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HomeMy WebLinkAbouts2019-0058 - Permitso City of Newport Beach - B160aiK ©ivi ien` - p11,1111 ,e ph1�1111111111111111111111111111111 Jill 100 Civic Center Drive, Newport Beach, CA:926f11111111 ' Permit Counter Phone (949)644-3288 i ° ` ° • ° • ° Y Y Y e. H 9 H H Job Address: 439 EL MODENA AVE Floor: Suite: Bldg: 1 Description of Work:SFR POOUSPA 240 SF Inspector Area: 2 - - Plan Check No: Code Edit: Legal Description: FIRST ADD TO NEWPORT HEIGHTS BLK 26 LOT.15 Owner: COX BRYAN. Contractor: RYAN BURRESS INC Address: 439 EL MODENA AV Address: 246 CATALINA DR NEWPORT BEACH CA 92663 NEWPORT BEACH CA 92660 Phone: Phone: 714-975-1434 Applicant: BURRESS RYAN Con State Lie: 946479 Address: PO BOX 7326 Lie Expire: 12/31/2020 NEWPORT BEACH CA 92658 Bus Lie: ST30053605 Phone: 714-975-1434 Lie Exp Date: 01/31/2020 Building Rear Worker's Compensation Insurance Setbacks: Front: Carrier: STATE COMP. INS Left: Policy No: 9207309 Right: Expiration: 03/24/2020 instruction Type : V-B Construction Valuation: $30,000.00 Building Permit Fee : $405.00 Permit Issuing Fee: $0.00. Investigation Fee: $0.00 Building Green Fee: $2.00 Plan Dept Plan Check: $0.00 Building Dep Plan Check: $361.00 Building PC Investigation :. $0.00 Plan check Ext. Fee : $0.00 WO Compliance Insp Fee: $0.00 TOTAL FEE : $1,066.00 PROCESSED BY: ZONING APPROVAL: Record Management Drainage Permit Fee :.. Drainage Plan Check: Grading Consultant Fee Additional Fee: FEES $4.00 $0.00 $0.00 $0.00 $294.00 Plan Check Fee 0717-2019 2016 Architect: Address: POOLPermit : S2019-0058 Project No : 0717-2019 Inspection Requests Phone.(949)644-3255 Phone: State Lie: Engineer: LACHERTODD Address: 1201 N TUSTIN AVE ANAHEIM CA 92807 Phone: 714-630-6100 State Lic:C-067656 Special Conditions: Issued Date:' Water Quality Building Dept Inspection Fee: Water Quality Dept Insp Fee:. Building Dept WQ Plan Check: Others: Fee PLAN CHECKED BYV APPROVALTOISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION at Permit Issuance : $0.00 $0.00 $0.00 $0.00 $0.00 ea OWNER -BUILDER DECLARATION :. i .. • I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the raason�,J mdlCa!db, IbMaV-th% t4eckmark(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, irrSprove, dmo elish, 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 Sectiorl 7031.5 by any 4ppliirant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). • • • s • 14204 t*TL#STIN AV€ ' • • s . + • ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or (.Lportiens of the%orl, rtd th$st4uciurle is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of propertyV09, tolwgh a yeas' 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 improved for the purpose of sale). ❑ 1, 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 legall, 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://w .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 700) of Division of the Business and Professi0 license is in full force and effect. License Class License No Dat Contractor Signat o `t 1 �f \ I I /\ WORKERS' COMPENSATION DECLARATION U� WARNING: 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 COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I 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 eI ormance of the work for which this permit is issued. Policy No. JI have 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 i rance carrier and policy number are: .arrier Policy Number Expiration Date lame of Agent Phone # ]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 become subject to the workers' compensation laws of California, and agm rat, if I should become su ' t e,Iwof( pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignature of Applica t 1\ Dat 2_'- iECLARATION RE CT ENDING AGENCY hereby affirm under penalty of perjury that th re is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, LAI Code). Ender's Name Lender's Address y 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 ordinan n laws relating to building construction. I authorize representatives of this city or coygnty to abov -I le 'fi y for inspection purposes. jtl O u _2 G lirnature of Prmoerly Owner or Authorized ADS t t V Print Proaertv Owner's or Authorized Agent's NaMEN 1 C- (�L✓� Ur�S Date ACTION DATE BY OWd RATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY IL - REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED 0 I SUBMITTED ASBESTOS NOTIFICATION TO A;! required alarms,latches gales & fences which serve as part of a pool / spa PERMITCANCELLED OEPA EIAQMD PERMIT EXTENDED barrier, s in place POOL ALARMS ASBESTOS NOTIFICATION IS NOT APPLICABLE TO prior approv I t0 fill INSTALLED ' / (J PROPOSED DEMOLITION. pOovs remain in & S SIGNATURE: place& ma dfOr _. PERMIT FINAL