B22-1640 - 27732 PASEO BARONACITY OF SAN JUAN CAPISTRANO
BUILDING PERMIT
Permit No. 822-1640
Permit Number B22-1640 DESCRIPTION
*CE* DEMO 72sfSUNROOM
CODE YEAR 2019
ISSUED BY CJ5
SITE APN 666-192-14
SITE LOT NO 66
SITE TRACT
SITE SUBDI VISION
JOB VA LUE $ 3,500
OCCUPANCY TYPE
PERMIT TYPE. BUILDING ELECTRICAL PERMIT
BUILDING SF 0
NO STORIES 2
NO UNITS 0
JOB ADDRESS: 27732 PASEO BARONA
OWNER NAME PATEL,NEAL
PHONE
MAILING ADDRESS 8220 LI VORNO DRIVE
CITY,STATE,ZIP ORLANDO, FL 32836 Total Electrical
CONTRACTOR NAME BERUMEN CONSTRUCTION SERVICES PLUMBING PERMIT 1066089
ST. LIC EXPIRE 05/31/2024
PHONE (714)561-0061
ADDRESS 7737 BRIARWOOD AVENUE
CITY. ST. ZIP FONTANA, CA 92336
TENANT NAME
PHONE#
MAILING ADDR Total Plumbing
CITY, ST. ZIP MECHANICAL PERMIT MOBTLEHOME PERMIT AMOUNT
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 certify and agree if a pennit is issued: to comply with all City, County, and State laws governing ISSUED
01/12/2023
AMOUNT
AMOUNT
AMOUNT building construction, whether specified herein or not, I also'agree to save, indemnify and keep expiration:: Every permit issued shall become invalid unless the work on the site authorized b} hannless the City of San Juan Capistrano against all liabilities, judgments, costs and expenses which may in any way accrue agai�City in consequence of the granting of this permit. Owner/Contractor /--(/(.,/ / _ _j} Print Name ,/ ' . .
Applicant's signature r1JJ� L(A c '\'\ri I) ,,j r/u.,,,n uch permit is commenced within 12 months after its issuance, or if the work authorized on the ite by such permit is suspended or abandoned for a period of 180 days after the time the work ommenced. An OSHA pennit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. l:!j_ Contractor: I hereby affirm that I am licens�d under provisions of Chapter 9 of Division 3 of the Business and Professions Code, and my license is in full force and effect __ O·wncrlBuildcr: 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 fm the purpose of sale)
Own<!1·/Buih1�r. 1, as owner of the property, am exclusively contracting with licensed con ti actors to construct the p10jcct (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 conhactor's) license pursuant to the Contractor's License Law. ___ Workers Co111n�n$l!ion-I hereby affirm under penally of perjury one of the following declarations:! have and will maintain workers' compensation insurance, as required by Section 3700 ofth Labor Code, for the perfonnance of the work for which this perrnit is issued_ My workers' compensation insurance carrier and policy number are: Carrier EXEMPT Policy# (This section needs to be completed if the pennit is for one hundred dollars($100) or less) C 1 7 J F,.�4•m•1tion. I certify that in the perfonnance of the work for which this pennit is issued, I shall not cmp1oy any pe1son in any manner so as to become subject to the workers' compensation Jaws of
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I � 7 f WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TI CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSDAND DOLLARS($] 00,000) IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY"S FEES 01/12/24