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Home My WebLink AboutS2019-0006 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II ' 100 Civic Center Drive, Newport Beach, CA 92660_ 8 2 0 1 9 0 0 0 6 Permit Counter Phone (949)644-3288 .lab Address: 2021 SANTIAGO DR Floor: Suite: Bldg: 1 Setbacks: Front: Carrier: BENCHMARK INS CO Description of Work:SFR REMODEL (E) POOL, ADD SPA 462 SF Policy No: CST5014680. Right: Inspector Area:3 -. Plan Check No: 0108-2019 - - Building Dept Inspection Fee: Code Edit: 2016 Legal Description: N TR 3801 LOT 23 $0.00 - $0.00 Owner: KHOO JOURDAN Contractor: AMPLE CONSTRUCTION Architect: Address: 33021 SEAWATCH Address: 3857 BURCH ST#333 Address: DANA POINT CA 92629 NEWPORT BEACH, CA 92660 $0.00 Phone: Phone: 714.464.4305 Phone: Applicant: ISAAC/AMPLE CONSTRUCTION Con State Lie: 957060 Engineer: Address: 3857 BIRCH ST Lie Expire:. 01/31/2019 Address: NEWPORT BEACH, CA 92660 Bus Lie: BT30057810 $294.00 Phone: 714-454-4305 Lie Exp Date: 11/30/2019 - Phone: Building Rear: Worker's Compensation Insurance Setbacks: Front: Carrier: BENCHMARK INS CO Left: Policy No: CST5014680. Right: Expiration: 12/15/2019 Construction Tvoe `. $0.00 FEES Construction Valuation: $20,000.00 POOLPermit : S2019-0006 Project No : 0108-2019 Inspection Requests Phone (949)644-3255 State Lie THOMPSON MATTHEW 12021 N TUSTIN AVE ANAHEIM CA 92807 714-630.6100 State LiaC-086051 Special Conditions: DRAINAGE X2017-1866 Issued Date: 01/28/2019 Building Permit Feer. $367.00 Record Management: $8.00 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: $1.00 Drainage Plan Check: $0.00 Building Dept WQ Plan Check: $0.00 Plan Dept Plan Check: $0.00 Grading Consultant. Fee: $0.00 Others Building Dep Plan Check: $319.29 $0.00 Building PC Investigation : $0.00 Additional Fee:. $294.00 $0.00 Plan check Ext. Fee : $0.00 WQ Compliance Insp Fee: .:$0.00 _ TOTAL FEE: $989.29 Plan Check Fee: $613.29 Fee Due at Permit Issuance ; $376.00 PROCESSED BY: - " • • • ®• • f • .., .4AN CHECKED BY:: ZONINGAPPROVAL: - �� `.�6m ,`„ a EAf�PROVAL TO ISSUE +� - PERMIT EXPIRES 1901,13AY9 AFTl ISS UANEE GR LAST VALID INSPECTION o® coc `ac e� E v c ccs ou` I '. 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 is 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 'rofessions 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 of more than five hundred dollars ($500). 12021 N TUSTIN AVE I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044, Wsiness 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 nprovements 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 n 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 pply to an owner of property who builds or improves thereon, and who contracts for the projects wither licensed Contractor pursuant to the Contractors'. State License Law). I am exempt from licensure under the Contractors' State License Law for the following reason: ly my signature below 1 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 legall, ell 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 'rofessions 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 .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 0 f 'vi ' of the Business and P of dons d my license' 'n full force nd effect. License Class License No Dat Contractor Signatu� VORKERS' COMPENSATION DECLARATION 'ARNING: 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 OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 1 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 erfo;mance of the work for which this permit is issued. Policy No. have and willCtain 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' rance carrier artd I) icy number are: Date of Agent I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to became subject to the workers' compensation laws of California, and agre I, if I should become su ject to t w rkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions./�� mature of Applicant Dat CLARATION REGARDyffCONSTRUCTION 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�to/�nter t�j�ahheeGGe-identified property for inspection purposes. , / �SQ�G/1/'9/'7pl�r�r, .nature of Prooertv Owner or Authorized ADent �1[ a1//�i�R�� _—Print Property Owner's or Authorized Agent's Name X ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 11armS latches PERMITEXPIRED U I SUBMITTED ASBESTOS NOTIFILATIOW• • • • • • ::e5 r. • I@S which Serve • • s • �• � �i q pool/ spa • ,nab be in place ` ` " PERM/TCANCELLED OEPA • • • • • • PERMITEXTENDED QMD • • ^proval to fill ;hall remain in POOL ALARMS / S ASBESTOS NOTIFICATION IS NOT APPLICABLE TO INSTALLED PROPOSED DEMOLITION. ..... ., �. •;• naintainedfor SIGNATURE: • " '.• ••. • • th ai In OI/S PERMITFINAL /S' + • ••