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Home My WebLink AboutS2017-0079 - Permits (3)City of Newport Beach - Building Division 11111111111p1p1111111�1111111111p11111111p11111111(9) 100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 1 7 0 0 7 9 Permit Counter Phone (949)644-3288 Job Address: 15 SAN ANTONIO Floor: Suite: Bldg: 1 Description of Work:SFR - POOL & SPA 350 SF WIDRAINAGE Inspector Area: 4 Plan Check No: 0981-2017 Code Edit: 2016 Legal Description: N TR 15517 LOT 59 Owner: BARON JONATHAN Contractor: PREMIER POOLS ORANGE CTY Address: 15 SAN ANTONIO Address: 22 SAN RAPHAEL NEWPORT BEACH, CA 92660 DANA POINT CA 92629 Phone: Phone: 626-422-5426 Applicant: TOUFANI REZA Con State Lic: 798298 Address: 22 SAM RAPHAEL Lic Expire: 1213112017 DANA POINT CA 92629 Bus Lic: BT30066113 Phone: 949-532-6630 Lic Exp Date: 0813112017 Building Rear: Setbacks: Front: Left: Right: V-B Construction Valuation: $38,000.00 Building Permit Fee : $380.00 Permit Issuing Fee: $0.00 Investigation Fee: $0.00 Building Green Fee: $2.00 Plan Dept Plan Check: $37.50 Building Dep Plan Check: $338.00 Building PC Investigation : $0.00 Plan check Ext. Fee: $0.04 WQ Compliance Insp Fee: o TOTAL FEE : PROCESSED BY: ZONING APPROV Worker's Compensation Insurance Carrier: STATE COMP Policy No: 9168204 Expiration: 06/1912017 FEES Architect: Address: Phone POOLPermit : S2017-0079 Project No : 0981-2017 Inspection Requests Phone (949)644-3255 Engineer: LACHER TODD Address: 1201 N TUSTIN AVE ANAHEIM CA 92807 Phone: 714-630-6100 Special Conditions Issued Date: 06/0212017 � i + State Lic: " State Lic:C-067656 .. Record Management: $14.00 Water Quality- -- Building Dept Inspection Fee: $0.00 Drainage Permit Fee: $293.00 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: $376.50 PLAN ee Due at Permit Issuance : $689.00 BY:: ! 1-C� `` 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 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 resIUres the applicant for he 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 Irofessions 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 lot more than five hundred dollars ($500). 1201 N TUSTIN AVE 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, 3usiness 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 mprovements 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 mproved 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 Cade: The Contractors' State License Law does not Ipply 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). 7 1 am exempt from licensure under the Contractors' State License Law for the following reason: 3y 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 Iega11,, ;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 7044 of the Business and 'rofessions 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 _ICENSED CON I RACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0 o Division 3 of the Business adProfusievs Codet and license is in full force ,nd bhaat. Licel,sa Class License No Date Contractor Signatu $�J._ �,.. VORKERS' COMPENSATION DECLARATION 1ARMNC: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS I$100,0001, IN ADDITION TO THE :DST OF COMPENSI'T^N DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. he.-eby-affirm urd=, penalty of perjury one of the following declarations: �rYfia 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 erfq,Zn a of tte wore for which this permit is issued. Policy No. hzvlAnd 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' rant carrier and policy number are: �1 �1 . j-/ Policy Number % 1 Z b T Expiration Date or Agent _ Ul 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 agre that, if I should become subject to the workers' corppensation previsions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Cater" -)Signature of Applicam DECLARATION R CARDING CONSTRUCTION LENDING AGENCY �`/G� L I hereby affirm un er penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 97, Civil Code). Lender's Name Lender's Address By 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 I agree to comply with all applicable city and county ordinances and state laws relating to building construction. / , 1 authorize representatives of this city or coun to enter the = e fled property for inspection purposes. Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Na 7 D ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMITEXPIRED LJ I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED EPA PERMIT EXTENED nMn NOTIFICATION IS NOT APPLICABLE TO INSTALLED PROPOSED DEMOLITION. PERMIT FINAL V Z�� SIGNATURE: r�