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Home My WebLink AboutPACIFIC ST 150 06/06/2016• CITY OF TUSTIN • PAID Community Development Department — Building Division JAN 300 Centennial Way, Tustin CA 92780 _ 6 206 Building Counter (714) 573-3131 — Inspection Recorder (714) 573-3141 CIN OF TUSTIN CASHIER BUILDING PERMIT NUMBER: B2015-0517 ADDRESS: 150 PACIFIC ST TUST SUITE ASSESSOR'S PARCEL NUMBER: 401-551-10 LOT NUMBER ................................: DEVELOPMENT AREA ................: TUSTIN PROPERTY OWNER ................... CONTRACTOR SOLARCITY CORPORATION 3055 CLEARVIEW WAY SAN MATEO, CA 94402 (510)414-8120 JOB DESCRIPTION: OCCUPANT LOAD: RESIDENTIAL SQ.FT: GARAGE SQ FT: ROOF SQ FT: NUMBER OF UNITS: NUMBER OF SEATS: JAMES JUNIOR L 150 PACIFIC ST TUSTIN CA 92780-2129 SUITE NUMBER::.: TRACT NUMBER.: ISSUED BY .............: DATE ISSUED.......: 01/06/2016 ARCHITECT 001? ROOFTOP PV SOLAR 4.77 KW, 18 MODULES, 1 INVERTER O.C.F.A. Number.........: OCCUPANCY GROUP: FEE SUMMARY COMMERCIAL SQ FT: 0 OFFICE SQ FT: 0 TENANT IMPR. SQ FT: 0 NUMBER OF STORIES: 0 VALUATION...: $0.00 CONSTRUCTION TYPE.: INDUSTRIAL SQ FT: 0 WAREHOUSE SQ FT: 0 OTHER SQ. FT: 0 CBC EDITION: 2013 BUILDER VALUATION: $16,000.00 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: 888104 LICENSE CLASS: B C10 C20 Expires DATE: 12/31/2016 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 peen 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 L: 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 pennit 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 inhprovemen, 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 contractor(s) license pursuant to the Contractor's License Law). I am exempt under Section , Business & Professions Code for the following reason(s): Owner Signature: Date: WORKERS' COMPENSATION DECLARATION: 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 for by Section 3700 of the Labor Code, for the perfonnance of the we 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: EWC0182018 COMPANY: ZURICH AMERICAN (This section need not be completed if the permit is for one hundred dollars ($100) or less). 1 certify at 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 Compensal subject to the ker's Cons on p�visi!5hs,of Section 3700 of the Labor Code, I shall forthwith cQ�mply with those provisions. Signature Date: ( t/ (r9 WARNING: Fa e to ur orke�' mpensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (' as provided for in Secyq n 9Khe 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 appiicati( 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 occupancy of any building authorized by this permit until final inspection has been received. I certily 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 in ***BUILDING PERMITS ARE SUBJECT TO Ex OF ISSUANCE OR IF IS _z Date / tv — ( IS NOT COMMENCED WITHIN 180 DAYS AFTER DATE D FOR 180 DAYS*** FEE SUMMARY PLAN CHECK $148.00 BUILDING PERMIT: $246.43 PLN INSP.: $42.29 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: $2.08 MICROFILM FEE: $0.00 OCFA FEE: $0.00 PENALTY FEE.: $0.00 REFUNDABLE BOND: $0.00 MISCELLANEOUS: $0.00 PLN REVIEW: $29.60 TOTAL FEES: $469.40 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: 888104 LICENSE CLASS: B C10 C20 Expires DATE: 12/31/2016 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 peen 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 L: 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 pennit 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 inhprovemen, 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 contractor(s) license pursuant to the Contractor's License Law). I am exempt under Section , Business & Professions Code for the following reason(s): Owner Signature: Date: WORKERS' COMPENSATION DECLARATION: 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 for by Section 3700 of the Labor Code, for the perfonnance of the we 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: EWC0182018 COMPANY: ZURICH AMERICAN (This section need not be completed if the permit is for one hundred dollars ($100) or less). 1 certify at 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 Compensal subject to the ker's Cons on p�visi!5hs,of Section 3700 of the Labor Code, I shall forthwith cQ�mply with those provisions. Signature Date: ( t/ (r9 WARNING: Fa e to ur orke�' mpensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (' as provided for in Secyq n 9Khe 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 appiicati( 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 occupancy of any building authorized by this permit until final inspection has been received. I certily 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 in ***BUILDING PERMITS ARE SUBJECT TO Ex OF ISSUANCE OR IF IS _z Date / tv — ( IS NOT COMMENCED WITHIN 180 DAYS AFTER DATE D FOR 180 DAYS***