B23-0002 - 26911 CALLE ESPERANZACITY OF SAN JUAN CAPISTRANO
BUILDING PERMIT
ISSUED
01/03/2023
Permit No. 823-0002 Permit Number B23-0002 CODE YEAR 2022 ISSUED BY CJ55 SITE APN 675-143-11SITE LOT NO 4 SITE TRACT SITE SUBDIVISION JOB VALUE $ 9,000 OCCUPANCY TYPE PERMIT TYPE. ROOFING BUILDING SF 0 NO STORIES 2 NO UNITS 0 JOB ADDRESS: 26911 CALLE ESPERANZAOWNER NAME CLERKIN, MICHAEL & NICOLE PHONE MAILING ADDRESS 26911 CALLE ESPERANZA CITY,STATE,ZIP SAN JUAN CAPISTRANO, CA 92675 CONTRACTOR NAME MIKE EVANS BUILDERS 782288 ST. LIC EXPIRE 08/31/2024 PHONE (949)228-2846ADDRESS 28302 PASEO ESTABLO CITY, ST, ZIP SAN JUAN CAPISTRANO, CA 92675 TENANT NAME PHONE # MAILING ADDR CITY, ST, ZIP '
MOBILE HOMl.i: 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 certify and agree if a pennit is issued: lo comply with all City, County, and State laws governing building construction, whether specified herein or not. I also agree to save, indemnify and keep harmless the City of San Juan Capistrano against all liabilities, judgments, costs and expenses which may in any way accrue against saiM in consequence of the granting of this permit.
Owner/Contractor \(K{xCL Fv�r
Print Name
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Applicant's signaturf#t ·A _,...�
DESCRIPTION REROOF 22sq. R/R TILE. REPLACE 40# FELT & TILE LIKE FOR LIKE ELECTRICAL PERMIT AMOUNT
Total Electrical
PLUMBING PERMIT AMOUNT
Total Plumbing
MECHANLCAL PERMIT AMOUNT
Total Mechanical :xpiration:: Every permit issued shall become invalid unless the work on the site authorized bl 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 permit is required for excavations over 5'0" deep and demolition or construction ri structures over 3 stories in height.
I� �ontr�£t2r; I hereby aflinn that I am licensed under provisions ofChapter9 of Division 3 of the Business and Professions Code, and my license is in full force and effect.
__ Owne:c[Rujldcr; 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 im proves thereon, who does such work himself or thrnugh 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)
__ Ownarffiuildrri I, as owner of the prope1ty, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not
apply to an owner of propetty who builds or improves thereon and who contracts for such projects with a contractor's) 1icense pmsuant to the Contract01 's License Law.
W2rkcns Compensnifon-1 hereby affinn under penalty of perjury one of the following declarations:! have and will maintain workers' compensation insurance, as required by Section 3700 ofth Labor Code, for the pcrfonnance of the work for which this permit is issued. My workers' compensation insurance carrier and policy num bcr are: Carrier _EXEMPT Policy# (This section needs to be completed if the pennit is for one hundred dollars(SI00) or Jess)
//f/�u>mntion 1 I certify that in the perfonnance of the work for which this pennit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation Jaws of I Clir.fenn1it-and agree that if I should become subject to the worke:r:s' c7tion isious..nf.Soetion 3700 of the Labor Code, I shall forthwith comply with those provisions
)m� I" .I)..-<2_ J,.,. Applicant �.: ,,,_
_J ,, V WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE JS UNLAWFUL, AND SHAL L SUBJECT AN EMPLOYER Tl CRJMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSDANO DOLLARS(S 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
01/22/24