Loading...
B24-0087 - 33811 DONEGAL LN01/09/2024 City of San Juan Capistrano Development Services Department 32400 Paseo Adelanto San Juan Capistrano, CA 92675 Phone: (949) 443-6347 Email:buildinq@sanjuancapistrano.org www.saniuancapistran0.org/building BUILDING PERMIT APPLICATION WARNING: THIS PERMIT APPLICATION WILL EXPIRE 1 YEAR FROM THE DATE SHOWN BELOW UNLESS THE PERMIT HAS BEEN ISSUED OR AN EXTENSION IS APPROVED BY THE BUILDING OFFICAL PRIOR TO APPLICATION EXPIRATION. --'--'--$ PERMIT NUMBER fj:;;-y -(1{187 JOB VALUATION 20,000.00 OCCUPANCY GROUP(S) CONS TRU CTION TYPE NO. OF STORIES PROJECT ADDRESS UNIT#: OCCUPANCY CURRENT OCCUPANCY PROPOSED SPRINKLERS □YES □NO EXISTING BUILDING NEW BUILDING □INT. ALT.SQ.FT. OCC. GROUP □ADDITION SQ.FT. SQ.FT. li2f' PATIO 523 SQ.FT. SQ.FT. □POOL/SPA SQ.FT. SQ.FT. □DEMOLITION SQ.FT. SQ.FT. ACCESSORY DWELLING UNIT 1.□ ATTACHED □DETACHED □JADU 2.□ NEW CONSTRUCTION □CONVERSION OF EXISTING STRUCTURE COMBINING OR SUBDIVIDING SUITES? □ YES □NO CHANGE OF OCCUPANCY USE? □ YES □NO State License #: Name Address CONTRACTOR TBD City/State/Zip ______________ _ ELECTRICAL QTY MECHANICAL QTY Extend Electrical AC/Comp BTU= Lioht Fixtures/Fans Appliance Vent Motors > than 1 HP Duct/Reaister/Grill Motors < than 1 HP Exhaust Fans Miscellaneous Fireplace Pool/Spa FAU < 100k BTU's Outlets/Switches FAU > 100k BTU's Meters/Main Panels Miscellaneous Sians Pool/Spa Temo Power Vent/Exhaust Hood ISSUANCE 1 ISSUANCE 1 33811 Donegal Ln, San Juan Capistrano, CA 92675 DESCRIPTION OF WORK adding a new trellis in the rear yard. attached to the exsltlng home. CONT ACT NAME CONTACT PHONE APPLICANT daniel gabay ( 310)9515314 EMAIL ADDRESS: daniel@nationalpermitgroup.com PROPERTY OWNER Name Steve Kuntz Address 33801 Donegal Ln City/State/Zip San Juan Capistrno CA 92675 Phone ( ) TENANT NAME PLUMBING QTY MOBILE HOME Buildina Sewer Carport Extend Plumbinq Porch Fire Sorinkler Heads Awning Fixtures/Hose Bibs Cabana Gas Systems Grease Interceptor New/Setup Pool/Spa Earthquake BracinQ Water Heater Electrical Wirinq Water Pioina Gas Piping Sewaqe Disposal Water Piping ISSUANCE 1 ISSUANCE QTY As the applicant for this project, I am aware of the potential liabilities with undertaking construction within any private easement or use restriction areathat­may exist on this property. I acknowledge that I have or will review the Title Report for this property to ensure that thls project does not Impact any private easements or use restriction areas. By signing below, I CERTIFY THE ABOVE INFORMATION TO BE TRUE AND CORRECT. D��a6� daniel gabay 1/23/24 APPLICANT s«fNA T PRINT NAME DATE LL 10/09/23 REV 0/1 PAGE 1 of 2 PROPERTY OWNER'S PACKAGE DEVELOPMENT4&37*$&4 Building and Safety [Disclosures and Forms for Owner-Builders Applying for Construction Permits] IMPORTANT! NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at . We are providing you with an Owner-Builder Acknowledgment and Verification of Information to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner-Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER-BUILDER ACKOWLEDGMENT AND VERIFICATION OF INFORMATION Please read and initial each statement below to signify you understand or verify this information. 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an Owner-Builder building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. 2. I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. 3. I understand as an Owner-Builder I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. 5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an “employer” under state and federal law. 6. I understand if I am considered an “employer” under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each “employee.” I also understand my failure to abide by these laws may subject me to serious financial risk. 7. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. 8. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. 33811 Donegal Lane, San Juan Capistrano, CA 92675 sk sk sk sk sk sk sk sk B6139735 REV 0/1 PAGE 2 of 2 PROPERTY OWNER'S PACKAGE 9. I understand I may obtain more information regarding my obligations as an “employer” from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. 10. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the following address: 11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner-Builders as well as employers. 12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner-Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. NOTE: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. PROPERTY OWNER SIGNATURE DATE NOTE: The following Authorization is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner-Builder. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner-Builder Permit for my project: SCOPE OF CONSTRUCTION PROJECT OR DESCRIPTION OF WORK PROJECT LOCATION OR ADDRESS AUTHORIZED AGENT NAME PHONE AUTHORIZED AGENT ADDRESS I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. NOTE: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. PROPERTY OWNER SIGNATURE DATE ermit iiiiiiiiiiiiiiiiiiiiiiiiiiiiis ssssss isiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiisued tttttttttttttttttttttttttttttto o o oo vevvvvvvvvvvvvvvvvvvvvririririririiririiririririrrrirify th when thhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhe e eeeee eeeeeeee eee eeee permittttttttttttttttt iiiiiiiiiiiiiiiiiis isisisisisisisisiiisiiisiisisisisisiisiiiiiiiiisuuuuuuuuedeeeeeeeeeeeeeeeee to sk sk sk sk 4/22/2024 Pergola Construction Bruna Bernini 949-315-8364 208 Avenida Serra, San Clemente, CA 92672 4/22/2024 33811 Donegal Lane, San Juan Capistrano, CA 92675 33811 Donegal Lane, San Juan Capistrano, CA 92675