B23-1466 - 31952 VIA MONTURAPermit Number B23-1.466
CITY OF SAN JUAN CAPISTRANO
BUILDING PERMIT
Permit No. 823-1466
DESCRIPTION
ISSUED
11/2/2023 CLOSE OUT 822-0146. REPLACE (10) WINDOWS. LIKE FOR LIKEISSUED BY CJ5SITEAPN666-162-02SITE LOT NO 39SITE TRACTSITE SUBDIVISIONJOB VA LUE $ 5,000OCCUPANCY TYPEPERMIT TYPE.BUILDINGBUILDING SF 0NO STORIES 2NO UNITS 0JOB ADDRESS: 31952 VIA MONTURAOWNERNAME DE LOS COBOS, BRIAN & KELLYPHONEMAILING ADDRESS 31952 VIA MONTURACITY,STATE,ZIP SAN JUAN CAPISTRANO, CA 92675 CONTRACTOR NAME OWNER BUILDERST. LIC EXPIRE.PHONEADDRESSCITY, ST, ZIPTENANT NAMEPHONE#MAILING ADDRCITY, ST, ZIP '
MOBILE HOME PERMIT AMOUNT
Total Mobile Home
I have carefully examined the completed pennit application and do hereby certify under penalty of
perjury that all infonnation hereon including the declarations are true and correct and I further
ID li:l":TlUCAr::-P ERM 11
Total f:lectrical
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Total �lmqbing
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PLUMBING PERMIT ..:
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MECHANICAL PERMIT
.. . . Total Mechanical
AMOUNT
AMOUNT
AMOUNT
I
certify and agree if a perrnit is issued: to comply with all City, County, and State laws governing ,�_pirt,tion:: Every permit issued shall become invalid unless the work on the site authorized h} building construction, whether specified herein or not. I also agree to save, indemnify and keep
harmless the City cif San Juan Capistrano against all liabilities, judgments, costs and expenses uch permit is commenced within 1Z 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 perrnit. it• by such permit is suspended or abandoned for a period of 180 days after the time the work
. (st,\1-t..)
ommenced Owner/Contractor OE:.�� Print Name
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An OSHA perrnit is required for excavations over 5'0" deep and demolition or construction of
structures over 3 stories in height.
Applicant's signature
__/Contrnclnr: _I hereby affirrn 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, lvl/ Owncr/Rulhler; 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 for the purpose of sale)
QwnerJB1.1Udcr. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (SecL 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 contractor's) license pursuant to the Contractor's License Law.
___ Wnrkcrs C:nm uen,;Mion-1 hereby affinn under penalty of perjury one of the following declarations:! have and will maintain workers' comp�nsation insurance, as required by Section 3700 of th,
Labor Code, for the perforrnance of the work for whi"ch this perrnit is issued, My workers' compensation insurance carrier and policy number are: Carrier_ Policy# (This section needs to be completed if
the pennit is for one hundred dollars($l00 ) or less)
I-::-::-� E�c.mpt..ion I certify that in the performance of the work for which this permit 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 th,
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workers' :p•nsniion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. )ate / / -2 -7. 2 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 THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
11/03/23