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Home My WebLink AboutPASADENA AVE 165 05/17/20160 165 Pasadena Soars o� "CK: /% A -G l - 60i �urtiai,G//'0 &4& � 2,10k, / eivepily 1 t e h rlrj, CI-711"OF TUTIN BUILDING DIVISION APPROVED This set of plans & soecifications must be kept on the jofl at aH times and it is unlawful to make any changes or a IlG,rdti Jl C mc i_ on sae with cut written permiccin,n front the RL!iltjirlrg Civision, City of Tustin. The stamping of this plan & specifications SHALL NOT be held to permit or he an ai-prove! of the violation of any provisions of ANY City Ordinance, State or Federal Law. APPROVED DATE_- �,a z a l;17e, APPROVED COMMUNITY DEVELOPMENT DEPT MAY 17 2016 Community Development Department Certificate of Appropriateness ..,yn v..rrwrn w nrucmurete) ata_ t ware Inciva d in the C4rival Rsaarees Sunay Report O VES T'�utid�^..' *(a) Silvia: Rating: with Ordinance No. 1001, the Commurkty Daysiopmsnt Department finds it that W swork conforms to the Municipal Code and established design M applicablesed work does not edvsrsey affect the character of it distrid or dCultural Resources within the district sed work is harmonious with existing surroundings in terms of eness of materials, scale, size, height, placement, and use of a MW building or structure In relationshlp to existing buildings and structures and lha suruuldrng s ring 151 «11� Appy. 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: 765074 LICENSE CLASS: CIO C20 C36 Expires DATE:06/30/2017 OWNER BUILDER DECLARATION: I hereby affirm that 1 am exempt from the Contractor's License taw for the following reason (Section 7031.5, Business Professions Code: Any City or county which requires a Penn 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 U• 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). _ 1 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 iniprovemem building or improvement is sold within one year of completion, the owner -builds will have the burden of proving that he or she did not build or improve for purposes of sale). L 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: 1 have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Lahor 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 the work for which this permit is issued. Number are: POLICY NUMBER: WC7631508631 COMPANY: LIBERTY INS (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' mpehtsation r 'sions of Section 3700 of the labor Code, I shall forthwith cora ly w th those provisions. WARN ore to orker's Compensation coverage is unlawful, and shall subject an employer to as provi ed for N Section (3700) of the labor Code, interest and attorney kes. IMPOR ANT: penalties and civil fines up to one hundred thousand dollars (t 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 trader 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. 1 agree not to occupy or allow occupancy of any building authorized by this pennit until final inspection has been received. I certify information 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 -BUILDING PERMITS ARE SUBJECT T P ATIO RK IS NOT COMMENCED WITHIN 180 DAYS AFTER DATE OF ISSUANCE Olt IF WORK IS SUSPENDED FOR 180 DAYS" `'•CITY OF *TIN Community Development Department — Building Division PAID 300 Centennial Way, Tustin CA 92780 Building Counter (714) 573-3131 — Inspection Recorder (714) 573-3141 MAY 17 2016 Cm OF TUSTIN BUILDING PERMIT NUMBER: C2016-0159 ADDRESS: 165 PASADENA AV TUST SLaASHIER ASSESSOR'S PARCEL NUMBER: 401-541-09 SUITE NUMBER...: LOT NUMBER ................................: TRACT NUMBER.: DEVELOPMENT AREA ................: TUSTIN ISSUED BY ............. DATE ISSUED.......: 05/17/2016 PROPERTY OWNER ......................: VERRALL TRAVIS & WENDY 165 PASADENA AV TUSTIN CA 92780-2914 CONTRACTOR ARCHITECT RIGHTIME HOME SERVICES 965 RIDGE LAKE BLVD SUITE 201 MEMPHIS, TN 38120 (951)276-9744 JOB DESCRIPTION: NEW A/C, COIL, FURNACE,DUCTS, 3TON, 70K BTU O.C.F.A. Number.........: OCCUPANT LOAD: 0 OCCUPANCY GROUP: R CONSTRUCTION TYPE.: 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: I NUMBER OF STORIES: 0 CBC EDITION: 2013 NUMBER OF SEATS: 0 VALUATION...: $0.00 BUILDER VALUATION: $0.00 FEE SUMMARY PLAN CHECK $0.00 BUILDING PERMIT: $0.00 PLN INSP.: $0.00 MECH PERMIT: $70.85 PLUMBING PERMIT: $0.00 ELEC PERMIT: $44.32 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 SMIP FEE: $0.00 MICROFILM FEE: $6.75 OCFA FEE: $0.00 PENALTY FEE.: $0.00 REFUNDABLE BOND: $0.00 MISCELLANEOUS: $0.00 PLN REVIEW: $0.00 TOTAL FEES: $121.92 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: 765074 LICENSE CLASS: CIO C20 C36 Expires DATE:06/30/2017 OWNER BUILDER DECLARATION: I hereby affirm that 1 am exempt from the Contractor's License taw for the following reason (Section 7031.5, Business Professions Code: Any City or county which requires a Penn 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 U• 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). _ 1 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 iniprovemem building or improvement is sold within one year of completion, the owner -builds will have the burden of proving that he or she did not build or improve for purposes of sale). L 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: 1 have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Lahor 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 the work for which this permit is issued. Number are: POLICY NUMBER: WC7631508631 COMPANY: LIBERTY INS (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' mpehtsation r 'sions of Section 3700 of the labor Code, I shall forthwith cora ly w th those provisions. WARN ore to orker's Compensation coverage is unlawful, and shall subject an employer to as provi ed for N Section (3700) of the labor Code, interest and attorney kes. IMPOR ANT: penalties and civil fines up to one hundred thousand dollars (t 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 trader 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. 1 agree not to occupy or allow occupancy of any building authorized by this pennit until final inspection has been received. I certify information 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 -BUILDING PERMITS ARE SUBJECT T P ATIO RK IS NOT COMMENCED WITHIN 180 DAYS AFTER DATE OF ISSUANCE Olt IF WORK IS SUSPENDED FOR 180 DAYS"