B23-1418 - 31520 CAMINO CAPISTRANOCITY OF SAN JUAN CAPISTRANO
BUILDING PERMIT
Permit No. 823-1418
Permit Number B23-1418 DESCRIPTION
CELL SITE MODIFICATION TI. VERJZON.
ISSUED BY CJ5
SITE APN 124-180-06
SITE LOT NO I
SITE TRACT 693
SITE SUBDI VISION
JOB VA LUE $ 50,000
OCCUPANCY TYPE
PERMIT TYPE. COMMERCIAL TENANT IM ELECTRICAL PERMIT
BUILDING SF 0 MISCELLANEOUS APPRTUS/CNDUJT/CNDUCTR� NO STORJES 0 ELECTRICAL ISSUANCE FEE NO UNITS 0
JOB ADDRESS: 31520 CAMINO CAPISTRANO
OWNER NAME MISSION BASILICA SAN JUAN CAP.
PHONE
MAILING ADDRESS 13280 CHAPMAN AVE
CITY,STATE,ZIP GARDEN GROVE, CA 92840 Total Electrical
CONTRACTOR NAME PLUMBING PERMIT
ST. LIC EXPIRE
ALAMON
652774
08/31/2024
PHONE
ADDRESS
CITY, ST, ZIP
(800) 252-8838
315 WEST IDAHO ST
KALISPELL, MT 59901
TENANT NAME
PHONE#
MAILING ADDR Total Plumbing
CITY, ST, ZIP . MECflANJCAL Pli:RMIT 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 information hereon including the declarations are true and correct and I further certify and agree if a penn it i s issued: to comply with all City, County, and Stale laws governing Total Mechanical
ISSUED
06/20/2024
AMOUNT
20.15
27.24
47.39
AMOUNT
AMOUNT building construction, whether specified herein or not. I also ab'Tee to save, indemnify and keep ,:xpiration:: Every permit issued shall become invalid unless the work on the site authorized b} 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 again;z;;;�ues:;;u;:his permit. ite by such permit is suspended or abandoned for a period of 12 mounths after the time the vork commenced. Print Name
� An OSHA penn it is required for excavations over 5'0" deep and demolition or constrnct ion rf structures over 3 stories in height . �ppl_!9nt's signature
O(J 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 effect. Owner'(0uild£Ci I, as owner of the property, or my employees with wa�es as thci1 sole compensation. will do the work and the structure is not intended 01· offered for sale (Sec. 7044, Business and Professions
Code: the Contractor's License Laws docs not apply to and owner of propctty who builds or improves thereon, who does such work himself or through his employees, provided that such imp,•ovements arc not
intended or offered for sale If however, the building or improvement is sold within one year of completion, the owner•buildcr will have the burden of proving that he did not build or imp1ove for the purpose of sale)
__ Owner/Builder: I, as owner of the property. am exclusively contracting with licensed contractors to consh1Jct the project (Sec� 7044, Business and P1ofessions Code: The Contractor's License Law docs not
npply to anp·w.:i of property who builds or improves thereon and who contracts for such projects with a conbactor's) license pursuant to the Conn·actor's License Law. I� W,u·k,-r:c Com nensalion-1 hereby affinn under penalty of perjury one of the following declaralions:I have and will maintain workers' compensation insurance, as required by Section 3700 of th E,,abor. Code, for the perfonn ance of the work for which this pennit is issued My workers' compensation insurance carrier and policy number are: Carrier BITCO GENERAL INSURANCE CORPORATION Policy#WC374l091 (This section needs to be completed if the pennit is for one hundred dollars($100) or less) Exemption: J certify that in the perfonnance of the wmk for which this pc1mit is issued, I shall not employ any person in any manner so as to become subject to the workel's' compensation laws of
California and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, l shall forthwith comply with those provisions.
)ate Applicant WARNING:FAILURE TO SECURE WORKERS'COMPENSATlON COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER Tl CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUS DA ND 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 EXPIRED06/20/2025