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B23-1545 - 33870 PASEO ETERNIDADCITY OF SAN JUAN CAPISTRANO BUILDING PERMIT ISSUED 11/20/2023 Permit No. 823-1545 Permit Number B23-1545 ISSUED BY CJ5 SITE APN 675-471-36 SITE LOT NO 3 SITE TRACT 16752 SITE SUBDIVISION OCEAN HILLS JOB VALUE $60,000 OCCUPANCY TYPE R3 / U PERMIT TYPE. POOL AND SPA BUILDING SF 0 NO STORJES 2 NO UNITS I JOB ADDRESS: 33870 PASEO ETERNIDAD OWNER NAME PHONE ·REHARD, JASON 33870 PASEO·ETERNIDAD . MAILING ADDRESS CITY,STAT E,ZIP SAN JUAN CAPlSTRA�O, CA 926.75 CONTRACTOR NAME CF PROMOTIONS INCORPORATED 44033} ST. LIC EXPIRE PHONE ADDRESS CITY, ST, ZIP TENANT NAME PHONE# MAILING ADDR CITY, ST, ZIP 03/31/2024 (949) 859-8466- 24512 BRJDGER-R.D LAKE FOREST, CA 92630 MOBILE HOME PERMIT Total Mobile Home AMOUNT I have carefully examined the completed pennit application and do hereby certify under penalty of perjury that all infonnation hereon including the declprations are true and correct and I further certify and agree if a pennit is issued: to comply with all City, County, and State laws governing building construction, whether specified herein or not. I also agree to save, indemnify and keep hannless the City of San Juan Capistrano against all liabilities, judgments, costs and expenses which may in any way accrue against said City in consequence of the granting of this pennit. • I Owner/Contractor /j L�N; ·c, \ 1::Sf)L'Jlfc___J\_ Print Name Applicant's signature DESCRIPTION. CLOSE OUT 822-0876 -904sf POOL & SPA w/ AUTOMATIC POOL COVER ELEC'I UICAL-Pll:RMll' EXTEND ELECTRJCAL PRJVATE COMBO -POOL/ SPA •• ELECTRJCAL ISSOANCE FEE ._,, ·, •• • '• I ......... �. . . • ' : <. : ... •, • ·:: -.. :,,, __ Total Ele�trica_l . . ., • t --.• ,, ... �. EXTEND PLUMBING: ,, ,.' .. ,· ,.,-;·V.' ;:,'.;• ..... '·· •. POOL/ SP-A PUJMBING- • • .... : - PLUMBING ISSUANCE FEE· • Totaf Piumbin'g ·., MECflANICA'L PERMIT POOL/ SPA -MECHANICAL ...... AMOUNT 2.62 38.94 27.i4 68.80 AMOUNT 2.63 33:64 27 .24 63.51 AMOUNT 15.03 MECHANICAL ISSU ANCE FEE 27.24 . , . . ... -:. .. :. ,_ ... '. -· •,;:,. I 42.27 �xpirnrion:: Every permit issucd'shall b�come invali'<i unless tfi·c work-o�'.the site authorized b) uch permit is C'Om"IJlenced wilhi_n 12 months after its is�uan.ce, .f!r if th·�-,vor;k;authorized on the ire by such permit.is suspended or abandoned fora.period of 180 days after the ti.me the work ommenc<'.d.. • •• · • · ·., ·'· ,:. ··• · ·• • • An OSHA.pennit is required for excavatipn; over 5'.0';' deep and demolition or construction of structures over 3 stories in height. '• • • : \ ..W Contractor: I hereby affinn 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 e�ect. Owner/Builder: J, as owner of the property, 01 my employees with wages as their sole compensation, will do the work and the structure is not intcndCd or offered fo1 sale. (Sec 7044, Business and Professions Code: the Conh·actor's. License Laws does not apply to and o,,11cr of property who builds or improves thereon, who docs such work himself or through his enlployees, provided that such imp1ovements arc 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) __ Owntr/Burlder: I, as owner of the prope1ty, am exclusively contracting with licensed contractors to construct the project (SCc 7044, Business and Pr0rcssiOns Code: The Contractor's License Law does not apply to an _J)W"Crof p1opcrty who builds or impro\'cs thereon and who contracts for such projects with a contnctor's) license pursuant to the Contractor's License Law. _f[::(workcr,• Cnmnen�•tjan-l hereby affinn under penalty of perjury one of the following declarations:! have and will maintain workers' compensation "insur.ince, as required by Section 3700 ofth Lnbo1 Code, for the perfonnance of the work for which this pennit is issued. My workers' compensation insurance carrier and policy number are: Carrier STATE COMPENSATION INSURANCE FUND Policy#9228545 (This section needs to be completed if the pem1it is for one hundred dollars($ I 00) or less) Exc.ntpCion_ l certify that in the performance of the work for which this pcnnit is issued, J shall not employ any person in any manne1' s_o as to bccom.c subject to the workers' compensation laws of California and agree that ifl should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply wit� those provisions. Date ______ _ Applicant ________________ _ WARN!NG:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJEC T AN EMPLOYER TI CRIMIN AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSDAND DO LLARS(SI00,000) IN ADDI TION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IN TEREST, AND ATTORNEY'S FEES 11/19/24