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Home My WebLink AboutS2018-0083 - PermitsCW1 City,of Newport Beach Building Division II IIIIIIIIIII�IIIIIII IIIIII�IIIIIIIIIII IIIIII II POOLPermit : S2018-0083 s0 100 Civic Center Drive, Newport BAI;,h, CA 92Eb60o m m Q m S 2 0 1 8 0 0 8 3 Project No: 1144-2018 Permit Counter Phone (949)64•;-32§8 �'�Lweix.�a Inspection Requests Phone (949)644-3255 _.... o oom e • m m D o m o m m• •o o e o e me • •• e• m e ° e•• e e e e e Job Address: 2401 ALTA VISTA DR F18or: Suite!' "Bldg: 4 ®° 7" Description of Work:SFR NEW SPA 64 SF `1 Inspector Area: 8 Plan Check No: 1144-2018 ■ x Code Edit: 2016 - Legal Description: N TR 4705 LOT 65 Owner: MED EQUITY LLC Address: 3700 CAMPUS DR STE 200 NEWPORT BEACH, CA 92660 Phone: Applicant: MASON WILLIAM Address: 3276 DAKOTA AVE COSTA MESA CA 92626 Phone: 714/427-0688 Building Rear: Setbacks: Front: Left: Right: Construction Valuation: $7,200.00 Contractor: O W N ER/B LDR Address: Phone: Con State Lic: O/B Lic Expire: Bus Lic: Lic Exp Date: Worker's Compensation Insurance Carrier: Policy No: Expiration: Building Permit Fee : $380.00 Record Management: Permit Issuing Fee: $0.00 YAGHI SHUCRI I Investigation Fee: $0.00 Drainage Permit Fee: Building Green Fee: $1.00 Drainage Plan Check: Plan Dept Plan Check: $0.00 Grading Consultant Fee: Building Dep Plan Check: $338.00 Building PC Investigation : $0.00 Additional Fee Plan check Ext. Fee : $0.00 WQ Compliance Insp Fee: $0.00 TOTALFEE: PROCESSED BY: ZONING Architect: MASON WILLIAM Address: 3276 DAKOTA AVE Issued Date: 05/29/2018 FEES $4.00 COSTA MESA CA 92626 Phone: 714/427-0688 State Lic:CO23759 Engineer: YAGHI SHUCRI I Address: 112 E. CHAPMAN #D $0.00 ORANGE CA 92866 Phone: 714-997-9120 State Lic:C-043205 Special Conditions: O/B AUTH FORM ATTACHED Issued Date: 05/29/2018 FEES $4.00 Water Quality --- Building Dept Inspection Fee: $0.00 Water Quality Dept Insp Fee: $0.00 Building Dept WQ Plan Check $0.00 Others : $0.00 Plan Check Fee : $338.00 ��FFe��e Due at Permit Issuance PLAN CHECKED BY:: r r t APPROVALTO 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) india°Data°d belaw ty (hecheckmark(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, den1gjiSh„grjeffajr'anys11ru&Vit, 94or to its issuance, also requires the applicant for is 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). i 12 E. CHAPMAN #q I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of A wc;q,, andjhE:stiucfure is rot injended or offered for sale (Section 7044, lusiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, througl eQlplojees' oyflersor%efforC byil* of improves the property, provided that the nprgvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion!tue Owner -Builder will have the burden of proving that it was not built or hproved for the purpose of sale). 1 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 only 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: ly my signature below I acknowledge that, except for my pe nal r sidence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall, ell a structure that I have built as an owner-builde ' c truc ed in its entir y licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and 'rofessions Code, is available upon request when Yi I u m t th lowing Web site:http://www.leginfo.ca.gov/calaw.html. signature of Property Owner or Authorized Agent I ' Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Pr fQessions Code, and my license is in full force no effect. License Class License NoD Contractor Signatu VORKERS' COMPENSATION DECLARATION DARNING: FAILURE TO 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 OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3103 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: NI 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 err mance of the work for which this permit is issued. Policy No. 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' carrier and policy number are: Policy Agent _ Date cert fy that, in the pe c f for which this rmit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and t, if I houId become u j c k s sati provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. loaf re of Applic nt Date ARATION R R CONSTRUC ON L DING AGENCY :reby affirm under penalty of perjury that there is a construction lending agency for the pertormance of the work for which this permit is issued (Section 3097, Ci I Code). ider's Name Lender's Address 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 provi is act. I agree to comply with all applicable city and cou y a d a s relati to building construction. ��/�,,r�,/� I authorize representatives of this city or county a -i n PI.0 for inspection purposes. ,� ��1 �/� ��F[� of Prooertv Owner or Authorized ACTION PERMIT CANCELLED PERMIT EXTENDED POOLALARMS INSTALLED PERMIT FINAL I DATE I U/v4 Print Property Owners or Authorized Ag OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY PART 61 OF TITLE 40 AND AQMD RULE 1403 SUBMITTED ASBESTOS NOTIFICATION TO DLII ,fp.{IM��`� K. EPA QMDASBESTOS �� X7� /�ui,��c C�� d� Y •. ION IS NOTAPPLICABLE TO PROPOSED DEMOLITION SIGNATURE: °Wry/i%�6'Y / �' / "I'��l TL°'• /_ l S `�,(� 5'V/N! SIC-9�> n