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B25-0185 - 26621 VIA LA JOLLA 2 (2)FINAL08/22/2025 2 25 CITY OF SAN JUAN CAPISTRANO RULE 1403 09/24/24Page 2 of 2 ASBESTOS SURVEY CERTIFICATION (ASC) FORM REQUIRED PRIOR TO PERMIT ISSUANCE IF THIS PROJECT IS A “RENOVATION” WITH NO “DEMOLITION” AND THE SURVEY FOUND NO ASBESTOS PRESENT IN THE PROPOSED WORK AREA OR IF THE SURVEY FOUND “LESS THAN 100 SQUARE FEET” OF ASBESTOS PRESENT IN THE PROPOSED WORK AREA. Permit Applicant’s Name: ____________________________________________________ Permit #: ____________________________________________________ Job Site Address: ____________________________________________________ SAN JUAN CAPISTRANO, CA 92675 DOES THIS PROJECT INCLUDE ANY DEMOLITION AS DEFINED BY SCAQMD? “Demolition” means the wrecking, or taking out, of any load-supporting structural member of a facility or structure and related handling operations, or the intentional burning of any facility. This means that if you remove as little as one (1) two-by-four from a load-bearing wall, it is considered a demolition. Other examples of load-bearing members include foundation, slab, rafters, porch pillars, etc. CHECK ONLY ONE: NO YES – If “yes,” STOP; this form does not apply to you. Please refer to page 1. WORK AREA: Describe all materials that would be affected by renovation. (CHECK ALL THAT APPLY - list all others. Attach additional pages as necessary.) Acoustic Ceiling Drywall Ducting Fire Proofing Floor Tiles (VAT) Resilient Floor Covering Insulation Linoleum Mastic Plaster Roofing Stucco Transite Cement TO BE COMPLETED BY A CALIFORNIA STATE CERTIFIED ASBESTOS CONSULTANT: I, the undersigned, certify that I have personally conducted an asbestos survey of the work area described above, in full compliance with all applicable state, federal, and local laws and regulations, including South Coast Air Quality Management District Rule 1403, and found that (CHECK ONE):  no asbestos is present OR  less than 100 square feet of asbestos is present. I certify under penalty of perjury that the foregoing is true and correct to the best of my knowledge, and that I am a California State Certified Asbestos Consultant in good standing holding the California Department of Industrial Relations’ Division of Occupational Health and Safety (Cal/OSHA) (DOSH) Asbestos Certification Number below. Certified Asbestos Consultant’s Cal/OSHA (DOSH) Asbestos Certification Number: _______________ California State Certified Asbestos Consultant’s Name: _____________________________________ California State Certified Asbestos Consultant’s Signature: _________________________________ Date: ________________________________ ** Please email completed form to building@sanjuancapistrano.org ** Signatures suspected of being forged or not unique to this document will be reported to Cal/OSHA. Nathan Borsheim 04/03/2025 13-5048 March 19, 2025 Attention: Address Coordinator RE: NEW ADDRESS NOTIFICATION FOR 26621 VIA LA JOLLA #2, SAN JUAN CAPISTRANO, CA 92675 Please be advised that the City of San Juan Capistrano has established a new unit address at 26621 VIA LA JOLLA due to the addition of an accessory dwelling unit per LEAH HILL’s request. Existing/Prior Address(es): 26621 VIA LA JOLLA New Address(es): 26621 VIA LA JOLLA – MAIN RESIDENCE 26621 VIA LA JOLLA #2 – ACCESSORY DWELLING UNIT Mailing Industry Detail: San Juan Capistrano, CA 92675 Legal Description: N TR 16748 BLK LOT 34 Address Type: BUILDING Deliverable Address: YES Assessor’s Parcel Number (APN): 675-411-34 Reason for Change: NEW UNIT ADDRESS DUE TO THE ADDITION OF A NEW ACCESSORY DWELLING UNIT (ADU) Effective Date: 3/19/2025 Sincerely, Dianna Flores Dianna Flores Permit Technician City of San Juan Capistrano 32400 Paseo Adelanto San Juan Capistrano, CA 92675 949-443-6347 Building@SanJuanCapistrano.org City of San Juan Capistrano Development Services Department 32400 Paseo Adelanto San Juan Capistrano, CA 92675 Phone: (949) 443-6347 Email: building@sanjuancapistrano.org www.sanjuancapistrano.org/building OFFICE USE ONLY Date Received: Date Issued:Pen A: B25 -0185 ADDRESS ASSIGNMENT REQUEST TYPE OF REQUEST:New Addresses ? Address Change Address Verification (NOTE: Unverifiable addresses may result in a new address being assigned. The Building Division will investigate the legitimacy of the tenant space or structure. If the space or building was not constructed with proper building permits, the address will not be verified.) APPLICANT - PLEASE PRINT CLEARLY AND COMPLETE ALL SECTIONS BELOW PROJECT NAME OR SUBDIVISION NO.: (one letter per box) DEVELOPMENT TYPE (check all that apply): NON-RESIDENTIAL:New Construction or Addition RESIDENTIAL:Single Family Townhouse OTHER:Mixed Use Tenant Improvement Other Apartment X Accessory Dwelling Unit PROJECT SITE ADDRESS/LOCATION:aldeal via la Jala APN: 615-411-24 APN: APN: _ REASON FOR REQUEST:unit address for attached ADU APPLICANT: Name and mailing address of person requesting the filing of this application. NAME: LeCh Hill COMPANY: ADDRESS: 26621 Via la Jalla CITYISTATEZIP: Jan Juan Capistran CA PHONE # 836250-3808 FAXH, 92675 E-MAILADDREss.jerlenh@gmail.com SIGNATURE: (Use other side if more room is needed) MAIN CONTACT PERSON: Person to be contact other than applicant regarding this application. PROPERTY OWNER AUTHORIZATION: NAME Leah thll COMPANY: ADDRESS: 26621 VIn la JuIla CIVISTATEZIP. San juan emputan CA PHONE#: (831) 2503808 FAXH L S 92675 EMALAODRESS.jerlesh@ymail.com ARCHITECT ENGINEER TENANT _ OTHER_ NAME: Sandra COMPANY: ADDRESS: 9917 Pradera Ave CITYSTATE/IP: Montclair CA 91763 PHONE #: do 2 a 485-9381 FAX#: L _). E-MAILADDRESs_inez9blen@hotmail.com I am authorizing City officials, staff, or their agents or consultants to enter the property for the purpose of this application. I understand that if this request involves the issuance of new addresses, there is no guarantee that the exact address requested will be assigned. AND (choose one): I am the sole owner and hereby authorize the filing of this application; I own the project site jointly with one or more persons and am empowered to authorize the filing of this application on behalf of my fellow property owners; or, I own the project site in conjunction with one or more persons who are listed with their acknowledgement and authorization for the filing of this application attached for additional property owner authorization/acknowledgements. SIGNATURE: REVISED: 3/01/2022 ATTACHED ADU WILL BE UNIT #2 03 10 25 03 19 25 Pacifica San Juan Community Association c/o Seabreeze Management Company 26840 Aliso Viejo Parkway, Suite 100 Aliso Viejo, CA 92656 ARCHITECTURAL APPROVAL January 21 2025 Jeremy A. Hill Leah P. Hill 26621 Via La Jolla San Juan Capistrano, CA 92675 RE: Pacifica San Juan Community Association Architectural Approval - 26621 Via La Jolla Dear Jeremy A., Your architectural plans for Exterior Modifications- removal of garage door, installation of window with shutters were reviewed by the Architectural Review Committee at their most recent meeting. After review of the plans submitted, the Committee determined to approve your architectural application as submitted. Please be advised that if your plans have been approved, they are subject to acquiring any required City/County permits (if applicable), and work must be completed within the timeframe as stipulated in your governing documents. When completed with your project, please return your Notice of Completion form along with photos of the completed work to your community manager. If you have any questions, please contact the Architectural Review Committee via your General Manager, Norma Fowler at norma.fowler@seabreezemgmt.com Sincerely, The Architectural Review Committee Pacifica San Juan Community Association From:Adams-Handy, Grace To:jerleah@gmail.com Cc:Marti, Pablo; engcounter; Building Department; Hildebrand, Ozzie Subject:Sanitation Clearance - 26621 Via La Jolla SJC - ADU Date:Friday, March 14, 2025 9:35:04 AM [The e-mail below is from an external source. Please do not open attachments or click links from an unknown or suspicious origin.] Good Morning, Address 26621 Via La Jolla, San Juan Capistrano has been cleared by SMWD. ADU garage conversion connection to existing on site water and sewer is adequate. No impacts to the Public Water and Sewer. Best Regards, Grace Adams‑Handy Engineering Technician M: 949-540-5342 smwd.com ***** Please note that email correspondence with the City of San Juan Capistrano, along with attachments, may be subject to the California Public Records Act, and therefore may be subject to disclosure unless otherwise exempt.