HomeMy WebLinkAboutS2021-0048 - Permitsxv City of NewportBeach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
A V Permit Counter Phone (949)644-3288
u:
Job Address: 724 ST JAMES PL Floor: Suite: Bldg: 1
Description of Work:SFR POOLISPA 600 SF W/YARD DRAINAGE
Inspector Area: 3
Legal Description: N TR 1218 LOT 20
SI� �II0 I1 ��Ill0 0 48� II
Plan Check No: 0368-2021
Code Edit: 2019
Owner:
HORIOKA LINDA
Contractor:
LA PAZ LANDSCAPE DEVELOP
Address:
724 ST JAMES PL
Address:
10 PORTLAND PL
NEWPORT BEACH, CA 92663
LAGUNA NIGUEL CA 92677
Phone:
Phone:
949-443-4200
Applicant: LOCKER JACK
Con State Lic:
937052
Address:
13 POINTE SUR
Lic Expire:
09/30/2022
LAGUNA BEACH CA 92677
Bus Lic:
BT30059605
Phone:
949310-8007
Lic Exp Date:
08/3112021
Building
Rear:
Worker's Compensation Insurance
Setbacks:
Front:
Carrier:
STATE COMP. INS
Left:
Policy No:
9210309
Right:
Expiration:
05111/2021
Construction Valuation: $85,000.00
Building Permit Fee :
$430.00
Permit Issuing Fee:
$0.00
Investigation Fee:
$0.00
Building Green Fee:
$4.00
Plan Dept Plan Check:
$0.00
Building Dep Plan Check:
$387.00
Building PC Investigation :
$0.00
Plan check Ext. Fee:
$0.00
WQ Compliance Insp Fee:
$0.00
FEE : $2,466.00
PROCESSED BY:
ZONING APPRO).
Architect
Address:
POOLPermit: S2021-0048
Project No : 0368-2021
Inspection Requests Phone (949)644-3255
Phone:
State Lic:
Engineer:
FREGOSO PABLO
Address:
1000 N COAST HWY #10
LAGUN BEACH CA 92651
Phone:
949-371-3690 State Lic:GE-002961
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Special Conditions:
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LANDSLIDE AREA
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Issued Date:
0410512021
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Record Management:
$32.00
Water Quality--
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Building Dept Inspection Fee:
$@IN. m .
Drainage Permit Fee:
$232.00
Water Quality Dept Insp Fee:
$i1.00
Drainage Plan Check:
$195.00
Building Dept WQ Plan Check:
$0.00
Grading Consultant Fee :
$1,176.00
Others
$0.00
Additional Fee :
$0.00
$0.00
Plan Check Fee : $542.00 Fee Due at Permit Issuance :
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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 applicablAiem(s)
rction 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
rfessions 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). 1000 N COAST HWY #10
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U 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
ily 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).
J I am exempt from licensure under the Contractors' State License Law for the following reason:
,y 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 coven
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
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
ignature of Property Owner or Authorized Agent D
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty o p ri that I1am f ensed under provisions qi ap[er 9 ommencing with Section 7000) f Ivi i n 3 of the B si ess and rofessi e;
nd effect. License Class b License No �l J C ��i t]�,}`a Conti or Sign lure
VORKERS' COMPENSATION DECLARA ION r )
ARNING: FAILURE TO S5E�CURE WORKERS' COMPENSATION
DST OF COMPErIIS•ATIDN,.PAMAGES AS PROVIDED FOR IN S
of the Business and
is in full force
($100,000(, IN ADDITION TO THE
hereby affirm uMOMpenalty of perjury one of the following declarations:
J'I•�ave and will.gajintain 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
)IJIfoilgrance of the work for which this permit is issued. Policy No.
e and wiu tr�njntain 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' compensatiol
ppp urasce carrier.%ndpolicy number are:
:arrin•0 Policy Number Expiration Date
llama of Agent • • ' Phone #
•:I MAify that, in the pe ce of the for this permit is issued, I shall not employ any person in any manner so as to become subject to the works s' compensation laws of California, and agree
hat:if r should bapo subject o t s' p tion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
i��tgg,n��a��turg of App ' ` D���
CLA�li4TIO CONSTRU ON LENDING AGENCY -
harbb j affirm r Ity of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3 7, Civi Code).
-ender's Name Lender's Address
3y my signature b I certify to each of the following:
I am the pro rty owner or authorized to act on the property owner's behalf. e,' 14Ar
e
I have read this application and the information I have provide cor I.
I agree to comply with all applicable city c u y o an s n t s relating to building construction.
I authorize representatives of this city o ty t a - ad property for inspection purposes.
'
Signature of Property Owner or Authorize A t Print Property Owner's or Authorized Agent's a a
ACTION DATE B D CLAR N OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY required ale atC ulre al rms,latches
REGULA NS PART61 OF TITLE 40ANDAQMD RULE ores & fences which se s & fences which serve
1403 as part Of a nnnI
PERMITEXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO barrier, shall be in plicLpairner. shall be in place
PERMITCANCELLED LIEPA prior to approval to fill prior to approval to fill
PERMITEXTENDED ftl
QMD pool/spa & shall remairf'¢V11spa & shall remain in
POOL ALARMS �^l / ASBESTOS NOTIFICATION IS NOT APPLICABLE TO place & be maintained i�hCe & be maintained for
INSTALLED 1 (1 n /� n Y ,/ PROPOSED DEMOLITION. -, C }h Dool/spa �i/l - o0
FINAL
roar- Pr^<.aI