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Home My WebLink AboutS2018-0135 - PermitsCity of Kiwo pber failcr -a"J ing Division 11111111111111111111111111111111111111111111111111111111111 ' 100 Civic Center griv�, New,,iP�oi Ia ash, CF:92660 S 2 0 1 8 0 1 3 5 xk Permit Couniclr'PhoBe (946j644.328$• e ° e m e o e • em • mm ° ,lob Address: 1963 PORT DUNLEIGH CIR Floor: Suite: Bldg: 1 Description of Work:SFR POOLISPA 528 SF Inspector Area: 4 Plan Check No: 1826-2018 Code Edit: 2016 Legal Description: N TR 7027 LOT 48 Owner: CONCHACASA LLC Contractor: PREMIER POOLS ORANGE CTY Address: 5316 SEA SHORE DR Address: 22 SAN RAPHAEL NEWPORT BEACH, CA 92663 DANA POINT CA 92629 Phone: Phone: 626-422-5426 Applicant: ELLISON PAUL Con State Lic: 798298 Address: 26052 MERIT CIR #106 Lic Expire: 12131/2019 LAGUNA HILLS CA 92653 Bus Lic: BT30056113 Phone: 949-215-4144 Lic Exp Date: 08131/2018 Building Rear: 10 Setbacks: Front: 20 Left: 5 Right: 5 Construction Tvice : Construction Valuation: $43,000.00 Building Permit Fee : $380.00 Permit Issuing Fee: $0.00 Investigation Fee: $0.00 Building Green Fee: $2.00 Plan Dept Plan Check: $0.00 Building Dep Plan Check: $338.00 Building PC Investigation : $0.00 Plan check Eat. Fee : $0.00 WQ Compliance Insp Fee: $0.00 TOTAL FEE : $724.00 PROCESSED BY: ZONING APPROV Worker's Compensation Insurance Carrier: STATE COMP Policy No: 9158204 Expiration: 05103/2019 FEES POOLPermit : S2018-0135 Project No : 1826-2018 Inspection Requests Phone (949)644-3255 Architect: Address: Phone: Engineer: LENEHAN GERRY Address: 1024 IRON POINT State Lic: FOLSOM CA 925630 Phone: State Lic:C-073459 � Special Conditions: TOR SP Issued Date: 0812112018 Record Management: $4.00 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 : $0.00 $0.00 Plan Check Fee: $300.50 PLAN CHECKED BY:: APPROVAL TO ISSUI PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Fee Due at PerrDlt Issuance : $423.60 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 checkrr ri(s f I trave pA9Od g$4 to the applicable items) Bection 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 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 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 apermiit subjects the applicant to a civil penally of ❑ of more than five hundred dollars ($500). 1024 IRON POIIJT. :. ! • • ; 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 strudture i� not Inte*ded drpfferejl fbr sele.(Saction 7044, Business nd Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal ef%rt,.builds or inlpjgvas the propAtty, pr'bvided 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-8uilr%r will have the burden of proving that it was not built or n roved for the purpose of sale). 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 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). 7 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 legall) 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. ;ignature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of isi n 3 of the Business and P ofes rus license is in full force nd effect. License Class License No Date Contractor Signa VORKERS' COMPENSATION DECLARATION 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDR THOUSAND DOLLARS ($100,000), IN ADDITION TO THE DST 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: I 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 th ee rf/oormance of the work for which this permit is issued. Policy No. �911ave' 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' compensatiol Isurance carrier and policy number are: �arrier Policy Number Expiration Date lame of Agent Phone # ]I certify that, in the=that ork f w ' th' permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation Is s of California, and agree rat, if I should becom' co a ion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignature of ApplicanDot IECLARATION REGTION LENDING A Y hereby affirm under 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. - R_ I have read this application and the information I rovided is corretp, I agree to comply with all applicable city and cc ty ord s as rela' g to building construction. I authorize representatives of this city or coun o ente a ove-i nrty for inspection purposes. y�1/ nature of Property Owner or Authorized A ent Print Property Owner's or Authorized gent's Nam �O Date P Y 9 \CTION DATE BY D ATI F COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY EGULATIONS PART 610E TITLE 40 AND AOMD RULE - PERMITEXPIRED I I I U I SUBMITTED ASBESTOS NOTIFICATION TO POOL ALARMS U ASBESTOS NOTIFICATION IS NOT APPLICABLE TO INSTALLED PROPOSED DEMOLITION. _ t _ SIGNATURE: