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Home My WebLink AboutS2021-0168 - Permitsay,wl(r}4, City of Newport Beach - Building Division I IRIII 1111111111111 HE IIII 11i 11111111111111111111111 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone(949)644-3288 r'azYriiY�� ,lob Address: 19 POINT LOMA DR Floor: Suite: Description of Work:SFR - NEW POOL & SPA 318 SF Inspector Area: 6 Legal Description: N TR 7432 LOT 51 Owner: PETROFF CHRIS & JILL Address: 19 POINT LOMA DR CORONA DEL MAR, CA 92625 Phone: Applicant: MATA'S CONSTRUCTION CO Address: 910 E. 4TH ST SANTA ANA CA 92701 Phone: 714-393-6358 Building Rear: Setbacks: Front: Left: Right: Construction Construction Valuation: $80,000.00 Building Permit Fee : $440.00 Permit Issuing Fee: $0.00 Investigation Fee: $0co Building Green Fee: $4.00 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: PROCESSED BY: ZONING Bldg: 1 Plan Check No: Code Edit: Contractor: MATA'S CONSTRUCTION CO Address: 910 E. 4TH ST SANTA ANA CA 92701 Phone: 714.393-6358 Con State Lic: 861880 Lic Expire: 07/31/2021 Bus Lic: BT30015664 Lic Exp Date: 0413012022 Worker's Compensation Insurance Carrier: CYPRESS INS CO Policy No: MAWC128604 Expiration: 0 2/01/2022 FEES Record Management: $10.00 Drainage Permit Fee : $0.00 Drainage Plan Check: $0.00 Grading Consultant Fee : $0.00 Additional Fee : $0.00 POOLPermit: S2021-0168 Project No : 1609-2021 Inspection Requests Phone (949)644-3255 1609-2021�� 2019 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: . �+ Issued Date: 07/16/2021 Water Quality --- Building Dept Inspection Fee: $0.00 Water Quality Dept Insp Fee: $152.00 Building Dept WO Plan Check: $0.00 Others $0.00 $0.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $1,002.00 ✓� PLAN CHECKED BY:: LV APPROVAL TO ISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION 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). 1201 N TUSTIN AVE 111, 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 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). 111, 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 Iega111 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 C9'N1 FACTOR'S DECLARATION ! hereby affirm uncer penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000�of vis. 3 of the Business and Profess s�� ,y license is in full force anu effect. License Class License No Data Contractor Signature N'OR.KERS' COMPENSATION DECLARATION NANNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SURIECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED O AND DOL IS100,0001, IN ADDITION TO THE COST 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: l�r+' have and wli l 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 the ,brfofrr.ance o` the mork 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' came. anC rolicy number are: ie'ofAgeRt----- certify that, in the pi if I should become of Policy Number Expiration Date 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 agre the wo om n visions ection 3700 of the Labor Code, I shall forthwith comply with those provisions. Date/!!b CLARATION REGARD CO AGENCY )reby affirm under pe e' 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 below6petTify 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 c'oounty ordinances and state laws In I authorize representatives of this city or gcour}ry to enter the ov i-,t�aritifi nature of Property Owner or Authorized A e purposes. ACTION DATE BF 4!�ATION OF REGULATIONS PART 611 OFEDERAL�CE WITH CODE OF FT TITLE 40 AND AQMD RULE VCttrvuI eer1Ktu L-1I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED LJEPA PERMIT EXTENDED LIAQMD POOLALARMS INSTALLED LJ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: PERMIT FINAL (O %$' %1 rG.}-ems Forte SM FOR OFFICE USE ONLY Name gates & fences which serve as part of a pool / spa barrier, shall be in place prior to approval to fill pool/spa & shall remain in place & be maintained for the life of the Dool/soa Date 7