B22-1173 - 31981 PASEO AMANTE08/14/24
3
CSG 06/05/23
CITY OF SAN JUAN CAPISTRANO
BUILDING PERMIT
Permit No. 822-1173
Permit Number B22-1173 DESCRIPTION FOUNDATION REPAIR. 24 HELICAL PIERS & 4 TIEBACKS ISSUED BY LL! SITE AP N 666-341-27SITE LOT NO 21 SITE TRACT SITE SUBDIVISION JOB VALUE $ 74,250 OCCUPANCY TYPE PERMIT TYPE. BUILDING ELECTRICAL PERMIT BUILDING SF 0 NO STORJES I NO UNITS 0 JOB ADDRESS: 31981 PASEO AMANTEOWNER NAME PHONE MAILING ADDRESS CITY,STATE,ZIP CHAMBERS REVOCABLE TRUST31981 PASEO AMANTE SAN JUAN CAPISTRANO, CA 92675 Total Electrical CONTRACTOR NAME ISLAND CONSULTANTS INC PLUMBING PERMIT 970526 ST. LIC EXPIRE 04/30/2024 PHONE (760) 889-8150ADDRESS PO BOX 1921CITY, ST, ZIP CARLSBAD, CA 92018 TENANT NAME PHONE# MAILING ADDR Total Plumbing CITY, ST, ZIP MECBANJCAL PERMIT MOBILE HOME PERMIT AMOUNT
Total Mobile Home
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 Total Mechanical certify and agree if a pennit is issued: to comply with all City, County, and State laws governing
ISSUED
02/01/2023
AMOUNT
AMOUNT
AMOUNT
building construction, whether spccified hc...-eiJ -0r not. I also agree to save, indemnify and keep ,:xpiration:: Every permit issued shall become invalid unless t_he work on the site authorized b)
harmless the City of San Juan Capislr.:rno a_£, 1�t all liabilities, judgments, cosls and expenses uch permit is commenced within 12 months after its issuance, or if the work authorized on the
which may in any way aC:crue ag· · s:Iiai£! · · consequence�� b'Tanting of this permit ite by such perm'it is suspended or abandoned for a period of 180 days after the time the work -_,,,, ommenccd. Owner/Contractor �/�/ Print Name -�An OSHA permit is required for excavations over 5'0" deep and demolition or construction of
Applicant's signature �.hill-.ell"�
structures over 3 stories in height.
o? !:;on tractor: 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. �I
I �Pwnsr/RuUdC:ti 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 fm sale (Sec.7044, Business and P1ofcssions 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 impro,·cmcnts aJ'c 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 bw·den of proving that he did not build or improve fo1 the purpose of sale)
__ OwncrJB11i1dcr I, as owner of the property, am exclusively contracting with licensed contractms 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 ptojects with a contractor's) license pursuant to the Contractor's License Law.
� Workcrt C11mnensnjion-J hereby affirm under penalty of perjury one of the follo"ing declarn1ions:I have and will maimain workers' compcns.11w11 insurance, as required by Scctil)ll 3700 of th
O<,le, for 1he performance of the work for which this permit is issued. My workers' compcnsanon insurance carrier and policy number arc: Cnmcr BERKSHIRE II ATMA WAY DIRECr
A.NQ;; !;;QMPAJ::lYPolicy/!tl9W!;;4662�2 (This section needs to be completed if the pcnnit is for one hundred dollars(SJ00) or less)
Exentption: I certify that in the performance of the work fol' which this pennit 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 [ should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shal1 forthwith comply with those provisions. bate Applicant WARNJNG:FAILURE TO SECURE WORKERS'COMPENSATlON COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER Tl CRIMINAL PENALTIES AND CIVIL FINES UPTO ONE HUNDRED THOUSDAND DOLLARS(S100,000) IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES SEE REV 1