HomeMy WebLinkAboutS2020-0020 - PermitsCity of Newport Beach - Building Division II�IIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIII II
7r 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
la��itt3lr�'Y:
Job Address: 201 SANTA ANA AVE Floor:
Description of Work:SFR POOL REMODEL 260 SF
Inspector Area: 2
Legal Description: TR 444 LOT 50 POR ABAND ST
Owner: VONBEGENBERG SHIRLEY
Address: 201 SANTA ANA AVE
NEWPORT BEACH, CA 92663
Phone:
Applicant: JET AQUATICS
Address: 7056 ARCHIBALD STE #102.406
CORONA, CA 92880
Phone: 714-730-1610
Building Rear:
Setbacks: Front:
Left:
Right:
Construction Tvoe :
Construction Valuation: $30,000.00
Building Permit Fee : $542.00
Permit Issuing Fee:
$0.00
Investigation Fee:
$0.00
Building Green Fee:
$2.00
Plan Dept Plan Check:
$0.00
Building Dep Plan Check:
$471.54
Building PC Investigation :
$0.00
Plan check Ext. Fee:
$0.00
WQ Compliance Insp Fee:
$0.00
PROCE£
ZONING
TOTAL FEE : $1,021.54
Suite: Bldg:1
Plan Check No: 0252-2020
Code Edit: 2019
P001 -Permit: S2020-0020
Project No: 0252-2020
Inspection Requests Phone (949)644-3255
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Contractor:
JETAQUATICS
Architect:
Address:
7056 ARCHIBALD STE #102-406 Address:
CORONA, CA 92880
Phone:
714-730-1610
Phone:
State Lie: ....
Con State Lie:
931718
Engineer: LACHERTODD®
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Lie Expire:
04130/2021
Address: 1201 N TUSTIN AVE
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Bus Lie:
BT30070902
ANAHEIM CA 92807
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Lie Exp Date:
02128/2021
Phone: 714-630-6100
State Lic:C-067656
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Worker's Compensation Insurance
Special Conditions:
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Carrier:
STATE COMP
0860
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Policy No:
9206577
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Expiration:
03115/2020
Issued Date: 02/0412020
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FEES
.00000
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Record Management:
$6.00
Water Quality- --
Building Dept Inspection Fee:
$0.00
Drainage Permit Fee :
$0.00
Water Quality Dept Insp Fee:
$0.00
Drainage Plan Check:
$0.00
Building Dept WQ Plan Check:
$0.00
Grading Consultant Fee :
$0.00
Others
$0.00
Additional Fee:
$0.00
$0.00
Plan Check Fee :
PLAN CHECKED
APPROVALTOI:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Fee Due at Permit Issuance : $1,021.54
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)
!ction 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
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
ifessions 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
more than five hundred dollars ($500). 1201 N TUSTIN AVE
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,
siness 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
)rovements 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
)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
fly 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:
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 Iegall,
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
fessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
nature of Prop
.,V tj Owner or Authorized Agent Date
TENSED 0(2VJ1;h4CTOR'S DECLARATION
;rebg affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 of ivi ion 3 of the Business and Professi s Code, and license is in full force
I*e%ct. Ligenset2ass License No Date 2 4 Z o Contractor Signature
)RKERS' CbMPENSATION DECLARATION
Hirild: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE RUNORE THOUSAND DOLLARS )8700,008), IN ADDITION TO THE
;T OF
IT OF COMPENSATIbd,pAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE U160R CODE, INTEREST, AND ATTORNEY'S FEES.
,reby affirm under -penalty of perjury one of the following declarations:
,I,have and*wiil 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
�,Q,ratnce of the Mfk for which this permit is issued. Policy No.
leave 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' compensatioi
hwle carriQr'and policy number are:
rieG: SIV 4 r— c. Policy Number Expiration Date
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certify that, in the parlor nca 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' compensation laws of California, and agre
I, if I should become sub ct to the workers' cora rovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant Dat _ Z/3 /170CLARATION REGAR NG CONSTRUCTION LENDING AGENCY
veby affirm under pe Ity of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 30 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 rirdinances and state laws relating to building construction.
I authorize representatives of this city or county to ter the above -id ' ' d property for inspection purposes. �3�2d
nature of Propertv Owner or Authorized Aoent 7. Print ProDertv Owner's or Authorized Agent's Name � Dat
DATE BY DECLARATION OF COMPLIANCE WITH CODE OF I/I REGULATIONS ONS PART 61 OF TITLE 40 AN AQMD RULE FEDERAL FOR OFFICE USE ONLY
PERMIT EXPIRED
I SUBMITTED ASBESTOS NOTIFICATION TO
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PERMITCANCELLED
UEPA
PERMITEXTENDED
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POOLALARMS
INSTALLED
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AS NO/�IFICATION IS NOT APPLICABLE TO3
PROPOSED DE OLITION.
SIGNATURE:
PERMIT FINAL