HomeMy WebLinkAboutS2021-0197 - Permitsw.ts)�.R City of Newport Beach - Building Division 1111IIIII 111111111111p1111111111p11111p1111111p 11 POOL -Permit: S2021-0197
p .ri r. 100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 2 1 0 1 9 7
`,,"�. `�: Permit Counter Phone (949)644-3288 Project No : 0740-2021
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x .. �''t�rh¢Ni� Inspection Requests Phone (949)644-3255
Job Address: 2720 PEBBLE DR Floor: Suite: Bldg: 1
Description of Work:SFR ADD SPA TO (E) POOL 150 SF W/YARD DRAINAGE & V X 32 LF (INSIDE P/L) WROUGHT IRON FENCE *CHANGE OF CONTRACTOR*
Inspector Area: 6
Legal Description: N TR 3660 LOT 44
Owner:
SHOKRIAN MAHIN
Address:
2720 PEBBLE DR
CORONA DEL MAR, CA 92625
Phone:
949-278-1187
Applicant: YOUNG DAVID
Address:
6197 E PALO AITO DR
ANAHEIM HILLS, CA 92807
Phone:
714-866-1411
Building Rear:
Setbacks: Front:
Left:
Right:
Construction
Construction Valuation: $0.00
Building Permit Fee :
$0.00
Permit Issuing Fee:
$0.00
Investigation Fee:
$0.00
Building Green Fee:
$0.00
Plan Dept Plan Check:
$0.00
Building Delp Plan Check:
$0.00
Building PC Investigation :
$0.00
Plan check Ext. Fee :
$0.00
WQ Compliance Insp Fee:
$0.00
TOTAL FEE : $38.00
PROCESSED BY:
ZONING
Plan Check No: 0740-2021
Code Edit: 2019
Contractor: INTEX DESIGN & CONSTRUCTION OC INC
Architect:
Address:
2646 DUPONT DR STE 60 # 348
Address:
IRVINE CA 92612
Phone:
949-664-2377
Phone: State Lie:
Con State Lic:
1073000
Engineer: BIEDENBACH CHRISTOPHER
Lie Expire:
Address: 1201 N TUSTIN
Bus Lie:
BT30076404
ANAHEIM CA 92807
Lie Exp Date:
08/31/2022
Phone: 714-630-6100 State Lic:C-074003
Worker's Compensation
Insurance
Special Conditions:
Carrier:
NATIONAL LIABILITY & FIRE INS
LETTER ATTACHED
Policy No:
A9WC273029
�G(k'tIM.tYSGYYIC+%r t�Y1,Y.i
Expiration:
08/11/2022
Issued Date: 09/01/2021
FEES
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Record Management:
$0.00 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 :
Additional Fee :
$38.00
Plan Check Fee :
AAN CHECKE-) BY
APPROVAL TO
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
$0.00
$0.00
Fee Due at Permit Issuance : $38.00
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 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
he 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
3rofessions 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
iot 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 U all of or U 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
mprovements 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
rm 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
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 legal
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 CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7IlOR) f Divi ion 3 of the Business and Profe sions Code, an Icense is in full for e
and effect. License Class License No Date ll�� ``YY 73 Contractor Signature
WORKERS' COMPENSATION DECLARATION
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENA TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO TH
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
111 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 t
Ece 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' compensati
ce carrier and policy number are:
le of Agent
certify that, in the performance of
if I should become subject to th
Policy Number
Date
work forwhich this ermit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agrer
rkers' compensati provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. n n
nature of Applica Date
CLARATION REGNJ
CO�that
N LE ING AGENCY
d f re construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civi Code).
I iereby affirm un er pena y o pep y
Lender's Address
.ender's Name
3y 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 correc
I agree to comply with all applicable city and county ordinances and s laws relating to bu' ding construction.
I authorize representatives of this city or county to enter the above tified property for i coon purposes.
Signature of Property Owner or Authorized Agent Print Property Owners or Authorized Agent's Name Date
ACTION
DATE
BY
111E ATION OF COMPLIANCE WIT ODE OF FEDERAL
FOR OFFICE USE ONLY
r
REG LATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403. -
Ail re Lure
PERMIT EXPIRED
: SOBM177D ASBESTOS;JOnFICATiON TG
— — — — — — — —
.❑LPA - - -
gates.&fences whi SQ$Y@
as part of a pool / spa
arriar. shall be in place
nrior to approval to fill
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PERMITC4NCELLED
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L1 ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
INSTALLED
PROPOSEb OEMUI ITION. -
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SIGNATUNE _'_
ale life Of the pOOVSpa
PERMIT FINAL
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