B24-0728 - 27662-27666 PASEO VIOLETA 34Permit Number B24-0728
CITY OF SAN JUAN CAPISTRANO
BUILDING PERMIT
Permit No. 824-0728
DESCRIPTION
ISSUED
08/15/2024
REROOF 30sq TILE RELAY. w/ 2 LAYERS OF G40 UNDERLA YMENT.
CJ5 REPLACE PLY AS NEEDED. REINSTALL EXISTING TILE. ISSUED BY
SITE APN 939-95-069
SITE LOT NO 1
SITE TRACT
SITE SUBDIVISION
JOB VALUE $ 35,000
OCCUPAN CY TYPE
PERMIT TYPE. ROOFING El EC TRICAL PERMIT AMOUNT
BUILDING SF 0
NO STORIES I
NO UNITS 0
JOB ADDRESS: 27662-27666 PASEO VIOLETA 34
OWNER NAME SAN JUAN MESA VERDE HOA
PHONE
MAILING ADDRESS 26840 ALISO VIEJO PARKWAY
CITY,STATE,ZIP ALISO VIEJO, CA 92656 Total Electrical
CONTRACTOR NAME HOYT ROOFS INC PLUMBING PERMIT AMOUNT 606111
ST. LIC EXPIRE 12/31/2024
PHONE (714) 773-1820
ADDRESS 1809 N ORANGETHORPE PARK
CITY, ST, ZIP ANAHEIM, CA 92801
TENANT NAME
PHONE#
MAILING ADDR Total Plumbing
CITY, ST, ZIP MECHANICAL PERMJT AMOUNT MOBILE HOME PERMIT AMOUNT
Total Mobile Home
I have carefully exam ined the completed permit application and do hereby certify under p enalty of perjury that all information hereon includ in g the declarations are true and correct an d I further Total Mechanical certify and agree if a permit is issu ed: to comply with all City, County, and Slate laws governing building construct ion , whether specified herein or noL I also agree to save, indemnify and keep "'xpiration:: Every permit issued shall become invalid unless the work on the site authorized bJ hannless the City of San Juan Capistrano against all liabilities, judgments, costs and expenses uch permit is commenced within 12 months after its issuance, or if the work authorized on the
�:�:;/�:
n
::�::;:;
e against s
�
i
: :;::/"""!µ��7-g of this permit ite by such permit is suspended or abandoned for a period of 12 mounths after the time the York commenced.
Print Name /4 An OSHA pennit is required for excavations over 5'0" deep and demoli tion or constructi on of structures over 3 stories in height.
Applicant's signature f ./\.
�IA C2ntractor: I hereby affirm that I am l icensed under provisions of Chapter 9 of Divisi on 3 of the Business and Professi ons Code, and my license is in full force and effect .
.:__ bwnl!rllluildor: I, as owner of the property, or my employees with wages as their sole compensation, will do the work and the structuie 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 yeai of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale)
___ OwnCr/Ouiltlcr: I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec 7044, Business and Professions Code: The Contrnctor's License Law does not apply to ,iu�ownCf' of property who builds or improves thereon and who contracts for such projects with a contJactor's) license pursuant to the Contractor's License Law,
l> ..J,,, f lvork�.-,, Comm•nsalion-1 hereby affirm under penalty of perjury one of the following declarati ons:! have and will maintai n workers' compen sation i nsurance, as required by Section 3700 of Jh· Labo1 Cod e, for the perfonnance of the work for which this pennit is issued. My workers' compensation insurance carrier and policy number are: Carrier ZIJRICH AMERICAN INSURANCE COMPANY Policy#WCJ 12580505 (Th is sect ion needs lo be completed if th e permit is for one hundred dollars($!00) or less)
Exemption: l certify that in the perfonnance 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 the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Date Applicant
WARNfNG: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(SI 00,000) IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR TN SECTION 3706 OF THE LABOR CODE, IN TEREST, AND ATTORNEY'S FEES
10/03/24