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Home My WebLink AboutS2017-0057 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II 100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 1 7 0 0 5 7 Permit Counter Phone (949)644-3288 ,lob Address: 4527 ROXBURY RD Floor: Description of Work:SFR POOL/SPA 249/42 SF Inspector Area: 5 Legal Description: N TR 3357 LOT 41 Owner: BEENA REAL ESTATE LLC Address: 4527 ROXBURY RD CORONA DEL MAR CA 92625 Phone: Applicant: CATHY/VILLA POOLS Address: 17853 SANTIAGO BLVD STE 107-302 VILLA PARK, CA 92861 Phone: 714-488-7563 Building Rear: Setbacks: Front: Left: Right: Construction Type : V -B Construction Valuation: $70,000.00 Building Permit Fee : $380.00 Permit Issuing Fee: $0.00 Investigation Fee: $0.00 Building Green Fee: $3.00 Plan Dept Plan Check: $0.00 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 : $739.00 PROCESSED BY: ZONING APPROV Suite: Bldg: 1 Plan Check No: 0779.2017 Code Edit: 2016 Contractor: VILLA POLLS INC Address: 17853 SANTIAGO BLVD #107-302 Water Quality --- VILLA PARK CA 92861 Phone: 714-488.7563 Con State Lic: 1004609 Lic Expire: 06/30/2017 Bus Lic: BT30051925 Lic Exp Date: 07/31/2017 Worker's Compensation Insurance Carrier: STATE FUND Policy No: 9136998 Expiration: 07/07/2017 FEES Architect: Address: Phone: Engineer: Address: Phone: 12001 -Permit: S2017-0057 Project No: 0779-2017 Inspection Requests Phone (949)644-3255 State Lic: LACHER TODD 1201 N TUSTIN AVE ANAHEIM CA 92807 714-630-6100 State Lic:C-067656 Special Conditions: Issued Date: 04/17/2017 Record Management: $18.00 Water Quality --- Building Dept Inspection Fee: $0.00 Drainage Permit Fee : $0.00 Water Quality Dept Insp Fee: $0.00 Drainage Plan Check: $0.00 Building Dept WQ Plan Check: $0.00 Grading Consultant Fee : $0.00 Others: $0.00 Additional Fee: $0.00 $0.00 Plan Check Fee : $338.00 a PLAN CHECKED BY:: APPROVAL TO ISSUI PERMIT BXAIREE 180VAYSSAF-tBti I99L!ANCE OR LAST VALID INSPECTION n e. c x o Fee Due at Permit Issuance : OWNER -BUILDER DECLARATION 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 and Irofessions 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 lot more than five hundred dollars ($500). 1201 N TUSTIN AVE 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, 3usiness 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 that the mprovements 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 Tlproved for the purpose of sale). I, 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 Ipply to an owner of property who builds or improves thereon,. and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). 1 am exempt from licensure under the Contractors' State License Law for the following reason: 3y my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legalli sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw,html. signature of Property Owner or Authorized Agent Date -ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 of Division 3 of the Business and Professions Code, license is in full force Ind effect. License Class License No Date 1 Contractor SignatXA_)K VORKERS' COMPENSATION DECLARATION IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSANDOS$IN ADDITION TO THE :OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: I have and will 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 th erflirrmance of the work for which this permit is issued. Policy No. have and will rp tain 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' compensatiol nsurance carrier anN nNicy number are: ;arrier Polic Number Expiration Date Jame of Agent r Z Phone # :1I certify that, in the performance of the work for whit 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 agre hat, if I should become subject to the workers' comp n a ' n pr ns of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 3ignature of Applicant Da )ECLARATION REGAR N ONSTRUG ING AGENCY hereby affirm under pe alty of perjury that ! is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). -ender's Name Lender's Address 3y 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 have provided is correct. I agree to comply with all applicable city and county ordinances stat aws ating to building construction. I authorize representatives of this city or county t e r the ab i property for inspection purposes. 'n,� 3ignature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's N 1Vl a e ACTION DATE BY DE TION F COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY GULATIO PART 61 OF TITLE 40 ANDAQMD RULE 1403 a ••• • ••• PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO • - • •+• . s PERMIT CANCELLED EPA i•• i� �•• e° •+° PERMIT EXTENED QMD POOLALARMS ZI ASBESTOS NOTIFICATION IS NOT APPLICABLE TO INSTALLED ( Il-' PROPOSED DEMOLITION. ••i •• •. •. •°• SIGNATURE: • : : °• •• PERMITFINAL •.: •• I 0 I .. co FyAZ3 xz IL W CD �Z0) Q W co A O z u U x v W I� r W � a �o � W N N o_ I 0 I Gw m" V K FyAZ3 ......... IL W ^/.z �Z0) Q =O co A O z u U x v W I� r W a m cLi �AOa, a Z N a o W Q o_ �o O = YJ a) N LL C� U Uo U ' a o U CD q I 0 I I ._._.... ......... OJ M o. 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