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HomeMy WebLinkAboutS2017-0178 - Permits'gG41Y,y4,�. City of Newport Beach - Building Division 1111111111111111111111111111111111111111111111111111111 111� 04 a� 100 Civic Center Drive, Newport Beach, CA 92660 5 2 0 1 7 0 1 7 8 Permit Counter Phone (949)644-3288 Job Address: 19 VISTA LUCI Floor: Suite: Bldg: 1 Description of Work:SPA W/BASIN & DRAINAGE Inspector Area: 6 Plan Check No: 2355-2017 Code Edit: 2016 Legal Description: N TR 14070 LOT 2 Owner: VAKILI MARK Address: 19 VISTA LUCI Investigation Fee: NEWPORT COAST, CA 92657 Phone: $2.00 Applicant: GEOSCAPEISTEVE Address: 20372 HERMANA CIR Building PC Investigation : LAKE FOREST CA 92630 Phone: 949-916-4545 Building Rear: Setbacks: Front: Left: Right: Construction Construction Valuation: $35,000.00 Building Permit Fee : $380.00 Permit Issuing Fee: $0.00 Investigation Fee: $0.00 Building Green Fee: $2.00 Plan Dept Plan Check: $37.50 Building Dep Plan Check: $338.00 Building PC Investigation : $0.00 Plan check Ext. Fee : $0.00 WQ Compliance Insp Fee: $0.00 TOTAL FEE: Contractor: GEOSCAPE LANDSCAPE CONSTR INC Address: 20372 HERMANA CIR Address: LAKE FOREST CA 92630 Phone: 949.903-2766 Phone: Con State Lie: 632334 Engineer Lie Expire: 05131/2019 Address: Bus Lie: BT30023383 Lie Exp Date: 05131/2018 Phone: Worker's Compensation Insurance Carrier: STATE FUND Policy No: 9027912 Expiration: 06/0112018 FEES Record Management Drainage Permit Fee : Drainage Plan Check: Grading Consultant Fee Additional Fee: $22.00 $293.00 $0.00 $0.00 $0.00 PROCESSED BY: ZONING APPROVAL: P001 -Permit: S2017-0178 Project No : 2355-2017 Inspection Requests Phone (949)644-3255 Architect: ! State Lie: ZHANG YAO 15375 BARRANCA PKWY, H106 IRVINE CA 92618 0 949.788-0424 State Lic:C-074572 a®mmmm m Special Conditions: ...... C 0 °oocm Issued Date: 11/15/2017 ° s aoo m < < Water Quality- -- Building Dept Inspection Fee: Water Quality Dept Insp Fee: Building Dept WQ Plan Check: Others : Plan Check Fee: $300.50 PLAN CHECKED BY:: APPROVAL TO ISSUE PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION ° ccoco o c o oom000 0 0 ©Dome oco 0 a c •aoc $0.00 o® $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : 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). 15375 BARRANCA PKWY, H106 ❑ I, 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 improved 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 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 legally sell 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 Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent - Date LICENSED CONT CTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provislo of Chapter 9 (commencing with Section 7000) f D' is on 3 of the Business and Professions Code ead-ruv license is in full force and effect. License Class License N Date 11. 1-7 Contractor RKE,AS' COMPENSATION DECLARATION VING: FAILUR916MORE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000(, IN ADDITION TO THE r OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. eby affirm undeopenalty of perjury one of the following declarations: Awe and will. maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for IN fiance of the work for which this permit is issued. Policy No. have and Will mairliain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatior rake carrigrapd policy number are: ier . : Policy Number Expiration Date ie of Agent Phone # erIVy that, jQ tV.*rformance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree I.� hould become subje/ct ty the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. stare of Ap�pliBanr .✓ Dated$ / 'LARATIOFI REGARDING CONSTRUCTION LENDING AGENCY weby affirm under 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) 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 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 counJ,I',�o enteL� above -identified property for inspection purposes. /' nature of Pmnerty Owner or Authorized ADer < Print Prooertv Owner's or Authorized AGent's Name �4 Xe,,p� ,(, ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED I L1 I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT EXTENED LIAQMD POOLALARMS LJAS13ESTOS NOTIFICATION IS NOTAPPLICABLE TO INSTALLED PROPOSED DEMOLITION. PERMIT FINAL O E a) O CL Of a¢ as m o 9Cc:a2 c E C E -8 7 N N O� VO• COO O N Cl) Q E a)N ; � �,O y' N O Vr. a) X of O t0 A88 m S U mm lEU O_)8 O E Q cca U) �'m y�+ LO m O R N m L C a� m v- E o L -0 0 l w 0 Z a E ci O O c F E Q O c a) (D w0- °) c a) m 0 Q > E 0 0 z a) 0? 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