HomeMy WebLinkAboutS2019-0097 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II
o 100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 1 9 0 0 9 7
Perniif6ounter Phone (949)644-3288'
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Job Address: 2339 ARALIA ST Floor: Suite:
Bldg: 0
Permit Issuing Fee:
$0.00
Description. of Work:NEW POOLISPA 491 SF. WI DRAINAGE.
$0.00
Building Green Fee:
$2.00
Inspector Area: 8 -
$0.00
- Plan Check No:
1241.2019
-Building PC Investigation :
$0.00
Code Edit:
2016
Legal Description: N TR 4705 LOT 53
$0.00
Others
Owner: FOLEYTIMOTHY & KELLY
Contractor:
DREAMSCAPES BY M G R INC
Architect:
Address: 2339 ARALIA ST
Address:
1901 NEWPORT BLVD #350
Address:
NEWPORT BEACH, CA 92660
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°
COSTA MESA CA 92627
Phone:
Phone:
949-480-3420
Phone:
Applicant: ELLINGSON PAUL
Con State Lic:
694588.
Engineer:
Address: 1901 NEWPORT BLVD #300
Lie Expire:
10131/2019
Address:
COSTA MESA, CA 92627
Bus Lie:
BT30052223
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Phone: 949-608-1726
Lie Exp Date:
08131/2019
Phone:
Building Rear:
Setbacks: Front:
Left:
Right:
Construction
Construction Valuation: $47,000.00
Building Permit Fee :
$405.00
Permit Issuing Fee:
$0.00
Investigation Fee:
$0.00
Building Green Fee:
$2.00
Plan Dept Plan Check:
$0.00
Building Dep Plan Check:
$361.00
-Building PC Investigation :
$0.00
Plan check Ext. Fee :
$0.00
WQ Compliance Insp Fee:
$0.00
II TOTAL FEE : $1,700.00
PROCESSED BY:
ZONING APPROVAL'
Worker's Compensation Insurance
Carrier: WESCOINSURANCE
Policy No: WWC3348393
Expiration: 04106/2020
FEES
POOLPermit : S2019-0097
Project No: 1241-2019
Inspection Requests Phone (949)644-3255
Special Conditions:
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Issued Date: 05/31/2019
Record Management:
$14.00
Water Quality- --
Building Dept Inspection Fee:
$0.00
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Mz
Water Quality Dept InspFee:
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_
$312.00
Building Dept WQ Plan Check:
$0.00
Grading Consultant Fee:
$0.00
Others
$0.00
Additional Fee:
$294.00
State Lie:
$0.00
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BIEDENBACH CHRISTOPHER
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1201 N TUSTIN
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ANAHEIM CA 92807
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714-630.6100
State Lic:C-074003
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Special Conditions:
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Issued Date: 05/31/2019
Record Management:
$14.00
Water Quality- --
Building Dept Inspection Fee:
$0.00
Drainage Permit Fee:
$312.00
Water Quality Dept InspFee:
$0.00
Drainage Plan Check:
$312.00
Building Dept WQ Plan Check:
$0.00
Grading Consultant Fee:
$0.00
Others
$0.00
Additional Fee:
$294.00
$0.00
Plan Check Fee :
1.00 Fee Due at Permit Issuance : $0.00
PLAN CHECKED BY::
APPROVAL TO ISSUE: ��pi,
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
OWNER -BUILDER DECLARATION, *a
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the resson(s) indicated below by the checkmark(s) I have placed next to -the applicable item(s) n
lection 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 RIr
e 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
A more than five hundred dollars ($500). 1201 N TUSTIN 11.
as owner of the property, or my employees with wages as their sale compensation, will do U all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business
id 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
Iprovements 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
I 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 Code: The Contractors' State License Law does not
'ply 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:
y 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 legall)
;II 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
"ofessions Code,, is available upon request when this application is submitted or at the following Web site:hftp:/AvWw.leginfo.ca.gov/calaw.html.
gnature of Psope*�rtyy Owner or Authorized Agent Date
ICEIJSED CONTRACTOR'S DECLARATION
lereby affirm;fiVerpenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0 o Ivlsion 3 of the Business and Profes de an icense is in full force
id effect. LisenstUass License No Date 3 Contractor Signature
1@N*ERS' COMPENSATION DECLARATION
iRNING: FAILUTp SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI Al PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
9$T (IF.COMPENA&TIGINI DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
Ierlilly affirm under penalty of perjury one of the following declarations:
Pare 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
mance of the -work for which this permit is issued. Policy No.
and will,¢laintain 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 Number Expiration Date
ne of Agent ' • * Phone #
certify that, in the ?alty
nce of e w or 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
I, if I should becom o e ore compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of ApplicanDate �/,� 4
CLARATION REGCONSTRUCTION LENDING AGENCY
neby affirm underf perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 309 , Civil Code).
Ider's Name Lender's Address
my signature below, I certify to each of the following:
1 am the property owner or authorized to act on the property owner's behalf.
I have read this application and the information 1 provided is correct.
I agree to comply with all applicable city and c ty or in c a sta s relating to building construction.
I authorize representatives of this city or count t th a ve-id Ified ropert for inspection purposes.Ll.�� to
nature of Property Owner or Authorized A ent Print Property Owners or Authorized Agent's Name Q
ACTION
DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED
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