B22-1402 - 26332 VIA ALANOPermit Number B22-1402
CITY OF SAN JUAN CAPISTRANO
BUILDING PERMIT
Permit No. 822-1402
DESCRIPTION
ISSUED
01/10/2023
REPLACE I000sfDECK. 405sf ATT. SOLID ROOF PATIO COVER.
CODE YEAR 2019
ISSUED BY CJ5 44" BBQ COUNTER. (2) SINKS. 1 HOOD. (2) GAS HEATERS.
SITE APN 649-061-25
SITE LOT NO II
SITE TRACT 6169
SITE SUBDIVISION
JOB VA LUE $ 75,000
OCCUPANCY TYPE R3
PERMIT TYPE. BACKYARD IMPROVEMENT ELECTRICAL PERMIT AMOUNT
BUILDING SF 0
NO STORIES EXTEND ELECTRICAL 15.78 I LIGHTING FIXTURES I 22 NO UNITS I RECEPTACLE, SWITCH & LIGHT OUTLETS 17.08
JOB ADDRESS: 26332 VIA ALANO ELECTRICAL ISSUANCE FEE 27.24
OWNER NAME TERBLANCHE, JACQUES
PHONE
MAILING ADDRESS 26332 VIA ALANO ·-
CITY,STATE,ZIP SAN JUAN CAPISTRANO, CA 92675 Total Electrical 61.32
CONTRACTOR NAME MUDD INDUSTRIES INC PLUMBING PER.Mlt ;A.MOUNT 851763 BUILDING SEWER .. 27.29 ST. LIC EXPIRE 12/31/2022 EXTEND PLUMBING 15.78
PHONE (949) 7 I 6-7002 FIXTURES AND VENTS 43.40 ADDRESS 23042 ALCALDE DRIVE, STE . F GAS SYSTEMS -EACH . :" �-6.81
CITY, ST, ZIP LAGUNA HILLS, CA 92653 WATER PIPING SYSTEMS 5.26
TENANT NAME PLUMBING ISSUANCE FEE --27.24
PHONE#
MAILING ADDR Total Plumbing 125.78
CITY, ST, ZIP MECHANICAL PERMlTMOBILE HOME PERMIT AMOUNT AMOUNT
11-79 VENTS AND EXHAUST HOOD/DUCTS
MECHANICAL ISSUANCE FEE 27)4
..
Total Mobile Home
I have carefully examined the completed permit application and do hereby certify under penalty of ,·
perjury that all infonnation hereon including the declarations are true and correct and I further Total Mechanical · 39.03 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 a1,.,-ee to save, indemnify and keep 'xpirn1ion:: Every permit issued shall become invalid unless the work on the site aut�orized b)
harmless the City of San Juan Capistrano against all liabilities, judgments, costs and expenses ui:h permit is commenced within 12 months after its issuance; or if the work authorized on the
which may in any way accrue against said City in consequence of the granting of this pennit. ite by such permit is suspended or abandoned fqr a period of 180 _days after the time the work A rlr-; v\V\ {:° rP; '/e om meru.·ed. Owner/Contractor
Print Name
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An OSHA pennit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height.
Applicant's signature
"},£ Contra£12[: 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 P1ofessions
Code: the Contractor's License Laws does not apply to and owner of property who builds or improves thereon, who docs such work himself or through his employees, provided that such improvements �re not
intended or offered for sale. If however, the building or improvement is sold within one year of completion, Lhe O\\TICr•buildcr will have the burden of proving that he did not build or imp1ove fo1 lhe purpose of sale)
__ Ownerfnuildtri 1, as O\vner of the property, am exclusively conn·acting with licensed contractors to constmct the project (Sec. 7044, Business and Pmfessions Code: The Contiacto1 's License Law docs not
apply to an owner of prope1ty who builds 01 improves thereon and who contracts for such projects with a contractor's) license pursuant to the Contractor's License Law
___A£ Workers Cnmpr.11<ntio11-I hereby affirm under penalty of perjury one of the following declarations:] have and will maintain workers' compensation insurance, as required by Section 3700 oflh Labor Code, for the perfonnance of the work for which this pennit is issued My workers' compensation insurance carrier and policy number are: Carrier INC Policy#TWC4081 I 87 (This section needs to be completed if the pennit is for one hundred dollars(SI00) or less) ]];:CJ-INOL()Gy IJ::lSl.!8iiNCE COMPANY
Exemption: I certify that in the performance of the work fo1 which this pe1mit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of
Califomia and agree that ifl should become subject to the workers' compensation provisions of Section 3700 of the Labo1 Code, l shall forthwith comply with those provisions )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(SI00,000) IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF Tl-IE LABOR CODE. INTEREST. AND ATTORNEY'S FEES
05/09/24