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Home My WebLink AboutS2014-0034 - Permits�gR'VGi' ,a r U n e 'rLJY�3R'� City of Newport Beach - Building Division 11IIIIIII IIIIIIIIIIIIIIIIIIIIII11IIIIIIIIIIIIIIIIIII II 100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 1 4 0 0 3 4 Permit Counter Phone (949)644-3288 Job Address: 4512 ROXBURY RD Floor: Inspector Area: 6 Legal Description: N TR 3357 LOT 12 Owner: 4512 ROXBURY ROAD LLC Address: 43 RENATA NEWPORT COAST CA 926i Phone: Applicant: BOB/TESERRA OUTDOOR Address: 1270 SUNSHNE WAY ANAHEIM CA 92807 Phone: 949-678-0414 Building Rear: Setbacks: Front: Lek: Right: Construction Type: , Construction Valuation: $33,840.0.0 Suite: Bldg:1 Description of Work:SFR POOUSPA 465 POOLPermit : S2014-0034 Project No : 0533-2014 Inspection Requests Phone (949)644-3255 W Plan Check No: 0533-2014 Code Edit: 201T'G�✓Y+PI cal')!a: Contractor: TESERRA .T, Arc � cEti0f0 c.r ❑ 100% refund Address _.. P O BOX 1280 ` '� Address: COACHELLA CA 92236 - Phone: 760-398 9222 h on'a.V!-orn: State Lie: al -�--- Con State Lic: 656128 Engineer: COLLINS JEFFERY Lic Expire: 10/31/2014 _ _ Address: 1201 N. TUSTIN AVE lic` BT3.0022572 ANAHEIM CA 92807 4�t Lc€acp Date 08/3112014 Phone: 714-630-6114 State Lic: - J Wo"'a -Compensation Insurance Special Conditions: Carrier: EVEREST NATIONAL Policy No: 7600006481141 Expiration: 01/Q1/2015 '*. +ssmed Date 903/19/2g14 m I p tl Building Permit Fee : $547 00 KIo eecord Management $4 00--- Permit Issuing Fee: $0 00 Building Dept Inspection Fee.> $0.00 Investigation Fee: $0.00 Grading Permit Fee : $0.00 Water Qual#y-O qt It53p;Pe8 _ _ -_ -�$24.00 Building Green Fee: $2 00 i� r•r + p r•a. ,.v ,—r-- g Dept WQ Plan Check. - $0.00 Plan Dept Plan Check: $32.00 Grgg10 nsgliant_Fee �3,_; _- .@:00,-_= -- ---Others 9 �R._._ `--=__ ' ` - - Building Delp Plan Check: $393.84 � $0.00 $0.00 Building PC Investigation : $0.00 Additional Fee : $0.00 Plan check Ext. Fee : $0.00 WQ Compliance Insp Fee: $36.00 TOTAL FEE: $1,038.84 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $1,0 PROCESSED BY: ZONING PLAN CHECKED BY:: APPROVALTOISSUE' / Y PERMIT EXPIRFS.180,DAYS,AFTFR ISSIANCE OR LAST VALID INSPECTION )WNER-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 items) 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 to 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). 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, lusiness and Professions Code: The Contractors' State License Law does-not-apply-to-arrowner 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 butting or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or nproved for the purpose of sale) �,�// — - .. I, as owner of the property, am e�iblusively contractm ith4ic'€ns &Ictora-to-construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not pply to an owner of property who builds or Improves the jn, 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. ly 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 legal 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 IaW, Section 7044 of the Business and 'rofessions Code is available upon request when this a Iicetion is submitted or at the following Web site:htt //www:le info.ca: ov/calaW.bfm-l- � k P g PP 9 P� g� 9 signature of Property Owner or. Authorized Agent -7 Qte .ICENSED CONTRACTOR'S DECLARATION tie. hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectiopi 70001 of Division 3 of the Business and F<ref ssI(t ns C fe an my license is in full force nd effect. g -- icense Class -:?4icense No Date .1/ Contractor Signatu (�f PORKERS' COMPENSATIpN DECLARA .ION-- IARNING: FAILURE TO SECURE'WORkERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOPSAND DST OF COMPENSATION, DAMAGES is PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES ' hereby affirm under penaJ{{y ofB equry one of the following declarations I have and will mamtann..a tcert15° '�' consent tp sel in;. e fo�.x�o� PfA pensaUon Issued by the Director of Industrial R lati arsU vjd for by Secti< 00"Tance of the work fcrrwhiih this m Is Issued Polley No n h ®, I ha' a and intau lwor rs c mpensahon insurance as req lre�by Section 3700 of the Labor Code for the performanpe',Ui it t� work for whit permit is I r ce carrier d licy;nu er a e: ;arrier P icy um r Expiration D lame of Agent �a _ �H^ "— tat, if I should become rforman a two°r Is erml Is Issued, I shall not employ any person in any manner;o as to b ypr"salbect to r ens' c pe� �I certify that, in perfor ect he rker ns ction 3700 of the Labor Code shall fort ilhr 9+ Ifh 1h65e''0rowsr -,: denature of ADDllcant i /l __.... -�- - "' "-�" D , ereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Ider's Name Lender's Address 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 hav rovided is owed. I agree to comply with all applicable city and count or di nces d state laws relating to building construction. I authorize representatives of this city or County to nt ab e-identified property for inspection purposes. nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name )OLLARS (E100,000), IN ADDITION TO THE n 3700 of the Labor Code, for the issued. My workers' compensatior ration laws of California, and agree ACTION DATE BY DECLAPATION OFCOMPLIANCE KITH CODFOF FEDERLL REGULATIOYS PAF.T 61 OF TITLE 4C AND AQMU PULE 1493. ❑ I SUBM11TifUASBcSr OS VJTIFIe:ATIOd i0: ❑ EPA ❑ AQMD ❑ ASBESTOE MOTIPCARONIS NOT QO°LICABLE TO PROPOSi-D JEMGU;10.J. SIGNATURE, FOR OFFICE USE ONLY PERMIT EXPIRED 'S '� — 1 �J PERMITCANCELL€D PERMIT EXTENDED PERMIT FINAL CERTIFICATEOF OCCUPANCYISSUED