B23-0013 - 29351 APPLEWOOD CTCITY OF SAN JUAN CAPISTRANO
BUILDING PERMIT
Permit No. 823-0013 Permit Number B23-0013 DESCRIPTION 7 ROOF MOUNTED PANELS. 3.80 kW SYSTEM CODE YEAR 2022 ISSUED BY CJ5 SITE APN 650-132-31SITE LOT NO 31 SITE TRACT SITE SUBDI VISION JOB VALUE $ 7,000 OCCUPANCY TYPE PERMIT TYPE. SOLAR PANEL INSTALLA ELECTRIC AL PERMIT BUILDING SF 0 NO STORJES I NO UNITS 0 JOB ADDRESS: 29351 APPLEWOOD CTOWNER NAME BECK FAMILY TRUST, PHONE (949) 365-0873MAILING ADDRESS 29351 APPLEWOOD CT CITY,STATE,ZIP SAN JUAN CAPISTRANO, CA 92675 Total Electrical CONTRACTOR NAME SUNRUN INSTALLATION SERVICES INC PLUMBING PERMIT 750184 ST. LIC EXPIRE 06/30/2024 PHONE (415) 580-6857ADDRESS 21 WORLDS FAIR DRJ VE CITY, ST, ZIP SOMERSET, NJ 08873 TENANT NAME PHONE# MAILING ADDR Total Plumbing CITY, ST, ZIP ' MECHANICAL PERMIT MOBlLEHOME PERMIT AMOUNT
Total Mobile Home I have carefully examined the completed permit application and do hereby certify under penalty of perjury that all infonnalion hereon including the declarations are true and correct and I further certify and agree if a pennit is issued: to comply with all City, County, and State laws governing Total Mechanical
ISSUED
01/05/2023
AMOUNT
AMOUNT
AMOUNT
building construction, whether sp ecified herein or not I also agree to save, indemnify and keep �xpiration:: Every permit issued shall become invalid unless the work on the site authorized b) hannless the City of San Juan Capistrano against all liabilities, judb'lTlents, costs and expenses uch permit is commenced within 12 months after its issuance, or if the work authorized on the
;:�::1�:n:;:::;::e againstfe\,CO\G\ICC�o� U\\\o ite by such permit is suspended or abandoned for a period of 180 days after the time the work
ommenced.
Print Name �L, I An OSHA pennit is required for excavations over 5'0" deep and demolition or construction of
✓1<----c? structures over 3 stories in height
Applicant's signature
f'tl-!:;2ntro£t2r: I hereby affinn thafr 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: J, as ownc1 of the prope1fy, or my employees with wages as thefr sole compensation, will do the wo1k and the structure is not intended or offered for sale. (Sec, 7044, Business and Professions
Code: the Contractor's License Laws docs 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 arc not
intended or offered for sale. lf however, the building or improvement is sold within one year of completion, the owner-builder will have the bmden of proving that he did not build or improve fort.he purpose of sale)
Owner/Builder: I, as owne1 of the property, am exclusively conh·acting with licensed contractors to construct the p1oject (Sec. 7044, Business and Professions Code: The Conbactor·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, �\J.-wnrkeno Comucrmuion-1 hereby affirrn under penalty of perjury one of the following declarations:I have and will maintain workers' compensation insurance, as required by Section 3700 of th Labor Code, for the perfonnance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier AMERICAN ZURICH lliSURA!::KE COMPANY Policy#WC614287601 (This section needs to be completed if the p ermit is for one hundred dollars(Sl00 ) or less)
Exemption: l ce1tify that in the perf01mance of the work for which this pennit is issued, I shall not employ any person in any rnanne1 so as 10 become subject to the worke1s' compensation Jaws of
California and agree that if 1 should become subject to the workers' compensation provisions of Seclion 3700 of the Labor Code, l shall forthwith comply with those provisions. )ate Applicant WARN!NG:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER Tl CRIMINAL PENALTIES AND Cl VIL FINES UPTO ONE HUNDRED THOUSDANO DOL LARS(SI00,000) IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES
FINAL
03/02/23