HomeMy WebLinkAboutS2017-0171 - PermitsCity Newport Beach ghBuilding Div,!Ion
ovca hAssoII�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
_ Permit Counter Phone (949)644-3288
Job Address: 3621 SAUSALITO DR Floor: Suite: Bldg: 1
Description of Work:SFR SPA W/ REFLECTIVE POND 216 SF....
Inspector Area: 4
Legal Description: N TR 6229 LOT 6
Plan Check No: 2276.2017
Code Edit: 2016
Owner:
EDWARDS GARY
Contractor:
G D M LANDSCAPE
Address:
3621SAUSILITO
Address:
31878 DEL OBISPO, STE 118 9435
Plan Dept Plan Check:
NEWPORT BEACH, CA 92663.
Building Dep Plan Check:
SAN JUAN CAP CA 92675
Phone:
$0,00
Phone:
949-433-0057
Applicant: GRANT/GDM LANDSCAPE ':.
Con State Lie:
881282
Address:
31878 DEL OBISPO#1T-435
Lie Expire:
09/30/2019
SAN JUAN CAPISTRANO CA 92675
Bus Lie:
BT30048427
Phone:
949.433-0057.
Lie Exp Date:
09/30/2018
Building
Rear:
Worker's Compensation
Insurance
Setbacks:
Front:
Carrier:
WESCO INS
Left:
Policy No:
WWC3258893
Right:
Expiration:
03/21/2018
Construction Valuation: $35,000.00
.Building Permit Fee:
$380.00
Permit Issuing Fee:
$0.00
Investigation Fee:
$0.00
Building Green Fee:
$2.00
Plan Dept Plan Check:
$0.00
Building Dep Plan Check:
$338.00
Building PC Investigation :
$0,00
Plan check EM. Fee :.
$0.00
WQ Compliance Insp Fee:
$0.00.
TOTAL FEE : $726.00
Record Management:
Drainage Permit Fee
Drainage Plan Check:
Grading Consultant Fee
Additional Fee I
FEES
$6:00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee :
Architect
Address:
P001 -Permit: S2017-0171
Project No: 2276-2017
Inspection Requests Phone (949)644-3255
Phone: State Lie
Engineer:
LACHER TODD
Address:
1201. N TUSTIN AVE
Building Dept WQ Plan Check:
ANAHEIM CA 92807
Phone:
714.630-6100 State Lic:C-067656
Special Conditions
Issued Date: 02/16/2018
Water Quality- —
Building Dept. Inspection Feer
$0.00
Water Quality Dept Insp Fee:
$0.00
Building Dept WQ Plan Check:
$0.00
Others
$0.00
$0.00
$338.00 Fee Due at Permit issuance:
S38£
PROCESSED BY: �'� l.-
PLAN CHECKED BY::
ZONINGAPPROVAL:—
o < AePROVAL TO ISSUE:
e
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
6`
E C
E
G O
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 N 1.5 byTUSTa y applicant for a permit subjects the applicant to a civil penalty of
not more than five hundred dollars ($500). -
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do L) 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).
the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
E3 [,.as owner of the property, am exclusively contracting with licensed Contractors to construct
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 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.html. Date
Signature of Property Owner or Authorized Agent -
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) f Di isiContractor Sgnatur
ion 3 of the Business and Profe;sion 'Mrd my license is in full force
and effect. License Class License No Date 1U
ORKERS' COMPENSATION DECLARATION
WARNINF COMPENSATION,ILURE TO
OURE WORKERS'
PROVIDED FOR IN COMPENSATION COVER G IS UNLAWFUL, AND THE LABOR CODE, LL SU INTEREST, AND ATTORNEY'S TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($700,000), IN ADDITION TO THE
COST
DAM
I hereby affirm under penalty of perjury one of the following declarations:
I have 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 the
rmance of the work for which this permit is issued. Policy No.
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' compensatiol
1 s rance carrier and policy number are:
carrier Policy Number Expiration Date
to of Agent
certify that, in the p,
, if I should become
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 agree
rkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �n j(�ItQ
- Date_ SLI C
nature of Applicant
CLARATION REG BIN?I ZOCTION LENDING AGENCY
ireby affirm under penalty of peri that there is a construction lending agency forthe performance
er's Address of the work for which this permit is issued (Section 3097, Civil Code).
Ider's Name
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.
I agree to comply with all applicable city and county or 'na C and state laws relating to building construction.
I authorize representatives of this city or county to�itt r bo e -identified property for inspection purposes. / �-- LAP
n .:. * o... 4,, n,.,ner'e nr AI IthnrlJed Agent's Name .N/YJ1rJI , 1`-1
signature of Property Owner or Authorizea Agent ••••
ACTION DATE BY DECLA N OF COMPLIANCE WITH CODE OF FEDEI
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
ASBESTOS
POOL ALARMS ❑ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
INSTALLED ' PROPOSED DEMOLITION.
SIGNATURE: ”' •""
PERMIT FINAL •�. ��Y --•
FOR OFFICE USE ONLY
.•.,h3olo roo
•
Date l2 1b l$
\; Ck/&z
0
z
0
z
m
n
z
m
z
D
Cl)
v
rn
O
z
m
a
n
C/) O
m -o
r
m
ti ••
X
0
CD
CD
m
T
0
C
m
v
Q m
z
T 0
F 0
Lp
M r
-C
m
m
0
0
T
0
m
0
z Z
m 0
ro
z
Z
o p
M z
Z
Z
Q
0
W
n
0
x
Q
0
'D
N
O
D
(y .
A
0
0
m,
0
- -4..
O N
m
M. C
m
N
o qr
A
DD
Cm
N
N
W
m
c
;aO
rry
D D
z r
r
m
m_?
<
v
m
a
m
c
m�1Q
-r
m
(
o
6
m
tiipy,
S
r
yN
m
p
Pm
m
m
az
D
�
D
y
D
..
m
1
..
,m
z Z
3m
p
3mm�zxz3O
N
cm•=ioo
mam-1
gt
M
0 N
?
-ZI
CD)
m
N
z m'6
O
X
Ods
M
mz�
m
v
N G
m
C z
m
rnxn
Go
M
Z
r
GG)c
ymm_
O
mo
2
•
0..�
C:)otj m�
T
CD
O 0 )
Z
O
C ,
W
,
OD
0
_
N
W
v
O
Ol N
J
O
X
N....
O
.'P..
N
�
W
O
0
-n
O
_
C
O
W
N
.OP
W
v
0
W
W
X
W
?
o
W
O
0
-n
O
p
—
W
s.
IV
W
O
O'
N.
K
O
(NJl
W
O
0
N
A
rn
x
?
o
a
OD
w
CD
M
n
m
v
N
W
0
K
N
n
0
0
o
r-�O0�ovD Or -0
9
�
Ommo
n
z0Wom
-4xzm
n
°mm
10
m
momm
z
mac
-`
�
- -4..
O N
O_...3
M. C
N
o qr
A
DD
Cm
N
W
c
;aO
rry
D D
z r
<
v
D
mO
n
-r
m
(
o
S
r
m
�
cn
D
D
�
4>
Em
zm
3mm�zxz3O
N
cm•=ioo
mam-1
gt
O
0 N
=o
z m'6
O
Ods
M
mz�
m
N G
m
C z
m
rnxn
M
3
r
GG)c
ymm_
O
mo
C:)otj m�
T
N
O 0 )
O
C ,
W
N
OD
0
O
z
n
X
m
09
Dw
0
rn
O�
c,
Z ,
m
-n
m
r
O
D
a
O
z
m
i
N
m
n
m
m
z
CO)