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Home My WebLink AboutS2018-0204 - Permits1 City of Newport Beach - Building Division I11�1111 1111111111111111111111111111111111111111111111 Jill p- 100 Civic Center Drive, Newport Beach, CA 92660 5 2 0 1 8 0 2 0 4 '�• Permit Counter Phone (949)644-3288 �K3CFiiTF"� .lob Address: 28 MORRO BAY DR Floor: Suite: Bldg: 1 Description of Work:SFR POOL/SPA REMODEL 558 SF W/ DRAINAGE Inspector Area: 4 Legal Description: N TR 7386 LOT 65 Owner: LE TIMOTHY Address: 28 MORRO BAY DR CORONA DEL MAR, CA 92625 Phone: Applicant: POOL LOGIC Address: 1255 RUGGLES STREET LA VERNE, CA 91750 Phone: 909-450-7804 Building Rear: Setbacks: Front: Left: Right: Construction Construction Valuation: $31,000.00 Plan Check No: Code Edit: Contractor: POOL LOGIC Address: 1255 RUGGLES STREET LA VERNE, CA 91750 Phone: 909-450-7804 Con State Lic: 1013333 Lie Expire: 04/30/2020 Bus Lie: ST30062782 Lie Exp Date: 04/30/2019 Worker's Compensation Insurance Carrier: STATE COMP Policy No: 9155131 Expiration: 03/17/2019 Building Permit Fee : $502.00 Record Management: $14.00 Permit Issuing Fee: $0.00 Investigation Fee: $0.00 Drainage Permit Fee: $312.00 Building Green Fee: $2.00 Drainage Plan Check: $312.00 Plan Dept Plan Check: $0.00 Grading Consultant Fee: $0.00 Building Dep Plan Check: $436.74 Building PC Investigation : $0.00 Additional Fee: $0.00 Plan check Ext. Fee: $0.00 ee a tr WQ Compliance Insp Fee: $0.00 o}se TOTAL FEE: PROCESSED BY: ZONINGAPPROVAL: k ft/ FE 2642-2018 2016 Architect: Address: Phone 13001 -Permit: S2018-0204 Project No : 2642-2018 Inspection Requests Phone (949)644-3255 Engineer: LACHER TODD Address: 1201 N TUSTIN AVE ANAHEIM CA ,92807 Phone: 714-630-6100 Special Conditions Issued Date: Water Quality- — Building Dept Inspection Fee: Water Quality Dept Insp Fee: Building Dept WQ Plan Check: Others : Plan Check Fee: $0.00 Fee Due at Penult Issuance : PLAN CHECKED BY:: APPROVAL TO ISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION $0.00 $0.00 $0.00 $0.00 $0.00 s o , , e r.f� eme000 eeq�+m• „r o n e � 0 0 State Lie: eo 0 eet`4. ee a tr o e 0 o}se e .,e 4� 0000n 00000 State Lic:C-067656 to`��, O C 6� BYti NN C C 0 0 0 Fee Due at Penult Issuance : PLAN CHECKED BY:: APPROVAL TO ISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION $0.00 $0.00 $0.00 $0.00 $0.00 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 the 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 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 ❑ 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, 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 that 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 im roved for the purpose of sale). 1, 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 projects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ 1 am exempt from lisensure under the Contractors' State License Law for the following reason: By my signature'Bd M Cacknowledge 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 Tell 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 I1role sions Code'liaalilable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Sipnatyre of Property Owner or Authorized Agent Date CIMSED CONTRACTOR'S DECLARATION I Irmbv affirm I}n ilullO nalty of perjury that I am licensed under provisions of Chapter 9 (commencing with SYIMINAL 000) of IVIS on 3 of the Business and fessio C d d my license is in full force and -effect. License•Olass License No Contractor Sign re 41PAISERS' CD?IV"J4SATION DECLARATION �}'rLR7 INNQ!FAILURE-FO Y2CURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO PENALTIES AND CIVIL PINES UP TO ONE UNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE CCddSS �P°COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37080E THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. @14131;iffirm u4er pelpally of perjury one of the following declarations: • •••• I have and will•mai•ntain 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 IN •• .. r%r•mance of ttae Wank for which this permit is issued. Policy No. and Z1413Main 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' compensatior nsurance carrier and policy number are: :arrierPolicy Number Expiration Date Vame of Agent Phone # :1I certify that, in the pert once 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' co ensation laws of California, and agree hat, if I should become bject to the wo�rk�er/s�' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. signature of Applicant 7/ '"`'� Date )ECLARATION RE, E MING CONSTRUCTION LENDING AGENCY hereby affirm unde 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 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 count rdinances and state laws relating to building construction. n/jjj`� y yrn e..y I authorize representatives of this city or county Venter th/��abov�e-identified property for inspection purposes. d' signature of Property Owner or Authorized Agent � l/l, Print Property Owner's or Authorized Agent's Nam Dat ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED DEPA PERMIT EXTENDED QMD POOL ALARMSESTOS NOTIFI ATION IS NOT APPLICABLE TO INSTALLED \ \q PROPOS MOLI _ 41 / it SIGNATURE: w