BUILDING PERMIT:
??
PLN INSP.:
$0.00
MECH PERMIT:
$0.00
PLUMBING PERMIT:
$0.00
ELEC PERMIT:
$0.00
SIGN PERMIT:
$0.00
GRADING PERMIT:
$0.00
PRIVATE IMPR:
$0.00
NEW DEV. TAX:
$0.00
TSIP ZONE A FEE:
$0.00
TSIP ZONE B FEE:
$0.00
SMTP FEE:
$0.50
MICROFILM FEE:
$0.00
OCFA FEE:
$0.00
PENALTY FEE.:
$0.00
REFUNDABLE BOND:
$0.00
MISCELLANEOUS:
$0.00
PLN REVIEW:
$0.00
TOTAL FEES:
$35.50
LICENSED CONTRACTOR DECLARATION:
1 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 which requires a perm
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 G
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 st
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 improvemern
building or improvement is sold within one ear 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 ex ively contracting with licensed contractors to construct the project (Section 7044, Business & Professions Code: The Contractor's Lice:
or improves thereon, and who contracts f such pr ects with a contractor(s) license pursuant to the Contractor's License Law).
I am exeippt under Section Ausiness & Professions Code for the following reason(s):
Owner Signature . Date:
WORKERS' CO N Tl
I hereby affirm under penalty of p ury on of the ollowing declarations:
I have and will maintain certific to of co sent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the we
1 have and will maintain Worker' 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).
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 Compensat
subject to the Worker's Compensation provisions of Section 3700 of the Labor Code, l 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 ('
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 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, agen
Chapter 2 of the Uniform Administrative Code. I agree not to occupy or allow oc upancy of any building authorized 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 t the bt)iding construction, and hereby authorize representative of the City to enter upon the above in
***BUILDING PERMITS ARE SUBJECT TO EXPIRATION IFWO S N07COMMENCED WITHIN 180 DAYA AFTER DATE
OF ISSUANCE OR IF WORK IS SUSPEN D FO 180 DAYS***
• 0
Existing heights for the free-
standing post and existing
hardware. No modifications to
these heights with the new sign.
134 %"
123 %2"
Sign Panel
24" x 32"
109"
Margaret E. Pottenger
434 EI Camino Real
Tustin, California 92780
November 19, 2015
To whom it may concern:
•
I hereby grant to Zama Tea Corp. my personal approval and permission to replace the existing sign on
the post at "The Jabberwocky Building" located at 434 EI Camino Real, Tustin CA 92780 with a sign of
their choosing to identify the business which they lease from me.
Margaret . Pottenger
Owner, "The Jabberwocky Building"
•
New Sign Panel (Zama Tea)
434 EI Camino Real
y
1 41
y
Same exact hardware. Only difference is the sign panel itself. We are replacing a
damaged wood sign panel with a new sign panel (Zama Tea) made of .080
Aluminum with the graphic made of durable 3M vinyl and laminate.
•
E
Old Sign Panel (Jabberwocky)
434 El Camino Real
Sign panel will hang from existing free-standing
post and use existing hardware.
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