HomeMy WebLinkAboutS2020-0098 - PermitsCity ofCentervic NewDport Beachort - Building oDivision I IIuIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIilllllllll II
' Permit Counter Phone (949)644-3288
.lob Address: 2814 LIGHTHOUSE LN Floor: Suite: Bldg: 1
Description of Work:IN-GROUND SPA W/ DRAINAGE 100 SF
Inspector Area: Plan Check No: 1254.2020
Code Edit: 2019
Legal Description: N TR 6385 LOT 3
Owner:
SAMEN EDWARD
Contractor:
OWNER/BLDR
Address:
2814 LIGHTHOUSE LN
Address:
SAMEN EDWARD
Plan Dept Plan Check:
CORONA DEL MAR CA 92625
Building Dep Plan Check:
SEE X2019-4108
Phone:
949.639.8263
Phone:
$0.00
Applicant:
SAMEN EDWARD
Con State Lic:
O/B
Address:
2814 LIGHTHOUSE LN
Lic Expire:
$0.00
Additional Fee :
CORONA DEL MAR CA 92625
Bus Lic:
$0.00
Phone:
949-639-8263
Lic Exp Date:
Building
Rear:
Worker's Compensation Insurance
Setbacks:
Front:
Carrier:
Lek:
Policy No:
Right:
Expiration:
Construction Type
Construction Valuation: $10,000.00
Building Permit Fee :
$430.00
Permit Issuing Fee:
$0.00
Investigation Fee:
$0.00
Building Green Fee:
$1.00
Plan Dept Plan Check:
$0.00
Building Dep Plan Check:
$387.00
Building PC Investigation :
$0.00
Plan check EM. Fee :
$0.00
WQ Compliance Insp Fee:
$0.00
TOTAL FEE : $1,257.00
PROCESSED BY:
ZONING APPRO\o
FEES
Architect
Address:
Phone
P001 -Permit: S2020-0098
Project No : 1254-2020
Inspection Requests Phone (949)644-3255
Engineer: LACHERTODD
Address: 1201 N TUSTIN AVE
ANAHEIM CA 92807
Phone: 714-630-6100
Special Conditions
Issued Date: 10105/2020
°
ee°moe
State Lic: °
moon °
°ee m o°oor�,
mm
® o
State Lic:C-067656
° moc 000° c
m ° c
mo � 00000
c
° 00000
0o m 000000
000 °
Record Management:
$12.00
Water Quality ---
Building Dept Inspection Fee:
$0.00
Drainage Permit Fee:
$232.00
Water Quality Dept Insp Fee:
$0.00
Drainage Plan Check:
$195.00
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 BY::
APPROVAL TO ISSUI
..PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Fee Due at Permit Issuance:
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)
lection 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). 1201 N TUSTIN AVE
7 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,
lusiness 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
roved for the purpose of sale).
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
ppl 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:
ly my signature below I acknowledge that, except foriny 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 legal
ell a structure that i have built as an owner -buil r if t has t been constructed i 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 whe s a a' his sub to the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
signature of Property Owner or Authorized Agent
- Date r'a Z�
.ICENSEV.QQPTRACTOR'S DECLARATI
hereby affirm under penalty of perjury that I am Ifeensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
rdkffect. L•iCEd9e Class License No Date Contractor Signature
YOi!)UPENSATION DECLARATION
IAAKING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO TH
GOT OF COMPEIISARWN , DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
^
yhle�reby affirlR.under penalty of perjury one of the following declarations:
J'Phava anti•,&illervaintain 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 tl
elfdii lance of the Mork for which this permit is issued. Policy No.
and wilt 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'
carrSeT agd policy number are:
• • Policy Number Expiration Date
Tcertify 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 become subject to the workers' ompensalion laws of California, and agree
iat, if I should become su ' ct to the ker ' compensation pr is ions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
signature of Applicant Da
IECLARATION REGAR ING dtINSTRUCTION LENDING AGENCY
hereby affirm under pe ally 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).
ender's Name Lender's Address
ly 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.
1 agree to comply with all applicable city and cour4y ordinances and slate laws relating to building construction.
I authorize representatives of this city or counentgf�fibove-identified y for inspection purposes. U�'�I, c `!� S
of Dr....va., n,.,,.ar ,.r A,dbvivaH Anont x �s i ,. Print Prooertv Owner's or Authorized Agent's Nam K " � J r�ir✓ `Rale � /�
PERMIT EXPIRED
PERMITCANCELLEI
PERMIT EXTENDED
POOL ALARMS
INSTALLED
DATE BY D15CLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGGl1 IONS PART 61 OF TITLE 40 AND AOMD RULE
NOTIFICATION TO jo; paule;ulew eq g e0elu
UI ulewei pegs g edsjlood
pI► 01 leAcudde O; jolid
MIS NOT APPLICABLE TO aoeld LH eq lleLls 'laweq
eds I IOod a jo lied se
glues LIDI IM s9ouaj. V S9Ie6
- 52 sagojel'swIele pajlnbei pV
CD Col .o a
pr
m 0 0 N CD r� (�D CD
CD
C .4 0" a OECD
("i O C 0 Ep,rL
CD
5 _
o
N O (D
eCD
C
Gd �
e
0
o o 0 - m
a o 9 c rn
G
0
CL U.
Cl
oo and CD
0 `CD n 0 u"N" 0 CD,
aaa �ro o as
� � A
0
m
w
00
0 w o ° 0 a
r
z
b
W
N
N
C�
x
1--1
C
z
i
rz
N
w
N
�
(D
ro .
zr
rn
o
00
(D
�
oz
rn
z
o
N
w
w
CD Col .o a
pr
m 0 0 N CD r� (�D CD
CD
C .4 0" a OECD
("i O C 0 Ep,rL
CD
5 _
o
N O (D
eCD
C
Gd �
e
0
o o 0 - m
a o 9 c rn
G
0
CL U.
Cl
oo and CD
0 `CD n 0 u"N" 0 CD,
aaa �ro o as
� � A
0
m
w
00
0 w o ° 0 a
r
z
b
W
N
N
C�
x
1--1
C
z
ai
O
3
3
I1;
d d v
a m
m
w o a
v —
°1 c D
T II 6
N y d
N lD 6
N O'
J O
m �d
n
� o
m u c
n v
J
d o
Q � m
d O 3
J d J
II N p
n
� 1
� 3
o m a
C N <O
d A <
o v 3
o d
J m u
o_
s ='
a m
O
n n
N W N
J J
� O
o
J v m
� n s
3 mO
O O
aL O 00
a z ,
c
u � n
N �
d
T O j
m w
d
J 0 S
v � m
n
CL c w
N O O
Q a
�; o• m
S C J
d d N
c 3
N J
-di 3 3
� � d
C Q
O_ M
3 vo
a
a
m
'g
'�� o
,2
• �`
c
d
FD
pp
a§y�O
ip 3°"",j� tJj
3
ry
j
O
1"w�
rj
Fo
S
5
is,
.a fS�i C
rt
M
p
M
09
d
J
,g.�D
a� IM,A
O
O
N
c
J
=
�.
i
P.
.3�46u�
N i� °$°Ca�1'S
S
O
S
O
D
n
o
I J 1� Y�
,��
J
0
N..
O
3
N
J
to
to
._
m
"' o Er" G
J
N
p
It
<
O
N
uroD
m
p
'oMIS,
_.
m
J
`1
m
^
m
(��...
.,.n
of
..
_.
J
p0
.in
=
W
ry
a
Q 9 d
M
J
J<
o
d
y,
In
o
m
o
<
J
N f1
n v
(p
d
SD
m
d d v
a m
m
w o a
v —
°1 c D
T II 6
N y d
N lD 6
N O'
J O
m �d
n
� o
m u c
n v
J
d o
Q � m
d O 3
J d J
II N p
n
� 1
� 3
o m a
C N <O
d A <
o v 3
o d
J m u
o_
s ='
a m
O
n n
N W N
J J
� O
o
J v m
� n s
3 mO
O O
aL O 00
a z ,
c
u � n
N �
d
T O j
m w
d
J 0 S
v � m
n
CL c w
N O O
Q a
�; o• m
S C J
d d N
c 3
N J
-di 3 3
� � d
C Q
O_ M
3 vo