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HomeMy WebLinkAboutS2021-0289 - Permits�gwtr,, City of Newport Beach - Building Division "S2021 0289" 100 Civic Center Drive, Newport Beach, CA 92660��,s''-��� Permit Counter Phone (949)644-3288 a +4tea;ti+' Job Address: 19 VINCENNES Floor: Suite: Bldg:1 Description of Work:NEW POOL & SPA 404 SF WIDRAINAGE Inspector Area: 6 Legal Description: N TR 15717 LOT 41 Owner: GRI LAND DEVELOPMENT II LLC Address: 19 VINCENNES NEWPORT BEACH CA 92657 Phone: Applicant: VLADIMIR Address: 5000 BIRCH ST, STE 3000 NEWPORT BEACH CA 92660 Phone: 7141795-8080 Building Rear: I,Ur Setbacks: Front: 10J Left: 5 Right: $' �UIIC4 611ull Construction Valuation: $53,000.00 Building Permit Fee : $440.00 Permit Issuing Fee: $0.00 Investigation Fee: $0.00 Building Green Fee: $3.00 Plan Dept Plan Check: $0.00 Building Dep Plan Check: $396.00 Building PC Investigation : $0.00 Plan check Ext. Fee : $0.00 WQ Compliance Insp Fee: $0.00 TOTAL FEE : $1,451.00 Plan Check No: 3009-2021 Code Edit: 2019 Contractor: HIGH PROJECT CONSTRUCTION INC Address: 14200 VICTORY BLVD APT 117 Address: VAN NUYS, CA 91401 Phone: 818-384-4643 Phone: Con State Lic: 1067713 Engineer Lic Expire: 0813112022 Address: Bus Lic: BT30078718 Lic Exp Date: 05/31/2023 Phone: POOL -Permit: S2021-0289 Project No : 3009-2021 Inspection Requests Phone (949)644-3255 Architect: State Lic: PASOL DAWN 1411 N BATAVIA STE 208 - , - ORANGE CA 92867 714-363-3585 State LIc:C-06116V Worker's Compensation Insurance Special Conditions: Carrier: WC EXEMPT - NO EMPLOYEES Policy No: Expiration: Issued Date: FEES SUBCONTRACTOR AGMT: EG POOLS(908419) 05/11/2022 Record Management: $24.00 Water Quality -- $0.00 Building Dept Inspection Fee: Drainage Permit Fee : $237.00 Water Quality Dept Insp Fee: $152.00 Drainage Plan Check: $199.00 Building Dept WQ Plan Check: $0.00 Grading Consultant Fee : $0.00 Others $0.00 Additional Fee : $0.00 $0.00 Plan Check Fee : $595.00 Fee Due at Permit issuance: $8 PROCESSED BY: PLAN CHECKED BY:: N/k / 017-ft�. 5w ZONING APPROVAL: ' u--1_ 1 APPROVAL TO ISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION 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). 1411 N BATAVIA STE 208 ❑ 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, 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 Nlunerty, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apoly to an owner c` pi who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ aril exempt f, ❑n, 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 se" 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 Prufessiuns Code, is available upon request when this application is submitted or at the following Web site:hftp://www.leginfo.ca.gov/calaw.html. Sicnatur., of Propui:� O..mer or Authorized Agent Dat LICENSED CONTRACTOR'S DECLARATION I h.rES; affirm uMi r penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) f ivi n 3 of the Business and Professi ns C de d my license is in full force and eff=rt. License Class License No Date ' D Contractor Signature NORKERS' COMPENSATION DECLARATION NAINING: FAILURETO SE"UPE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUS D DOLLARS Ibi00,0001, IN ADDITION TO THE COST OF COMPENSATIJJ, DA:.IAGES As PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hurebv a'Firm under pe.ialty 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 thi )erformance of the work for which this permit is issued. Policy No. JI have 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' compensatioi nsurance carrier and policy number are: 3arrier Policy Number Expiration Date Vame of Agent Phone # 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 ertify that, in the p4operjury at, if I should becomrkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. y signature of Applicant Date )ECLARATION REGAUCTION LENDING AGENCY hereby affirm under pat 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 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 providej is orrect. I agree to comply with all applicable city and county ordinanc s a d state laws relating to building construction. I authorize representatives of this city or county to enter the bo dentified property for inspection purposes. x signature of Property Owner or Authorized Agent Print Prope Owner's or Authorized Agent's Name Date / ACTION DATE BY DECLAR N 10 OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGU IONS PART 61OFTITLE40AND AQMDRULE All required al rns,latches 1403 ates & fences which serve PERMITEXPIRED LJ I SUBMITTED ASBESTOSpIXOTIFICATION TO as part Ot a poloi I spa barrier, shall be in place prior to approval to fill poollspa & shall remain in PERMIT CANCELLED EPA PERMIT EXTENDED 13AQMD POOL ALARMS ASBESTOS NOTIFICAT N I TAPPLICABLE TO p lace & be maintained for INSTALLED P OSED DEMOLITION. the life of the p00 8 a SIGNATURE: X PERMIT FINAL