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HomeMy WebLinkAboutS2020-0009 - PermitsCity of Newport Beach - Building Division 111111III11111p11111111111111111p111p111p11111111 100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 2 0 0 0 0 9 Permit Counter Phone (949)644-3288 Job Address: 330 SANTA ANA AVE Floor: F�BLKTIFU&I-S' Bldg: 1 Description of Work:SFR POOL & SPA 300 SF / / / r��_ Date: / // _ Inspector Area: 2 � Plan Check No: 0121-2020 Code Edit 2019 Legal Description: FIRST ADD TO NEWPORT HEIGHTig - Owner: EDMONDS ERIC & KENDRA Contractor OUTDOOR CONCEPTS Architect Address: 330 SANTA ANA AVE " 24*11 RDWN VALLEY PKWY, F293 Address. NEWPORT BEACH, CA 92663 LAGUNA NIGUEL CA 92677 Phone: Phone: 949-363-7932 Phone: POOLPermit : S2020-0009 Project No: 0121-2020 Inspection Requests Phone (949)644-3255 5i%tL C _. O s,,vhQril: State Lie: to cox-'R+ Engineer: LACHER TODD Applicant: GABRIEL III LOUTS Lie31378 Address 28241 CROWN VALLEY PKWY STE F293 LAGUNA NIGUEL CA 92677 NC 1(e � 4P 282020 Ti30060506 -; " Address: 1201 N TUSTIN AVE ANAHEIM CA 92807 Phone: 949-295-4417 Lic Exp'Date: _ 09/330/2020 Phone: 714-630-6100 Building Rear: Setbacks: Front: Left: Right: Construction Construction Valuation: $40,000.00 Workers Compensation Insurance me . E RK It,NyS E j� (work si2,-&)"' FEES Note: Building Permit Fee : $418.00 Rae d Management Permit Issuing Fee: $0.00 Investigation Fee: $0.00 Drainage ermi ee�: Building Green Fee: $2.00 Drainage Plan Check: Plan Dept Plan Check: $0.00 Grading Consultant Fee Building Dep Plan Check: $373.00 Building PC Investigation : $0.00 Additional Fee Plan check Ext. Fee : $0.00 WQ Compliance Insp Fee: $0.00 TOTAL FEE: $786.00 PROCESSED BY: I ZONINGAPPROVAL: $0.00 $0.00 $0.00 Plan Check Fee 11 Special Conditions: IssUete: v 06 2 ii SP. I State Lic:C-067656 Building Dept WQ Plan Check: $0.00 Others $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $786.00 PLAN CHECKED BY:: APPROVALTO PERMIT EXPIRE 100 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION E5 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) 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 ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) 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 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). ❑ tF I' rthc f`nnfr�rrnrc' c�ie 1 ica . reason: am exemp rom (censure uq�r in whi I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legallt -Jdge that, except for my per%Vb&n, By my signature below I acknowIthorized sell a structure that I have built an owner -builder if it has nod' i s nti licensed contractors. I understand that a copy of the applicable Iaw,:Section 7044 of the Business and Professions Code, is available un req r) this a plicae o at t ollowin Web_site:http://www.le6infR.ca.gov/calaw.htmi. Signature of Property Owner or Agent Date LICENSED CONTRACTOR' I hereby affirm under penalty of p DECLARATION r _;,- �R D/o refund rjury used Pprovislons of Chagterco�mmSection 700 Meo' 3'ofifie Business and Pro s ' n'ts ode, nd e i or and effect. License Class License No i �D'a—� Contractor Signatur WORKERS' COMPENSATIO DE' ARAT • N y: ;, (J whom: ✓DARNING: FAILURE TO SECURE WORK OVERAGEG NLAwFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOU No DOLLARS ($100,000(, IN ADDITION TO THE S' CO ar1N COST OF COMPENSATION, DAMAGES A ROVIDED FOCTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 1 hereby affirm under penalty of p jury 1owing, eclarationS - ❑ I have and will maintain a c ifica o t to sure for workers' compensation, issued by the Director of Industrial Relations as provided for by S ction 3700 of the Labor Code, for the mance of the work for which his p"ml 's ,, d. PNo I Lfy ve and will maintain works co -: nsuras required by' Sectlon'3700 of the Labor -Code, "for the performance of the work for which this perm' is issued. My workers' compensation ins nce arri rand olicc numb are: Carrier �� G Policy Number Expiration Date Name of Agent - P a Phoile # 'm C. .� f, _ g ��1Io ❑I certify that, in the performance f th k or ,h'Ib4 I rr��nnit 171ss e4. !shall employ any rson a a o u Svwo ers' co ensation laws of California, and agre "ovisins5eti'3`/ that, if I should become subje h of the Labor sha ort wl comp y with [hose ovisions. a Signature of Applicant 1" �' no work started) at DECLARATION REGA I OLh=:::: TION L DING AGENCY I hereby affirm under penalt of pethere is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil C s). Lender's Name Lender's Address By my signature below, I certify tofollowing: I am the property owner or autperty owner's behalf. _ Insp. initials: I have read this application anr VI a Is correc .1 agree to comply with all appl I authorize representatives of this city or county to t r the bov Identifi pro erty for inspection purposes. Signature of Property Owner or Authorized Agent Int Property Owner's or Authorized Agent's Name Date LA ACTION DATE BY ECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 -squired alarms,atches PERMITEXPIRED I SUBMITTED ASBESTOS NOTIFICATION'.O ;',�S Sfencesw sitH VW L art of a pool I spa t PERMITCANCELLED LIEPA wirier, Shall be in place PERMIT EXTENDED QMD r;r io approval to fill ..„1 , g shall remain in POOLALARMS ASBESTOS NOTIFICATION IS NOT APPLICABLE TO INSTALLED PROPOSED DEMOLITION. , - iP^n ^„ be maintained for SIGNATURE: " fry ,Of the pool/spa _ _ _ _ � � _ _ PERMIT FINAL_