B23-1494 - 32065 VIA CANELAFINAL
01/26/2024
Permit Number
ISSUED BY
SITE APN
SITE LOT NO
SITE TRACT
SITE SUBDIVISION
JOB VA LUE
OCCUPANCY TYPE
B23-1494
CJ5
666-141-15
15
$ 14,200
CITY OF SAN JUAN CAPISTRANO
BUILDING PERMIT
Permit No. B23-1494
DESCRIPTION
CHANGE OUT AC & FURNACE LIKE FOR LIKE
ISSUED
11/08/2023
PERMIT TYPE. MECHANICAL ELECTRICAL PERMIT AMOUNT
BUILDING SF 0
NO STORIES I
NO UNITS 0
JOB ADDRESS: 32065 VIA CANELA :
OWNER NAME MALANOSKY, RONALD E
PHONE (949)48900538 . MAILING ADDRESS 32065 VIA CANELA
CITY,STATE,ZIP SAN JUAN CAPISTRANO, CA 92675 Total �kctrical
CONTRACTOR _NAME JUST RIGHT SERVICES .. PLUMBING PERMIT AMOUNT 970383
ST. LIC EXPIRE 04/30/2024
PHONE (949) 228-2108
ADDRESS 23482 PERALTA DR
CITY, ST, ZIP LAGUNA HILLS, CA 92653
TENANT NAME
PHONE#
MAILING ADDR
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:
' . .
Total Plumbing
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..
-
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CITY, ST, ZIP MECHANICAL PERMIT AMOUNT MOBILE HOME PERMIT AMOUNT
'
Total Mobile Home
I have carefully examined the completed pennit application and do hereby certify under penalty of
perjury that all infonnation hereon including the declarations are true and correct and I further
certify and agree ifa pennit is issued: to comply with all City, County, and State laws governing
building constrnction, whether specified herein or not. I also agree to save, indemnify and keep
hannless the City of San Juan Capistrano :igrunst all liabilities, judgments, costs and expenses
which may in any way accrue against�-ly in cu11sc·�q ,c cc uf c1 granting of this permit.
Owner/Contractor (I\ "1\.vt Print Name
�A_y,1tJicant's signature
MECHANICAL ISSUANCE FEE 27.24
AC/BOILR/COMP: <=3HP & IO0K BTU 16.28
FURNACE FORCED AIR<= IO0K BTU .. 16.39
.
Total Mechanical 59.91
:s>:pirntion:: Every ·permit issued shall become invalid unless the work on the site authorized b)
uch permit is commenced within 12 months after its issuance, or if the work authorized on the
ii• by such permit is suspended or abandoned for a period of 180 days after the time the work
umm�r.1ced..
An OSHA pennit is required for excavations over 5'0" deep and demolition or construction of
structures over 3 stories in height.
,.,_�f \ Contractor: I hereby affinn �icensed under provisions of Chapter 9 of Division 3 of the Business and Professions Code, and my license is in full force and effect.
__ Qvhler/Builder: I, as owner oftFle j)roperty, 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)
�
_Owper/RuHdtri 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
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.
� Worl;cll' Cnmpens:itinn-1 hereby affirm under penalty of perjury one of the following declarations:J have and will maintain workers' compensation insurance, as required by Section 3700 of 111
Labor Code, for the perfonnance of the work for which this pennit is issued. My workers' compensation insurance carrier and policy number are: Carrier SIRIUSPOINT AMERIC A INSURANCE
COMPANY Policy#WC73109 (This section needs to be completed if the pennit is for one hundred dollars($\ 00) or less)
Exemption: I certify that in the pccfom1ance of the work for which this permit is issued, r shall not employ any person in any manner so as to become subject to the workers' compensation la,,..·s of
California and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall fm1hwith comply with those p1'ovisions�
)ate Applicant WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER Tl 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. SEE REV1
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