B25-0668 - 25788 VIA DEL REYCITY OF SAN JUAN CAPISTRANO
BUILDING PERMIT #:
B25-0668
08/19/2025
ISSUED
JOB VALUE:
# OF UNITS:
PERMIT NUMBER:
ISSUED BY:
APN #:
TRACT:
LOT:
SUBDIVISION:
PERMIT TYPE:
OCCUPANCY:
BUILDING SQ. FT.:
STORIES:
DF4
668-181-26
105
7561
$ 8,000
ELECTRICAL
0
2
0
JOB ADDRESS:
D MARTIN LIVING TRUST,OWNER NAME
25788 VIA DEL REYMAILING ADDRESS
CONTRACTOR NAME
CSLB EXPIRATION
ADDRESS
TENANT NAME
PHONE
MAILING ADDRESS
I have carefully examined the completed permit 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 permit 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 harmless 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 permit.
SIGNATURE:
PRINT FULL NAME:
SUNRUN INSTALLATION SERVICES INC
21 WORLDS FAIR DR
06/30/2026
Every permit issued shall become invalid unless the work on the
site authorized by such permit is commenced within 12 months after
its issuance, or if the work authorized on the site by such permit is
suspended or abandoned for a period of 12 months after the time
the work commenced.
An OSHA permit is required for excavations over 50 deep and
demolition or construction of structures over 3 stories in height.
I hereby affirm 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.
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business
and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractors) license pursuant to the Contractors License Law.
DESCRIPTION OF WORK
I certify that in the performance 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 I should become subject to the workers
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
WARNING:FAILURE TO SECURE WORKERSCOMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TI CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSDAND DOLLARS($100,000) IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
B25-0668
750184
,
SOMERSET, NJ 08873
SAN JUAN CAPISTRANO, CA 92675
(714) 401-4472
(415) 580-6857
PHONE
PHONE
DATE: _________________ SIGNATURE: _______________________________________
(1)TESLA BATTERY BACK UP.
CSLB #
OWNER / CONTRACTOR DECLARATION
______
______
I, as owner of the property, or my employees with wages as their sole compensation, will do the work and the structure is not
intended or offered for sale. (Sec.7044, Business and Professions Code: the Contractors 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 year of
completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale)
I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain workers compensation
insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
My workers compensation insurance carrier and policy number are:
CARRIER: AMERICAN ZURICH INSURANCE COMPANY POLICY #: WC614287603
(This section needs to be completed if the permit is for one hundred dollars ($100) or less)
______
______
25788 VIA DEL REY
______
EXPIRATION
CONTRACTOR:
OSHA
OWNER/BUILDER:
OWNER/BUILDER:
WORKER'S
COMPENSATION:
EXEMPTION:
FINAL09/18/2025