HomeMy WebLinkAboutS2022-0001 - Permitsw City of Newport Beach -Building Division *S2022-0001*
100 Civic Center Drive, Newport Beach, CA 92660
r. Permit Counter Phone (949)644-3288
.lob Address: 20092 ORCHID ST Floor: Suite: Bldg: 1
Description of Work:SFR POOL/SPA 604 SF, YARD DRAINAGE
Inspector Area: 3
Legal Description: N TR 1500 LOT 45
Owner: AYOUB CHRISTINE
Address: 7911 IRWINGROVE DR
DOWNEY CA 90241
Phone:
Applicant: DONALIPOOLS ICONS
Address: 14790 PIPELINE AVE #C
CHINO HILLS CA 91709
Phone: 562-455-8883
Building Rear:
Setbacks: Front:
Left:
Right:
Construction Type : VB
Construction Valuation: $42,600.00
Building Permit Fee :
$440.00
Permit Issuing Fee:
$0.00
Investigation Fee:
$0.00
Building Green Fee:
$2.00
Plan Dept Plan Check:
$0.00
Building Dep Plan Check:
$396.00
Building PC Investigation :
$0.00
Plan check Ext. Fee:
$0.00
WQ Compliance Insp Fee:
$0.00
Plan Check No:
Code Edit:
0006-2022
2019
POOLPermit : S2022-0001
Project No : 0006-2022
Inspection Requests Phone (949)644-3255
Contractor:
POOL ICONS INC/ADAN
Architect:
Address:
15935 DEL PRADO DR
Address:
HACIENDA HEIGHTS CA 91745
Phone:
562-455-8883
Phone:
Con State Lic:
479446
Engineer: LACHER TODD
Lic Expire:
10/31/2023
Address: 1201 N TUSTIN AVE
Bus Lic:
BT30077496
ANAHEIM CA 92807
Lic Exp Date:
12/31/2022
Phone: 714-630-6100
Worker's Compensation Insurance
Special Conditions:
Carrier:
STATE COMPENSATION INS FUND
Policy No:
9268030
Expiration:
0111612023
Issued Date: 0311812022
FEES
Record Management:
$6.00 Water Quality- --
Building Dept Inspection Fee:
Drainage Permit Fee:
$237.00
Water Quality Dept Insp Fee:
Drainage Plan Check:
$199.00
Building Dept WQ Plan Check:
Grading Consultant Fee :
$0.00 Others :
Additional Fee :
$0.00
State Lic:
State Lic:C-067656
mm•
•
o� e •
am o
•
om•
•• m
• •
•om•m•
o 0
a
o 0
a• o
oa m
• m •
o�ao
mmom•
•
Doom•
0
00 0
0
• • •
•
• ••
••.•••
mo o
•
co••
$0.00
$152.00
$0.00
$0.00
$0.00
II TOTAL FEE : $1,432.000 - Plan Check Fee : $595 00 V Fee Due
at Permit Issuance : $837 00
PROCESSED BY: I h�[' te'J PLAN CHECKED BY:: /0t
ZONING APPROVAL: Mk(y APPROVALTOISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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
ie 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 offhe'Buspess and
'rofessions 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 pffnalty of
of more than five hundred dollars ($500). i 1201 N TUSTIN AVE
I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
'usiness 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
nprovements 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
nproved 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
pply 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).
I am exempt from licensure under the Contractors' State License Law for the following reason:
Iy my signature b%l'oty l 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 legally
ell a stlucture U"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
4efeestons Corley is -available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
lignature of Plear"6wner or Authorized Agent Date
]GETASED CONTRACTOR'S DECLARATION
heit:5y affirm under Renalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) ff Divisigp 3 of the Business and Professions Co ?d my license is i f 1 orce
to e}fact. License E amass License No Date T C�v ZContractor Signature 'X �� t
VORKERS' CpI1Q@ENSATION DECLARATION
IAAAIAW FAILUF%Tb-SfCURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEi ALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
OGSOF COMPENSATIOIISS, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
TI h2ve anrPVyi111olintain 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,
;Pf ance of the work for which this permit is issued. Policy No.
crave and dvjjl,rRaijtain workers' compensation insurance, as required by Section 3700 of the Labor Code, for they performance of the work for which this permit is issued. My workers' compensatior
tsurance carrier and policy number are:
Policy Number Expiration Date
Name of Agent L vi-t,1 I i rnone rr
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 agre
that, if I should become suubject workers' coompenn�ati�on provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant K kl f (A"Cl`JJl i Date 7—
DECLARATION REGARDIN TRUCTIION LEMING AGENCY j
I hereby affirm under penalty 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).
Lenders 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 have provided is correct.
I agree to comply with all applicable city and county ordinances and state laws relating to building construction. !
I authorize representatives of this city or county to enter t ove-identified perty for inspection purposes. X
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent' Date — O�
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY gates & fences which serve
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE as part of a ;_ ooI /Spa
1403In
PERMITEXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO prior to approval to fill
PERMITCANCELLED UEPA PCOI/Spa & shal'i remain In
PERMIT EXTENDED MD place & b ntained for
the (if
POOLALARMS A,f ASBESTOS NOTITION. ONi�NOT APPLICABLE TO O a
INSTALLED � n n2 �//// PROPOSED DEMOLITION. // �., /' X--�
JIUIYXrVRC:71 Zt9(---V
FINAL /