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B23-1612 - 31191 CALLE DEL CAMPOCITY OF SAN JUAN CAPISTRANO BUILDING PERMIT Permit No. B23-1612 12/20/2023 ISSUED JOB VALUE NO UNITS Permit Number ISSUED BY SITE APN SITE LOT NO SITE TRACT SITE SUBDIVISION PERMIT TYPE. OCCUPANCY TYPE BUILDING SF NO STORIES DF4 666-084-12 94 $0 ELECTRICAL 0 1 0 JOB ADDRESS: 31191 CALLE DEL CAMPO CUMMINGS, JAMES FOWNER NAME 31191 CALLE DEL CAMPOMAILING ADDRESS CITY,STATE,ZIP CONTRACTOR NAME ST. LIC EXPIRE ADDRESS CITY, ST, ZIP TENANT NAME PHONE # MAILING ADDR CITY, ST, ZIP I have carefully examined the completed permit application and do hereby certify under penalty of perjury that all information hereon including the declarations are true and correct and I further certify and agree if a permit is issued: to comply with all City, County, and State laws governing building construction, whether specified herein or not. I also agree to save, indemnify and keep harmless the City of San Juan Capistrano against all liabilities, judgments, costs and expenses which may in any way accrue against said City in consequence of the granting of this permit. Applicant's signature Owner/Contractor Print Name AMBRO ELECTRIC 43190 LANCASHIRE COMMON 02/29/2024 AMOUNT MECHANICAL PERMIT AMOUNT Expiration:: Every permit issued shall become invalid unless the work on the site authorized by such permit is commenced within 12 months after its issuance, or if the work authorized on the site by such permit is suspended or abandoned for a period of 180 days after the time the work commenced. An OSHA permit is required for excavations over 5’0” deep and demolition or construction of structures over 3 stories in height. _____Contractor:I hereby affirm that I am licensed under provisions of Chapter 9 of Division 3 of the Business and Professions Code, and my license is in full force and effect. _____Owner/Builder: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. (Sec.7044, Business and Professions Code: the Contractor’s License Laws does not apply to and owner of property who builds or improves thereon, who does such work himself or through his 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 did not build or improve for the purpose of sale) ______Owner/Builder:I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and 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. _______ Workers Compensation-I hereby affirm under penalty of perjury one of the following declarations: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: Carrier__EXEMPT Policy# (This section needs to be completed if the permit is for one hundred dollars($100) or less) AMOUNTELECTRICAL PERMIT DESCRIPTION _______Exemption: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 agree that if I should become subject to the workers’ compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. WARNING:FAILURE TO SECURE WORKERS’COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TI CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSDAND DOLLARS($100,000) IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY’S FEES. B23-1612 Total Electrical Total Plumbing Total Mechanical Total Mobile Home 1011527 , TEMECULA, CA 92529 SAN JUAN CAPISTRANO, CA 92675 (949) 289-1146 (310) 980-6653 PHONE PHONE Date _________________ Applicant _______________________________________ MOBILE HOME PERMIT AMOUNT 30amp PULSAR EV CHARGER LOCATED @ FRONT EXT. WALL PLUMBING PERMIT DocuSign Envelope ID: 97355875-40D6-481B-B3B0-508777BF8C17 12/20/2023 Clemente Ambrosano Ambro Electric Ambro Electric Clemente Ambrosano FINAL 01/25/2024 Date: Permit No. Ap plicant: Phone/E-Mail Job Location: CITY OF SAN JUAN CAPISTRANO BUILDING PERMIT FEES Account #Type Cost 01-44221 Building Permit 01-44223 Mechanical 01-44224 Plumbing 01-44225 Electrical 01-44221 Mobile Home Permit 01-44222 Grading Permit Fee 01-44231 Grading Plan Check 01-44222 On-Site Residential Permit 01-44231 On-Site Residential Plan Check Subtotal 01-44230 Bond Processing 01-44230 Building Plan Check 01-44230 Additional Plan Check 01-44230 Digital Record Fee ($1.00 per sheet) 01-44221 C & D Administrative Fee 01-44221 Special Inspection-Reinspection 01-44222 On-Site Commercial/Tract Permit Fee 01-44231 On-Site Commercial/Tract Plan Check Fee 01-44214 Geotechnical Soils Plan Review 10-44320 Ordinance 211 10-42510 Ordinance 364 01-45354 Copies @ .20 Each 90-23331 SMIP Fee 33-44370 H.O.P.E. Fee (Housing in Lieu) Other Fees TCA Fees Date Received HOA Approval Date Received School Fees Date Received Engineering Fees Date Received Water Division Fees Date Received 01-44221 01-44221 01-44240 90-23000 90-23000 TOTAL FEES PAYABLE TO CITY OF SAN JUAN CAPISTRANO Receipt # _________Date: ______________ Cashier: _____________________________ Refundable Bond/Deposit Posted by ______Owner_____Contractor ________Type Title 24 Energy Provision (20% Permit Subtotal & Bldg Plan Check)) Title 24 ADA Fee (10% Permit Subtotal & Bldg Plan Check) Refundable Bond/Deposit Posted by ______Owner_____Contractor ________Type NPDES Permit Fee (10% Permit Subtotal) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 12/20/2023 $0.00 $0.00 $0.00 12/20/2023 B23-1612 AMBRO ELECTRIC 31191 CALLE DEL CAMPO (310) 980-6653 $0.00 DocuSign Envelope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electrical EV charger ✔ 31191 Calle Del Campo 92675 30A circuit in MSP for hardwired Amp Wall Box Pulsar 24A output . Wall mounted 15 ft away from msp by front of house exterior wall Clemente Ambrosano 310 9806653 clementempu@gmail.com ✔ ✔ 1011527 Ambro Electric Inc 43190Lancashire Common Temecula CA 92592 George Gamble Cox Automotive 31191 Calle Del Campo SAn Juan Cap 92675 949 2891146 1 111 12 11 23 B23 1612