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Home My WebLink AboutS2017-0025 - Permits6 ik�er City of Newport Beach - Building Division 111111111111111111111111111111111111111111111111111111111111 100 Civic Center Drive, Newport Beach, CA 92660 8 2 0 1 7 0 0 2 5 'y r� Permit Counter Phone (949)644-3288 C�4Ji44��a .. Job Address: 4501 PERHAM RD Floor: Description of Work:SFR POOL/SPA 840 SF Inspector Area: 5 Legal Description: N TR 3357 LOT 111 Owner: DELPONTE MICHELLE LIVING TRUST Address: 4501 PERHAM RD CORONA DEL MAR, CA 92625 Phone: 949-756-2525 Applicant: DEVORE LARRY Address: PO BOX 828 SAN JUAN CAPISTRANO CA 92693 Phone: 9494934374 Building Rear: Setbacks: Front: Left: Right: Construction Type : Suite: Bldg:1 Plan Check No: 0312.2017 Code Edit: 2016 Contractor: DE VORE POOLS & SPAS Address: 32908 AVE DEL ROSAL SAN JUAN CAPSTRNO CA 92693 Phone: 949493-4374 Con State Lic: 401549 Lic Expire: 04/30/2018 Bus Lic: BT97026761 Lic Exp Date: 11/30/2017 Worker's Compensation Insurance Carrier: STATE,COMP INS Policy No: 1222520 Expiration: 11/01/2017 Architect: Address: Phone: Engineer: Address: Phone: P001 -Permit: S2017-0025 Project No: 0312-2017 Inspection Requests Phone (949)644-3255 wed State Lic: , BIEDENBACH CHRISTOPHER 1201 N TUSTIN ANAHEIM CA 92807 714.630-6100 State Li¢C-074003K Special Conditions: Issued Date: 04/04/2017 PROCESSED BY: ZONING a aer a -a e. o a e ac o c . o amm PLAN CHECKED BY:: APPROVALTO PERMIT E50$iRF818Q bAYS`AF7;ETi IS'iJANCE OR LAST VALID INSPECTION q, �a� oa cw >• � use ss FEES Construction Valuation: $150,000.00 Building Permit Fee : $380.00 Record Management: $34.00 Water Quality- -- Permit Issuing Fee: $0.00 Building Dept Inspection Fee: $0.00 Investigation Fee: $0.00 Drainage permit Fee : $0.00 Water Quality Dept Insp Fee: $0.00 Building Green Fee: $6.00 Drainage Plan Check: $0.00 Building Dept WQ Plan Check: $0.00 Plan Dept Plan Check: $0.00 Grading Consultant Fee : $672.60 Others Building Dep an Check: $338.00 $0.00 Building PC Investigation : $399.00 Additional Fee : $0.00 $0.00 Plan check EM. Fee: $0.00 WQ Compliance Insp Fee: $0.00 TOTAL FEE : $1,829.60 Plan Check Fee: $1,299.20 Fee Due at Permit Issuance: $530.40 PROCESSED BY: ZONING a aer a -a e. o a e ac o c . o amm PLAN CHECKED BY:: APPROVALTO PERMIT E50$iRF818Q bAYS`AF7;ETi IS'iJANCE OR LAST VALID INSPECTION q, �a� oa cw >• � use ss 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). 1201 N TUSTIN I, 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, 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). ❑ 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. Signature of Property Owner or Authorized Agent Da e. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) f ivi of the Business and Pr,,QQf��s ' my license is in full force and effect. License Class License No Date Contractor Signatureys WORKERS' COMPENSATION DECLARATION �� WARNING: FAILURE TO SECURE 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 COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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 th( performance of the work for which this permit is issued. Policy No. 1 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' compensatior nsurance carrierlkllpolicy number aryl ,f a„r,.J,1nl,...,1,e. Exoiration Date ne of Agent ' vI I ""` certify that, in the performance of the 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 t, if I should become sub} act to ker compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Dat nature of Applicant �� CLARATION REG41RI51 G CONSTRUCTION LENDING AGENCY �reby 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). Ider's Name Lender's Address 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 ordinances and state laws relating to building construction. I authorize representatives of this city or county t% t the abro%� Id ntifia pro arty for inspection purposes. f nature of Pro ertv Owner or AuthorPrint Property Owners or Authorized Agent's Nam 1J t>A Date 7 ' , ACTION DATE BY k. DECLARA`rION OF CDMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE Y ° • • • ° 1403 PERMITEXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO • • • • m Y ' ° ° ° • e • ••• PERMIT CANCELLED EPA ••• • PERMITE)TENED UQMD POOL ALARMS OASBESTOS NOTIFICATION IS NOTAPPLICABLE �0 °Y INSTALLED PROPOSED DEMOLITION. ° ° ° • ° SIGNATURE: e e • • s LO C9 ao F La Z `° w m F Vo cq d 4 W m� Q z CL-ta9 W E Z A0o oco Q O Cil; I� A�0 �^ma': r�7 � rc U O U (J 0 O r OI VI Y J z I V ,.m Cl e W N Q. m N it z o n Q m M d.N N y 3 m m o d � L)i N V ° E m U v 1 � Q £ N � N m m to m ,E ii ¢ D C C A N G n 0 2> yCt 3 rn�aL � o¢ S J y Z 3 2 Q N 64: Sw QQii!! O m P. 12 9 Z m u r c O N m mr m m m g a N o m a n d.N N y 3 ° c c c> m E Z m N m y ° > L m U £ S o m OR C A N G n 0 2> yCt 3 rn�aL 3 a t m m a w m N o '. m rs: