HomeMy WebLinkAboutS2018-0098 - Permitsa.
City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Job Address: 12 POINT LOMA DR Floor:
Description of Work:NEW POOL AND SPA. VVIDR
Inspector Area: 4
Legal Description: N TR 7432 LO�35
Owner: HOOTAN ATAIAN
Address: 12 POINT LOMA DR
CORONA DEL MAR CA
Phone:
Applicant: HOOTAN ATAIAN
Address: 12 POINT LOMA DR
CORONA DEL MAR CA
Phone:
Building Rear:
52144
Setbacks: Front:
6.
Left:
5'
Right:
5.
Construction
Construction Valuation: $60,000.00
Building Permit Fee:
$380.00
Permit Issuing Fee:
$0.00
Investigation Fee:
$0.00
Building Green Fee:
$3.00
Plan Dept Plan Check:
$37.50
Building Dep Plan Check:
$338.00
Building PC Investigation :
$0.00
Plan check Ext. Fee:
$0.00
WQ Compliance Insp Fee:
$0.00
TOTAL FEE:
*S2018-0098
ag ,
IINsA�GEE 3'6o0SF
r� $28
Project No
t r `t)WC In
1rM.
�a12N08
2016
: S2018-0098
2-2018
Phone (949)644-3255
C Otr'st- b NERIBLDR
E�r g5 ' + - `�` rchitect:
4U- driVs ATAIAN HOOTAN �`� ddress:
�y�.qF�'�
Phone: dad �'"'v.= �& Phone: a Lic:
Wn
Date:I Is
Worker's Compensati
Carrier: On qo�eko
$I �ed)
irksia
®te.
cord Management: Water Quality -
--
Building Dept Inspection Fee:
Dr:yaa erm' $293.00 Water Quality Dept Insp Fee:
rai Check: $293.00 Building Dept WQ Plan Check:
a ing Consultant Fee: $0.00 Others:
Additional Fee: $0.00
Plan Check Fee : $631.00 Fee Due at Permit Issuance
W
Engineer: LA D x6
res T INE
IM CA�}807
( hep IS 7.1k4 tkof& State Lic:C-067
SpkbiaT Conditions:
RIBLDR ATTAC
PROCESSED BY:
ZONINGAPPROVAL: \
PLAN CHECKED
APPROVALTO
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s)
;Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for
:he permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business anj
Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
not more than five hundred dollars ($500). 1201 N TUSTIN AVE
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided thiat the
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 it was not built or
i roved for the purpose of sale).
as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who contracts for the rojects with a licensed Contractor pursuant to the Contractors' State License Law).
❑ I am exempt felow I acknowledge
under the Contractors' State License a lh I reason:
By my signature below I acknowledge that, except for my persona s' en ich I st have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally
sell a structul t ldf bhave built as an owner-builder if has not beJJn o t c entirety by licensed contractors. I understand that a copy of the applicable law, Section 704jjj��� of the Business and
Professions-Cede, 1s available upon request when t Is application i s r at the following Web site:http://v�.leginfo.ca.gov/calaw.html. .leginfo.ca.gov/calaw.html. / y/'�/X
giggture of Pope""t�O�wner or Authorized Agent Dat/q/ c Y
LICEWSEDr(5NTRACTOR'S DECLARA
I hene¢y affirm under penalty of perjury that I a licensed un provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
and effect. Lic�er5e Class License No Date Contractor Signature
W0IRrERS1*(;Q 0ENSATION DECLARATION
NARNING: FAILU(tE =Q SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000(, IN ADDITION TO THE
COvS.T.1F COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
er•
�hejP`tly affirm undger penalty of perjury one of the following declarations:
t1, ineve"and )gill maintain a certificate of consent to self-insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for thi
pefforn$ance oiflhewbtk for which this permit is issued. Policy No.
Q Ae;e 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
jnsNraece carrier.&W dblicy number are:
Carrier Policy Number Expiration Date
Name of Agent Phone #
131 certify that, in the perfor ance of he work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' c9�npensation laws of California, and agre
that, if I should become su (ectfto t �w �yrrreompansattion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. D
Signature of Applicant
DECLARATION REGA DI NSTRUCTION LENDING AGENCY
I hereby affirm under net y of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Lender's Name Lender's Address
By my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owner's behalf.
I have read this application and the information I hav provide is orrect.
I agree to comply with all applicable city and count orch n ting to building construction. / _ L/�/✓_,,
I authorize representatives of this city or county t ante Identified property for inspection purposes.
Signature of Prooertv Owner or Authorized Agan /1 Print Property Owner's or Authorized Agent's Na
ACTION DATEBY C TION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REG TIONS PART 61 OFTITLE 40 ANDAQMD RULE
ASBESTOS NOTIFICATION TO
PERMITCANCELLED
POOLALARMS
INSTALLED
FINAL
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