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HomeMy WebLinkAboutS2016-0193 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II 100 Civic Center Drive, Newport Beach, CA 92660 '1 n Permit Counter Phone (949)644-3288 U Job Address: 10 SURFSPRAY BLUFF Floor: Suite: Description of Work: POOL & SPA W/DRAINAGE 520 SF Inspector Area: 6 Legal Description Owner: NEIL Address: 10 SURFSPRAY BLUFF NEWPORT COAST CA 92657 Phone: Applicant: GEOSCAPEITRACEY Address: 20372 HERMANA CIR LAKE FOREST CA 92630 Phone: Building Rear: Setbacks: Front: Left: Right: Construction Type : Bldg: 1 Plan Check No: 2855-2016 Code Edit: 2013 Contractor: GEOSCAPE LANDSCAPE CONSTR INC Address: 20372 HERMANA CIR Address: _ LAKE FOREST CA 92630 Construction Valuation: $60,000.00 Phone: 949.903-2766 Phone: Con State Lic: 632334 Engineer Lie Expire: 05/31/2017 Address: Bus Lic: BT30023383 $6.00 Lie Exp Date: 05/31/2017 Phone: Architect: POOLPermit : S2016-0193 Project No: 2855-2016 Inspection Requests Phone (949)644-3255 State Lie ZHANG YAO o 0 o m 15375 BARRANCA PKWY, H106 IRVINE CA 92618 0 0 949-788-0424 State Lic:C-074572 0 0 ° ° ° ° Worker's Compensation Insurance Special Conditions: o0 00 Carrier: STATE FUND Policy No: 9027912 00 ° 00 00 Expiration: 06/01/2017 Issued Date: 01/23/2017 m 0 om0000 0 0 o°eeo 000000 000000 PROCESSED BY: ZONINGAPPROVAL: kA / PLAN CHECKED BY:: `y tJi S V APPROVAL TO ISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION FEES _ n" I ° Construction Valuation: $60,000.00 ... ° o ° ° oocc 00 Building Permit Fee : $380.00 Record Management: $6.00 Water Quality - Permit Issuing Fee: $0.00 Building Dept Inspection Fee: $0.00 Investigation Fee: $0.00 Drainage Permit Fee : $293.00 Water Quality Dept Insp Fee: $0.00 Building Green Fee: $3.00 Drainage Plan Check: $0.00 Building Dept WQ Plan Check: $0.00 Plan Dept Plan Check: $0.00 Grading Consultant Fee: $448.40 Others Building Dep Plan Check: $338.00 $0.00 Building PC Investigation : $0.00 Additional Fee : $0.00 $0.00 Plan check EM. Fee : $0.00 WQ Compliance Insp Fee: $0.00 TOTAL FEE: $1,808.40 Plan Check Fee _ $1,808.40 Fee Due at Permit Issuance : $0.00 PROCESSED BY: ZONINGAPPROVAL: kA / PLAN CHECKED BY:: `y tJi S V 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). 15375 BARRANCA PKWY, H106 ❑ 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). ❑ I 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 legally 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.htmi. Signature of Property Owner or Authorized Agent - Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisiorls of Chapter 9 (commencing with Secti n 7000)g / of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License at Contractor Signature ...• WORKERS' 69WENSATION DECLARATION SOSRT *, FAILURE WO SEMRE GES AS COMPENSAIDED TION IN SECTION OGE IS UNLAWFUL, AND OF THE LABOR CODE, LL SUBTEAND ATTORNEY'S TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE I S. hereby. ffirm under penalty of perjury one of the following declarations: I Tiave and will meintain 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 IN perform Vince of fV.Oore for which this permit is issued. Policy No. I 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' compensatio irVUf fttg carriel and policy number are: • , Policy Number Expiration Date T))))))))ure gentPhone # .that,in the pe- formanoe 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' com ensation laws of California, and agrethaould bec �ri1e ub' to t or ' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. of App Dat DECLARATION RE R G C N RUCTIO L NDING AGENCY I hereby affirm under penalty 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). Lender's Name Lender's Address By 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 provided is correct. j I agree to comply with all applicable city and county o finances and state laws relating to building construction. l I/'ter I authorize representatives of this city or county to er e -identified property for inspection purposes. /J q� 1 �0 U /f / Signature of Property Owner or Authorized Agent Print Property Owners or Authorized Agent's Name 0� *�'•. 1, Y— 9 ACTION DATE BY DECLARATION M LIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY �---�� REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED El I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED OEPA PERMIT EXTENED QMD POOLALARMS ASBESTOS NOTIFICATION IS NOT APPLICABLE TO INSTALLED PROPOSED DEMOLITION, SIGNATURE: PERMIT FINAL c � '^ o v N s, o' 2 6 \a G � 2 ` Npp O C ''7:5^' N j 14 A -00 a yp m !q c 5 ( 9 v c m 6 x /y� ryry o� a (0 O 0 0. 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