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Home My WebLink AboutC ST N 170 06/21/2018CITY OF TUSTIN Community Development Department - Building Division 300 Centennial Way, Tustin CA 92780 Building Counter (714) 573-3131 - Inspection Recorder (714) 573-3141 BUILDING PERMIT NUMBER: BR -2018-00220 ASSESSOR'S PARCEL NUMBER- DEVELOPMENT UMBERDEVELOPMENT AREA: PROPERTY OWNER 401-531-24 NO COMMERCIAL DISTRIC ADDRESS: 170 N CST ISSUEDBY: ROBERT C14AVEZ DATE ISSUED: OWNER/BUILDER APPLICANT MIDDLETON THOMAS D & KEIL KATHLEEN KATHY KEIL 678 CLINTON ST, ORANGE, CA 92867 170 N C ST, TUSTIN, CA 92780 JOB DESCRIPTION: DEMOLISH NON PERMITTED TRELLES 414 1' a e. a O.C.F.A Number CONSTRUCTION TYPE: RESIDENTIAL SQTT: OCCUPANY GROUP: INDUSTRIAL SQ.FT: 0 GARAGE SQ FT: 0 COMMERCIAL SQ IT: 0 WAREHOUSE SQ FT: 0 ROOF SQ FT: 0 OFFICE SQ FT: 0 CBC EDITION: 2013 NUMBER OF UNITS: TENANT IMPR SQ FT: 0 BUILDER VALUATION: NUMBER OF SEATS: NUMBER OF STORIES: VALUATION: $100.00 BUILDING PERMIT FEE $144.00 BUB,DING PLAN CHECK FEF, $100.80 PERMIT ISSUANCE FEE- $35.00 BUILDING PLANNING INSPECTION FEE- $28.80 PLANNING PLAN CHECK FEE $20.16 SB1473 CITY FEE $0.10 BUILDING SEISMIC STRUCTURAL FEE - $0.50 STATE BUILDING 1473 FEE $0.90 RESIDENTIAL TOTAL FEES: LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am a licensed Contractor ander 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 of county which requires a permit to construct, alter, improve, demolish, or repair any 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 Law [Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions code] or that he or she is exempt therefromand the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five 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, Business & Professions Code: the Contractors License Law does 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 improvements are not intended or offered for sale_ If, however, the 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). L as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business & Professions Code: The Contractor's License Law does not apply to an owner of property who builds 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: WORKER'S COMPENSATION DECLARATION: _ I have and will maintain a certificate of consent to self -insure for Workers Compensation- as provided for by Section 3700 ofthe Labor Code, for the performance of the work for which this permit is issued. _ I 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. My Workers Compensation insurance carrier and Policy Number are: POLICY NUMBER COMPANY: (This section need not be completed if the permit is for one hundred dollars ($100) or lass). _ 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 Compensation laws of California, and I agree that if I should become subject to the Worker's Compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 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 ($100,000) in addition to the cost of compensation, damages as provided for in Section (3700) of the Labor Code, interest and attorney fees. IWORI'ANl': 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 application is made and eachperson at whose request and for whose benefit work is performed under or pursuant to any permit issues as a result of this application agrees to, and shall, indemnity and hold harmless the City of Tustin, its officers, agents and employees in accordance with the provisions of 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 certify that I have read this application and state flet the above information is correct. I agree to comply with all City and State laws relating to the building contraction, and hereby authorize representative of the City to enter upon the above mentioned property for inspection purposes. Signture of Owner. Contractor, or Authorized Agent Date ***BUILDING PERMITS ARE SUBJECT TO EXPIRATION IF WORK IS NOT COMMENCED WITHIN 180 DAYS AFTER DATE OF ISSUANCE OR IF WORK IS SUSPENDED FOR 180 DAYS*** 1 k---- Pa -ho e DTe4' WMwes mar I TM proposed wo:5 wnfom to ma MU .pw Coo. Mn eanbHOW eWlOrr mndvda, n eppicapla. TM proposed worxdose wradvereely ane.: d�e�harecW OISW rNf eWOr Dnignmed Celwnl Reeowcea within me my h.. The Om .d work m harnonioua swln •-0aang ecneurWlrp. N Wine of epprnpriareneas of MW.Hel., ...le, cliff. hepM, placement anfl Mf of • new b.;M'ng or nm in nl I ehy W etleWp Wb -g- and .bucluree enc M eo�roundinp a np 2I I APPRO\4ED OO(NUNITY DEVELDPMMENT DEPT _JUN 212118 PLA 1 ISION BY: f ----� PL This set of plans & specifications must be kept on the job at all times and it Is unlawful to make any changes or alterations on same without written permission from the Building Division, City of Tustin. The stamping of this pian & specifications SHALL NOT be held to permit or be an approval of the violation of any provisions of ANY City Ordinance. State or Federal Lam APPROVED DATE G/2, BY Uf � 1 � S1 StA Z uXa iA:. /70 F0*9..Y-4 (f- `�'i o-,7 � 4 <,I zlb 00 Cum,nuniry DaveloprrWr4 M � Certificate of AppfopN N l tV 10111 pwl� c W& NvoMe emen W (ei 4 Wen NCNgad N MM No- ! xkel Rry m /+ �+ OF JUSTIN CITY OF�TUJTIN i V Ire(WS le: BUIt 1 R.hng: WMwes mar I TM proposed wo:5 wnfom to ma MU .pw Coo. Mn eanbHOW eWlOrr mndvda, n eppicapla. TM proposed worxdose wradvereely ane.: d�e�harecW OISW rNf eWOr Dnignmed Celwnl Reeowcea within me my h.. The Om .d work m harnonioua swln •-0aang ecneurWlrp. N Wine of epprnpriareneas of MW.Hel., ...le, cliff. hepM, placement anfl Mf of • new b.;M'ng or nm in nl I ehy W etleWp Wb -g- and .bucluree enc M eo�roundinp a np 2I I APPRO\4ED OO(NUNITY DEVELDPMMENT DEPT _JUN 212118 PLA 1 ISION BY: f ----� PL This set of plans & specifications must be kept on the job at all times and it Is unlawful to make any changes or alterations on same without written permission from the Building Division, City of Tustin. The stamping of this pian & specifications SHALL NOT be held to permit or be an approval of the violation of any provisions of ANY City Ordinance. State or Federal Lam APPROVED DATE G/2, BY Uf � 1 � S1 StA Z uXa iA:. /70 F0*9..Y-4 (f- `�'i o-,7