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Home My WebLink AboutS2019-0158 - PermitsCity of Newport Beach - Building Division 11111111111111p1111111111111111111111111111111111111 100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 1 9 0 1 5 8 Permit Counter Phone (949)644-3288 �"�LPP:1Yr1� Job Address: 164 SIDNEY BAY DR Floor: Suite: Description of Work:SFR ADD SPA TO EXISTING POOL (49 SF Inspector Area: 6 Legal Description: Owner: KADOYA GRACE Address: 326 S STATE ST LOS ANGELES CA 90033 Phone: Applicant: NACIESAT KAKNASIAH Address: 3857 BIRCH ST NEWPORT BEACH CA 92660 Phone: Bldg: 1 Plan Check No: 2095-2019 Code Edit: 2016 Contractor: O W N ER/B LDR Address: AUTH AGNT: GAMA MICHAEL Phone: 951-224-2129 Con State Lic: O/B Lic Expire: Bus Lic: Lic Exp Date: Architect: Address: Phone: Engineer: Address: Phone: POOI_Permit : S2019-0158 Project No: 2095-2019 Inspection Requests Phone (949)644-3255 State Lic: THOMPSON MATTHEW =__• 12021 N TUSTIN AVE ANAHEIM CA 92807 714.630-6100 State Lic:C-086051 Building Rear: Worker's Compensation Insurance Special Conditions: Setbacks: Front: Carrier: O/B AUTH ATTACHED Left: Policy No: Right: Expiration: Issued Date: 02/05/2020 Construction Type : _ FEES Construction Valuation: $25,000.00 Building Permit Fee : $418.00 Permit Issuing Fee: $0.00 Investigation Fee: $0.00 Building Green Fee: $1.00 Plan Dept Plan Check: $0.00 Building Dep Plan Check: $373.00 Building PC Investigation : $0.00 Plan check Ext. Fee : $0.00 WQ Compliance Insp Fee: $0.00 TOTAL FEE : $793.00 PROCESSED BY: ZONING APPROV Record Management: $12.00 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 : $362.00 PLAN CHECKED BY:: APPROVAL TO ISSUE PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Fee Due at Permit Issuance : $431.00 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) iection 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 r essions 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 Kore than five hundred dollars ($500). 12021 N TUSTIN AVE 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, s'ness 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 nproved 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 Contra tors' 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 w). I am exempt from licensure under the Contractors' State License Law for the following reason: Iy my signature below I acknowledge that, except fo my personal residence in which I must have resided for at least one year prior to completion of the rovements overed by this permit, I cannot Iegalh .II a stricture that have built as an owner -build if it has not been can truct s entirety by licensed contractors. I understand that a copy of the ap licable law, S ction 7044 of the Business and ratessihns Code, is available upon reque n this ap lion i b 'tte r ing Web site:http://www.leginfo.ca.gov/calaw.html. innature of PropJ, ly Owner or Authorized A nt .IC'cNBED CONTRACTOR'S DECL kFrA11ION hereby affirm uni^_r penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Se I 000) of Division 3 of the Busine and Professions Cc e, and my license is in full force nd effect. Licers= Class License No I Contractor i ature 1/ORKERS' C^P9PENSATION DECLARATION 'ARNING: FAILURE TO F=- URE 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 4d. JI COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. ha;eby affirm under penalty of perjury one of the following declarations: 7 I hi�ve 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 eroi dfvrice of the work for which this permit is issued. Policy No. and wil! rvintain 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: ler Policy Number Expiration Date _ 1e of Agent Phone # certify that, in th erlY \ nce of tf{� or which this permit is issued, I shall not employ any person in any manner so as to become subject to the if I shout ome subjec the vjl�/prkers' c pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Iatu re ofA lica hereby affirm under penalty of perjury that there`Ka construction lending agency for the performance of the work for which this permit is issued (Section 3097 Ender's Name Lender's Address ly 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 provide Is correct. I agree to comply with all applicable cit and count rdin c d state laws relating to building construction. I authorize representatives of this c to n r the v identified property for inspection purposes. licnahue of Prooertv Owner or Au rtz� /� Print ProDertv Owner's or Authod2etl ��A"m/e�nt's Name BY PERMIT EXPIRED PERMITCANCELLED PERMITEXTENDED POOL ALARMS INSTALLED OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE PART 61 OF TITLE 40 AND AQMD RULE 1403 I SUBMITTED ASBESTOS NOTIFICATION TO L-IASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION. compensation laws of California, and Civil Code). k r5 PERMIT FINAL ET o f w_ N, o- w w 7- c o w o o p 'o s •o �< 3 "s p .�. �'I' _� m o- m ° q 11 9' oo 3 7 3 7 _ fry 3 m 'S m c m 7 O N Do N 7 O� y, w 0 w °) N w (n n m M W , N K m K =. w 0' ' N W K w a $N 7 7- �°-. - w- } w - N- q 'O - '�0 co�-i O o o a o C O N o w '< Q fh F' N N w d T ry 0 S 6. O N m CD M= oC. �omN 3om�' —a^° 3N y �O, w A c��N��a-3o 0 Nl °- 01 `w< C m 0 N S w O• - N � ID 0 N C N m m Q w o < Q Q 7 °- (D 7 0. w N C C- '< N O. N °- m 3 a 00 Q i '< < N O_ Q O. 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