HomeMy WebLinkAboutS2020-0121 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II
ae 100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 2 0 0 1 2 1
Permit Counter Phone (949)644-3288
a � ,
Job Address: 20201 ORCHID ST Floor: Suite:
Description of Work:SFR POOL & SPA 559 SF W/ DRAINAGE
Inspector Area: 3
Legal Description: N TR 1500 LOT 11
Owner: ROMIN RAD
Address: 20201 ORCHID ST
NEWPORT BEACH, CA 92660
Phone
Applicant: ROMIN RAD
Address: 20201 ORCHID ST
NEWPORT BEACH, CA 92660
Phone: 949-973.4666
Building Rear:
Setbacks: Front:
Left:
Right:
Construction
Construction Valuation: $40,000.00
Building Permit Fee :
$430.00
Permit Issuing Fee:
$0.00
Investigation Fee:
$0.00
Building Green Fee:
$2.00
Plan Dept Plan Check:
$0.00
Building Dep Plan Check:
$387.00
Building PC Investigation
02128/2022
Plan check Ext. Fee :
$0.00
WQ Compliance Insp Feel
$0.00
TOTAL FEE:
PROCESSED BY:
ZONING APPROV
Bldg: 1
Plan Check No: 1492-2020
Code Edit: 2019
Contractor: MASTERPIECE POOLS & SPAS INC Architect
Address:
22343 LA PALMA STE 104
Address:
YORBA LINDA CA 92887
Phone:
714-692-1132
Phone:
Con StateLic:
804110
Engineer:
Lie Expire:
02128/2022
Address:
Bus Lie:
BT30072007
$0.00
Lie Exp Date:
05131/2021
Phone:
Worker's Compensation Insurance
Carrier: STATE FUND
Policy No: 9042868
Expiration: 10101/2021
FEES
13001 -Permit: S2020-0121
Project No : 1492-2020
Inspection Requests Phone (949)644-3255
BEST p o
State Lie:
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BIEDENBACH CHRISTOPHER
1201 N TUSTIN o
ANAHEIM CA 92807 ......
714-630.6100 State Lic:C-074003
Special Conditions:
Issued Date:
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Docm
0
1111012020 " m
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Record Management:
$10.00
Water Quality- --
Building Dept Inspection Fee:
$278.00
Drainage Permit Fee :
$232.00
Water Quality Dept Insp Fee:
$120.00
Drainage Plan Check:
$195.00
Building Dept WQ Plan Check:
$0.00
Grading Consultant Fee:
$0.00
Others
$0.00
Additional Fee :
$0.00
$0.00
Plan Check Fee: $0.00
PLAN CHECKE
APPROVALTO
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Due at Permit Issuance : $1
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 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 perialry of
of more than five hundred dollars ($500). 1201 N TUSTIN ❑
as owner of the property, or my employees with wages as their sole compensation, will do L) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business
nd 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:
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 lega111
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:http://www.leginfo.ca.gov/calaw.htmi.
;ignalure of Property Owner or Authorized Agent Digits,
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm udder ppnalty of perjury that I am licensed under provision of (�nnienbi it Section 7 00 ivis' n 3/of the Business and Profes 'a d a I my license�is in full force
nd effect. Li(MAS Class License No _ 1� 1/ l� Date 1 ntractor Signatu
19rMRV CQMPIENSATION DECLARATION
'ARNIN(F. FAILUFt Orb*Sf?�URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (4100,000), IN ADDITION TO THE
OSTW COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
h6fre affirm under penalty of perjury one of the following declarations:
I ye and Milt TrIntain 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 the
nce of the work for which this permit is issued. Policy No.
...•
112 @ and 01II jnairfiain 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' compensatiol
m9ron5p carrier apd policy number are:
Policy Number
of Agent` ' '
Uy that, irn(Ne performs a of
of
Ireby affirm under f)enalty of perjury that there is a cc
Ider's Name
my signature below, I certify to each of the following:
I am the property owner or authorized to act on the
I have read this application and the information I ha,
I agree to comply with all applicable city and county
I authorize representatives of this city or county to}
Date
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 agree
I provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Date
kGEIJCY
lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Lender's Address
behalf.
laws relating to building construction.
A, pperty for inspection purposes.
ii nature of Property Owner or Authorized Agent — Print Propert
ACTION DATE BY–DECLARATION OF CO PLIANCE WITH CODE OF FEDERAL
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
FOR OFFICE USE ONLY
Name
t,Ll up
1403
All reClUired
PERMIT EXPIRED
U I SUBMITTED ASBESTOS NOTIFICATION TO
gates R fences Which serve
- as part of pool / spa
barrier, shall be in place
prior t0 approval to fill
poo shall r l/spa & shall remain in
place R be maintained for
V they�Jft_ _PIAS
PERMIT CANCELLED
UEPA _
PERMITEXTENDED
13AQMD
POOLALARMS
INSTALLED
omd
ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE:
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