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HomeMy WebLinkAboutS2021-0186 - Permitshr ry� City of Newport Beach - Building Division 111p1III 11111p11111p11111111111p11111p11111111111 ` 100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 2 1 0 1 8 6 w Permit Counter Phone (949)644-3288 �"liF illiNt� Job Address: 707 ST JAMES RD Floor: Description of Work:SFR POOL/SPA 450 SF Inspector Area: 3 Legal Description: N TER 1213 LOT 11 Owner: IRWIN ROBERT/JANELLE Address: 707 SAINT JAMES RD NEWPORT BEACH, CA 92663 Phone: Applicant: GABRIEL LOUIS Address: 28241 CROWN VALLEY F-293 LAGUNA NIGUEL CA 92677 Phone: 949-295-4471 Building Rear: Setbacks: Front: Left: Right: Construction Tvoe : VB Construction Valuation: $60,000.00 Building Permit Fee : $440.00 Permit Issuing Fee: $0.00 Investigation Fee: $0.00 Building Green Fee: $3.00 Plan Dept Plan Check: $0.00 Building Dep Plan Check: $396.00 Building PC Investigation : $0.00 Plan check Ext. Fee : $0.00 WQ Compliance Insp Fee: $0.00 TOTAL FEE: $851.00 Suite: Bldg:1 Plan Check No: 1874-2021 Code Edit: 2019 Contractor: OUTDOOR CONCEPTS Architect: Address: 28241 CROWN VALLEY PKWY, F293 Address:. LAGUNA NIGUEL CA 92677 Phone: 949-363.7932 Phone: Con State Lic: 831378 Engineer Lic Expire: 0212812022 Address: Bus Lic: BT30060506 Lic Exp Date: 0913012021 Phone: Worker's Compensation Insurance Carrier: BENCHMARK INS CO Policy No: CST5021783 Expiration: 06/1812022 POOLPern it: S2021-0186 Project No : 1874-2021 Inspection Requests Phone (949)644-3255 State Lic: PETROV PLAMEN 28161 CASITAS CT LAGUNA NIGUEL CA 92677 714-717-7542 State Lic:C-066947 Special Conditions: YARD DRAINAGE W/PERMIT X2020-2398 Issued Date: 09/20/2021 FEES Record Management: $12.00 Water Quality --- Building Dept Inspection Fee: $0.00 Drainage Permit Fee : $0.00 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 PROCESSED BY: ZONING APPROVAL: Plan Check Fee : PLAN CHECKED BY:: APPROVAL TO ISSUE PFRP91 i EXF IRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Fee Due at Permit Issuance 19 .00 OWNER -BUILDER I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law forth e 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). 28161 CASITAS CT ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) portions of the work, and the structure 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 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 improved 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 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://www.leginfo.ca.gov/calaw.html. 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 000) of Division 3 of the Business and Profes ion C,isode, and rryLlicense is in full force and effect. License Class License No Date /Contractor Signatu WORKERS' COMPENSATION DECLARATION 1 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED H SAND 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. II —hereby affirm under penalty of perjury one of the following declarations: w I 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 armance of the work for which this permit is issued. Policy No. ve 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' compensatiol in urance carrier and policy number are: arrier /wt-wL MBA_ Policy Number Expiration Date :1I certify that, in the performance of the work for which thispermit 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 '.hat, if I should become subject to th kere7pensa n pro ns of S lion 3700 of the Labor Cade, I shall forthwith comply with those provisions. �7 Signature of Applicant I L D / / _t DECLARATION REGARDING RUCTION LENDING N lJ� hereby affirm under penalty of pe ry 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 3y 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. Z +w I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or county t er the ov identified property for inspection purposes. �.i�' j Signature of Property Owner or Authorized A e t Print Property Owner's or Authorized Agent's Nam -5 Date ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY IV REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED 0 1 SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED OEPA PERMIT EXTENDED QMD POOL ALARMS OASBESTOS NOTIFICATION IS NOT APPLICABLE TO INSTALLED PROPOSED DEMOLITION. SIGNATURE: PERMIT FINAL