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Home My WebLink AboutS2019-0134 - PermitsCiti, of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II o,,.,.nter Drive, Newport Beach, CA 92660 5 2 0 1 9 6 1 3 4 P s. ., inter Phone (949)644-3288.. Job Address: 2191 MESA DR Floor: Suite: Description of Work:SFR NEW POOLISPA 626 5F Inspector Area: 8 Legal Description: TR 706 LOT 161 NWLY1/2 Owner: MOORE SEPARATE PROPERTY Address: 2191 MESA DR NEWPORT BEACH, CA 92660 Phone: 714-717-7019 Applicant: MOORE TOM Address: 2371ST ST HUNTINGTON BEACH, CA 92698 Phone: 714-717-7019 Building Rear: Setbacks: Front: Left: Right: Construction Tvoe : Construction Valuation: $50,000.00 Bldg: 1 Building Permit Fee : $405.00 1746-2019 Permit Issuing Fee: $0.00 Contractor: OWNER/BLDR Investigation Fee: $0.00 Address: Building Green Fee: $2.00 Con State Lie: 018 Plan Dept Plan Check: $0.00 Address: Building Dep Plan Check: 0 •m o Building PC Inv estiga $0.00 • m Plan check Ext. Fe $0.00 $0.00 WQ Compliance I p Fee: $0.00 TOTAL FE1,070.00 Bldg: 1 em®• ° Plan Check No: 1746-2019 Code Edit: 2016 Contractor: OWNER/BLDR Architect: Address: MOORE THOMAS Address: Phone: Phone: Con State Lie: 018 Engineer: Lie Expire: Address: Bus Lic: •m o Lie Exp Date: Phone: Worker's Compensation Insurance Carrier: Policy No: Expiration: FEES POOLPerr it : S2019-0134 Project No: 1746-2019 Inspection Requests Phone (949)644-3255 INSPECTOR Special Conditions: 0 000eoo omooam o c Issued Date: 08/06/2019 o 0o c c c e e•mcL Record Management: em®• ° Water Quality- -- e m•me State Lie: $0.00 m o $0,00 m m mm • ° BIEDENBACH CHRISTOPHER • m° °^° 1201 NTUSTIN ommm •m o ANAHEIM CA 92807 ° ® • m 714.630-6100 State Lic:C-074003 ° m m e $0.00 Additional Fee : ono¢ $0.00 o ° o 00 c oococ o Special Conditions: 0 000eoo omooam o c Issued Date: 08/06/2019 o 0o c c c e e•mcL Record Management: $6.00 Water Quality- -- Building Dept Inspection Fee: $0.00 Drainage Permit Fee : $0,00 Water Quality Dept Insp Fee: $0.00 Drainage Plan Check: $0.00 Building Dept WQ Plan Check: $0.00 Grading Consultant Fee : $0.00 Others $0.00 Additional Fee : $294.00 $0.00 Plan Check PROCESSED BY: PLAN CHE KED BY::. ZONING APPROVAL: APPROVALT E PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPEC Ago g Due at Permit Issuance : $776.00 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 t w"P 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 I�yuiies 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 ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) 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 U 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 licensure under the Contractors' State License Law for the following reason: By 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 legalq sell a structure that I have built as an owner -builder if it has not been cons cted! its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code.ig available upon request when lication is sib i ed or t the ollowing Web site:http://www.leginfo.ca.gov/calaw.html. Date r Signature of Pr%e�rly.Owner or Authorized Agent "7 - LICENSED CONTRACTOR'S DECLARATION -17 t Mire6paffirm errider penalty of perjury that I am ensed under provisions of pter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force arid effect. License Class License No Date Contractor Signature 6WRORS' COMPENSATION DECLARATION NVNINC: 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 ($700,000), IN ADDITION TO THE aOW OF eOMPENSA9"'DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. �'hereyl affirm untlerperalty, of perjury one of the following declarations: a[;Ile 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 the 3erfonivIce of the Work for which this permit is issued. Policy No. .I have, and will -melRleln 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 WTOW9 carrier and policy number are: "gat?, . .��. : Policy Number Expiration Date Name f Agent Phone 9 ce ify that, in the performance 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' compensation laws of California, and agre that I should become subject t At worke o pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. _ Signature of Applica Dat DECLARATION R ARDING CONSTRTI N LENDING AGENCY I hereby affirm un r penalty of perjury that re is a construction lending agency for the performance of the work for which this permit is issued (Section 7, Civil Cade). Lender's Name Lender's Address By 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 county ordinances and state laws relating to building construction. I authorize representatives of this city or county to enter the apv -!den i ed property for inspection purposes. Si nature of Property Owner or Authorized Aqant Print Property Owner's or Authorized Agent's Nam f Date ACTION DATE BY DECLARATION OF OPLIANCE WITH CODE OF FEDERAL 1 FOR OFFICE USE Of�1�Y REGULATIONS PART61 OF TITLE 40AND ACMD RULE AAII required alarms,latches 1403 gates & fences _ _. PERMITEXPIRED IJ I SUBMITTED ASBESTOS NOTIFICATION TO 1 Par a /� PERMITCANCELLED UEPA `` ,,�,, '' rl p`o-S all �j' j 'M/ fUr� PERMITEXTENDED qMD �,j��l�_1� Sava0.h� POOLALARMS ASBESTOS NOTIFICATION IS NOT APPLICABLE TO ['/,tr1e aft 14 Ii1 INSTALLED gr I�qq' PROPOSED DEMOLITION. "�' - alned for SIGNATURE: PERMITFINAL • 'I. 9i0 - (/" (�Ar nRye/ V ga;