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HomeMy WebLinkAboutS2018-0208 - PermitsaC�ity1Vofic cNewenter Dport Bpga BhaehB ilding DivisionIIIIIIIIIPermit Counter Phone (949)6`4441-3288 Job Address: 4545 PERHAM RD Floor: Description. of Work:SFR POOLISPA 126 SF Inspector Area: 5 Legal Description: N TR 3357 LOT 118 Owner: O'TOOLE BRIAN Address: 3419 VIA LIDO #483 NEWPORT BEACH CA 92663 Phone: 949.719-9010 Applicant: KAWACHI HIRO Address:. 20902 BROOKHURST ST STE 115 HUNTINGTON BEACH, CA 92646 Phone:. 714-968-0601 Building Rear: Setbacks: Front: Left: Right Construction Tvoe Construction Valuation: $48,000.00 PROCESSED BY:_ ZONING APPROVAL Suite: Bldg:1 P001 -Permit: S2018-0208 Project No: 2696-2018 Inspection Requests Phone (949)644-3255 ®a Building Permit Fee : $405.00 - Permit Issuing Fee: $0.00 2016 Investigation Fee: $0,00 LANDSCAPE BY HIRO INC Building Green Fee: $2.00 Address: Plan Dept Plan Check: $0.00 oe o Building Dep Plan Check: $361.00 ° Building PC Investigation : $0.00 714.968-0601 Plan check Ext. Fee : .$0.00 Con State Lie: WQ Compliance Insp Fee: $0.00 LACHER TODD TOTAL FEE : $816.00 PROCESSED BY:_ ZONING APPROVAL Suite: Bldg:1 P001 -Permit: S2018-0208 Project No: 2696-2018 Inspection Requests Phone (949)644-3255 ®a Worker's Compensation Insurance Carrier: PREFERRED PROF INS Policy No: ON0846901 Expiration: 06/0112019 Record Management: Drainage Permit Fee: Drainage Plan Check: Grading Consultant Fee: Additional Fee: $4.00 $0.00 $0.00 $0.00 $0.00 FEES Special Conditions: Issued Date: 12103/2018 Water Quality- -- Building Dept Inspection Fee: Water Quality Dept Insp Fee: Building Dept WQ Plan Check: Others : Check Fee i $405.00 PLAN CHECKED APPROVALTOI; PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION State Lie: m m Plan Check No: 2696-2018 - State Li¢C-067656 ° Code Edit: 2016 mmosoe Contractor: LANDSCAPE BY HIRO INC Architect: e ° Address: 20902 BROOKHURST ST #115 Address: oe o omom HUNTINGTON BEACH CA 92646 ° o 0 Phone: 714.968-0601 Phone: o Con State Lie: 738264 Engineer LACHER TODD Lie Expire: 07/3112019 Address: 1201 N TUSTIN AVE Bus Lie: BT99111509 ANAHEIM CA 92807 Lie Exp Date: 1013112019 Phone: 714-630-6100 Worker's Compensation Insurance Carrier: PREFERRED PROF INS Policy No: ON0846901 Expiration: 06/0112019 Record Management: Drainage Permit Fee: Drainage Plan Check: Grading Consultant Fee: Additional Fee: $4.00 $0.00 $0.00 $0.00 $0.00 FEES Special Conditions: Issued Date: 12103/2018 Water Quality- -- Building Dept Inspection Fee: Water Quality Dept Insp Fee: Building Dept WQ Plan Check: Others : Check Fee i $405.00 PLAN CHECKED APPROVALTOI; PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION State Lie: m m meomme State Li¢C-067656 ° m mo o mmosoe s ° � m mmm e ° oe o omom ° o 0 omoo o 0 °oe o ° e ° m . omoco omoo ° mmmic c c c oseoeo 0 o m e 000c $0.90' ° $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $411.00 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 items) 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 of the Business. 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 penalty of of 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 `) portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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 n roved 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 Coder 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 I am exempt from licensure under the Contractors' State License Law for the following reason: ly 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 Iegall ell 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 'rofessions Code, is available upon request when this application is submitted or at the following Web site:hftp://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 700 ) of Di isipn 3 of the Business and Profes ' C de a d licensp is in full force nd effect. License Class License No Date 'G Contractor Signatu IIORKERS' COMPENSATION DECLARATION DARNING: FAILURG iO $W:IRE 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 OST OF.COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 114r&%affirm uRderpanalty of perjury one of the following declarations: 1 have and Al 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 tht rinance of the work for which this permit is issued. Policy No. .... he 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 rence carrier artifpolicy number are: !abler- . ' Policy Number Expiration Date certify that, N the performance of a 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( hat, if T shouldlleconFe sub' t t th w r ars' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /lgC@�, / ago �. jigggl8reofAppplioent ' �� \ �Q Dat )ECLARATIO 16 RfrpA C"STP=TION LENDING AGENCY 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). -ender's Name Lender's Address 3y my signature below, I certify to each of the fallowing: 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 or m4n,,nd state laws relating to building construction. I authorize representatives of this city or county to te-identifie roperty for inspection purposes. pp..�� \,, ,3 3ionature of Prooertv Owner or Authorized ADent Print Property Owner's or Authorized Agent's Name �11u� ph 1 �1—�Date ACTION DATE BY/ tel ARATION OF COMPLIANCE WITH CODE OF FEDERAL REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE 1403 FOR OFFICE USE ONLY PERMITEXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED DEPA PERMIT EXTENDED IVY EIQMD POOLALARMS INSTALLED—PROPOSED 3.IAZBESTOS NOTIFICATION IS NOT APPLICABLE TO DEMOLITION. °l T M t m a 1 0 x m N X .P O m n =m 10 D _ � -Oi mm �r CO C z a U) D v ��Tzml00—M Ci0 m M m nm 3 0-1 Z Na0a Za ?z pr v Q m �1 y z. IT G7 m 0 0 m m 9 z P m z n 0' 3 v r N J n'. 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