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Home My WebLink AboutS2019-0069 - Permitsrw, City of Newport Beach'- Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIII�II�IIIIIIIIIIIIII II P001 -Permit: S2019-0069 $104.00. ' 11,100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 1 9 0 0 6 9 $0.00 Project No: 0837-2019 $90.48 a Permit Counter Phone (949)644-3288 - Plan check. Ext. Fee: $0.00 WQ Compliance Insp Fee: $0.00 TOTAL FEE: $595.AC\ ' oom000 Inspection Requests Phone (949)644.3255 $do®.°° Job Address: 1130 DOLPHIN TER Floor Suite: Bldg: 1 Description of Work:SFR INSTIL DROWNING PREVENTION DOOR ALARMS & SONAR, REPLACE POOOL LIGHITNG Inspector Area: 2 Plan Check No: 0837-2019 ?� �'� #'� Code Edit: 2016 Legal Description: N TR 1700 LOT 91 Owner MATTHEW VBA ALCONE Contractor: OWNER/BLDR Architect: Address: 122 MONTE CARLO DR ' Address: AUTH AGNT: NEAL CODY Address: LAGUNA BEACH, CA 92651 - Phone: Phone: Phone: State Lia Applicant: MATTHEW VBA ALCONE Con State Lie: OIB Engineer. Address: 122 MONTE CARLO DR Lie Expire: Address: LAGUNA BEACH, CA 92651 Bus Lia Phone: 949-300-1717 Lie Exp Date: Phone:. .State Lie: doom Building Rear: Worker's Compensation Insurance Special Conditions: 0000 - 000 owo Setbacks: Front: Carrier: O1B AUTH ATTACHED, 119-0631 .... °°° d '° .Left: Policy Na _ Right: Expiration: Issued Date: 0 411 212 01 9 Construction Tvoe: Construction Valuation: $1,000.00 Building Permit Fee: $104.00 Permit Issuing Fee: - - $0.00. Investigation Fee: $104.00. 'Building Green Fee: $1.00 Plan Dept Plan Check: $0.00 Building Dep Plan Check: $90.48 Building PC Investigation : $0.00 Plan check. Ext. Fee: $0.00 WQ Compliance Insp Fee: $0.00 TOTAL FEE: $595.AC\ - PROCESSED BY: ZONING APPRO% 0 Record Management Drainage Permit Fee : Drainage Plan Check: - Grading Consultant Fee Additional Fee: FEES cfo b $2.00 Water Quality- --. Building Dept Inspection Fee: $0.00 Water Quality Dept Insp Fee: $0.00 " Building Dept WQ Plan Check: $0.00 Others $294.00 000000 Plan Check Fee : $0.00 PLAN. CHECKED BY:: APPROVAL TO ISSUI PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION $0.66 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $595.48 cfo b '°0000 0 000000 000000 c o ° ' oom000 $do®.°° $0.66 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $595.48 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the resson(s) indicated below by the checkmark(s) I have placed next to the app l 'able itE97(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). I, as owner of the property, or my employees with wages as their sole compensation, will do U 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 im 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 Kto 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). am exempt from licensure under the Contractors' State License Law for the following reason: y 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 improvement�vere l by this permit, I cannot legal 9@II a structure that I have built as an owner -builder if it ha of been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law,-Sectlon 7044 of the Business and Professions Code, is available upon at when this load is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Signature of -Property Owner or A orized gent i Dee LICENSED CONTRACTOR'S CL RA [ON -- 'L hereby affirm under penalty of perjury t at —]am licensed Ander provisions of Chapter 9 (commencing wi h �6n 7000) of Division 3 o e Business and Profess ode, and my license is in full force and effect. License Class License No ctor Signature )RKERS' COMPENSATION DECLARATION lJ 3NING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO tRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE 3T OF COMPENgR'AdN IIAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. areby affirm urMf penalty of perjury one of the following declarations: I*have and wilMaintain 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 forWance of lhe'woort for which this permit is issued. Policy No. �Itave and will mairlain 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 Jraace carriare d policy number are: Tiei- Policy Number Expiration Date that, in file performance 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' efnpensation laws of California, and ould become„ SUbj nsation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. X , f I-7 .� ® fe�l DECLARATION REGARDING GeINSTRUCTION LEIMTNG AGENCY v lie-reby affirm undespenalty of perjury that 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 owners behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. - I authorize representatives of this cityrcounty toe t d -property for inspection purposes. Signature of Property ' Owner or Autho z Agent Print Property Owner's or Auth e. te /eq 1 ACTION DAT DEC TION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE SE ONLY REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE 1403 PERMIT EXPIRED I SUaNI TTED ASBESTOS NOTIFICATION TO PERMITCANCELLED DEPA (j If'Y►S (''ts��/r✓/LIy PERMITEXTENDED LIAQMD POOLALARMS ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CPO SIGNATURE: �^ U INSTALLED PROPOSED DEMOLITION. �j r f ) S/[A//I . 1 SIGNATURE: �C/ ^/O C OFFOAIT FINAI I %A