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Home My WebLink AboutX2017-3380 - Permits6ci' 100 r�. Per v Inst Q„n„*/ Col Job Address: 19 VISTA Description: RETAINIP Legal Desc.: N TR 140' Owner: VAKILI Address: 19 VISTA Phone: Applicant: GEOS Address: 20372 LAKE Phone: Code Edit: Type of Construction: Occupancy Group: Added /New sq.ft. Bldg: ?' Added /New sq. ft. Garage:.- No of Stories: 0 No of Units : 0 Bldg Height: 0 Bldg Sprinklers: Drive, Newport Beach, CA 92660 BLDG Z-0 If applicable: ❑ 80% or ❑ 100% COMB Permit: X2017-3380 No : 2355-2017 Issuedate "'1111512017 In pact on Area : 6 •6:00 p.n1. No work on L W/(4) 18' CAISSONS (INSIDE P/L) 2 EXPIREDNSTR INC Architect: Address: 20372 HERMANA CIR Address: r, CA 92657 LAKE FOREST CA 92630 Phone: X6949-903.2766 Phone: Nf CA CIR nLc $ ¢153V2019 El is 1.3NEab 18 PI 192630 B��y �L�ip BT30023383 I (work StafSW)Date: 05/31/2018 (no workF!Murted 749-788-0424 Worker's Compensation Insurance Designer: _ Note: Carrier: STATE FUND Address: Building Permit Fee: $386.00 Plan Check Fee: $342.50 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $0.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $767.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Qarn+=t __InSIPQeinitiais: Front: / Left: / Right: / 0 Fire Excise Tax: $0.00 Planning Department - Fire Inspection: Additional Fee: $0.00 Plan check Fee: Demolition Fee Grading Bonds Fee: $0.00 Fair Share : General Service Grading PC Consultant : $0.00 SJH Trans: Grading Bond: Grading Permit Fee: $0.00 In -lieu Housing Fee Grading PC Fee: $0.00 Public Works Department - WQ Insp. Fee: $0.00 Park Dedication : $0.00 PAN Plan Check: $0.00 Electrical %: $0.00 San Dist: $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 Plumbing %: $0.00 Holidays omemmm 0 m m comomm e o 000000 m o e oomemo m (` me0000 o > 000mco 0 0 0 0 0 moo 0 0 o e000 eoo $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Plan Check Fee : $342.50 Fee Due at Permit Issuance $424.50 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: Fire Department $0.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: Holidays omemmm 0 m m comomm e o 000000 m o e oomemo m (` me0000 o > 000mco 0 0 0 0 0 moo 0 0 o e000 eoo $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Plan Check Fee : $342.50 Fee Due at Permit Issuance $424.50 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION - .. V( 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). ❑ 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 thestructureis 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 im 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 '..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.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 provisions of Chapter 9 (commencing with Section 70 grof Division 3 of the Business and Profe�s E license is in full force and effect. License Class License No Date (115 Contractor Signature ORKERS' COMPENSATION DECLARATION ARMING: FAILURE i0 SgaRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SMALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE VOST OFC OMPENSATION, RAMAGES AS PROVIDED FOR IN SECTION 5706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. CITeralliaffirm urgder�mnalty of perjury one of the following declarations: I® I have and will mdlntain 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 5nce of the work for which this permit is issued. Policy No. ave and All"aistain 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 �i in reslce carrier and policy number are: - 'Oerrier V: Policy Number Expiration Date c€rjify that, ip the gerform�niice 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 st, if I'shouldtbe~eme subj€ct tto the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. .... giatareofA�p�caaG ��'_......^.,........,.'..,.., Date /��/T7 :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 rdinances and state laws relating to building construction. I authorize representatives of this city or county ente abo - 'fied property for inspection purposes. nsn,ro of Prnn.,n, n,.iner nr A,4Mnri7=rl Anon1 Print Pmnertv Owner's or Authorized Agent's Name S7LCVen N�_ DATE BY DECLARATION OF II RE ULATIONS PART 61 OF COMPLIAIITLE 40 AND QMD RULE CE WITH CODE OF AL FOR OFFICE USE ONLY PERMITEXPIRED /o-z-W�0I L. p_yY I L- II SUBMITIED.ASBESTOS PERMIT CANCELLED EPA PERMITFINAL L -I ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATEOF PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: J-1 rhe I I A 5