HomeMy WebLinkAboutS2020-0167 - PermitsCity of Newport Beach Building Division I llpil III 1111111111111111111111111111111111111111p JillP001-Permit: S2020-0167
100 Civic Center Drive, Newport Beach, CA 92660
Project No :1891-2020
^t Permit Counter Phone (949)644-3288
V � 1
Inspection Requests Phone (949)644-3255
Job Address: 1105 DEVON LN Floor: Suite: Bldg: 1
Description of Work:SFR POOL & SPA 350 SF W/ DRAINAGE
Inspector Area: 3 Plan Check No: 1891-2020
Code Edit: 2019
Legal Description: N TR 3000 LOT 16
Owner:
BRATZ CHERYL A
Contractor:
AQUA SCAPES POOLS & SPAS
Address:
1105 DEVON LN
Address:
321 CALLE FELICIDAD
Plan Dept Plan Check:
NEWPORT BEACH, CA 92660
Building Dap Plan Check:
SAN CLEMENTE CA 92672
Phone:
$0.00
Phone:
949.448-7665
Applicant: ELLISON PAUL
Con State Lic:
764729
Address:
24642 VIA RAZA
Lic Expire:
11/30/2020
$0.00
LAKE FOREST CA 92630
Bus Lic:
BT30069893
Phone:
949-683.9861
Lic Exp Date:
11/30/2020
.Building Rear:
Setbacks: Front:
Left:
Right:
Construction TVDB : V -B
Construction Valuation: $35,000.00
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 Dap Plan Check:
$387.00
Building PC Investigation :
$0.00
Plan check EM. Fee :
$0.00
WQ Compliance Insp Fee:
$0.00
TOTAL FEE : $1,252.00
PROCESSED BY:
ZONING APPROb
Worker's Compensation Insurance
Carrier: WC EXEMPT
Policy No: (NO EMPLOYEES)
Expiration:
FEES
Architect:
Address:
Phone: State Lic
Engineer: LACHER-TODD
Address: 1201 N TUSTIN AVE
ANAHEIM CA 92807
Phone: 714-630-6100 State Lic:C-067656
Special Conditions:INS�]�9
, -01
'( �!
Issued Date:
1011512020
Record Management:
$6.00
Water Quality -
Building Dept Inspection Fee:
$0.00
Drainage Permit Fee:
$232.00
Water Quality Dept Insp Fee:
$0.00
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 :
PLAN CHECKED BY::
APPROVAL TO ISSUE:
co
c
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
0
°0 0
Fee Due at Permit Issuance : $1,252.00
OWNER -BUILDER
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 app4cant 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 SBction 7000) of Division 3 of the BusineC'Yand
'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). 1201 N TUSTIN AVE
1 I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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
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
n 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
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.html.
signature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION �ptD1/��CB�y��
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 0 of IV on 3 of the Business and Prof si'—'c` y license is in full force
nd effect. License Class License No Dat ZV Contractor Signatu .00n --
YORKERS' 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 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES,
hereby affirm under penalty of perjury one of the following declarations:
] 1 have 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 lh
hormance 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 Number Expiration Date
of Agent
]I certify that, in the perfo22M,
rk 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
Iat, if I should become su rs' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
l/�� /
ignature of Apr lican
iECLARATION REGA N SO S UCTION LENDING AGENCY
hereby 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).
ender's Name Lender's Address
y 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
I agree to comply with all applicable city and c rdi n a d ata le s relating to building construction.
I authorize representatives of this city or count toe r t a e -idle t' ' d property for inspection purposes. �II �
kmature of Prooertv Owner or Authorized Age Print Property Owner's or Authorized Agent's Name '^'•'h (�/( Date
ACTION
DATE
BY V \
DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY —`
REGULATIONS PART 61 OF TITLE 40 AND AQ M'
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