HomeMy WebLinkAboutS2018-0133 - Permitsct��'
h.Jp�City of Newport Beach - Building Division IIIIIIIIIIII�IIIIIIIIIIIIIIII POOLPermit: S2018-0133
100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 1 8 0 1 3 3 Project No : 1809-2018
Permit Counter Phone (949)644-3288
au�°'s Inspection Requests Phone (949)644-32do
Job Address: 4645 CAMDEN DR Floor: Suite: Bldg: 1
IospecPolron of A eaW5rk:SFR REMOVE SHALLOW END STEPS FROM POOL plan Check No: 1809-2018 1��
Code Edit: 2016 SPECT
Legal Description: N TR 3357 LOT 127
Owner: MAI MICHAEL THANG Contractor: JARROD SCHUSTER Architect:
Address: 4645 CAMDEN DR Address: 3003 FELICIA DR Address: '
CORONA DEL MAR, CA 92625 YORBA LINDA CA 92886 ,
Phone: Phone: 714-318-0611 Phone: State Lic:
Applicant: JARROD SCHUSTER Con State Lic: 996915 Engineer: LACHER TODD
Address: 3003 FELICIA DR Lic Expire: 09130/2018 Address: 1201 N TUSTIN AVE
YORBA LINDA CA 92886 Bus Lic: BT30058305 ANAHEIM CA 92807
Phone: 714-318-0611 Lic Exp Date: 03131/2019 Phone: 714-630-6100 State Lic:C-067656
Building Rear: Workers Compensation Insurance Special Conditions:
Setbacks: Front: Carrier: NO EMPLOYEES
Left: Policy No:
Right: Expiration: Issued Date: 0713012018
Construction Type
FEES
Construction Valuation: $30,000.00
Building Permit Fee : $492.00 Record Management: $8.00 Water Quality- --
Permit Issuing Fee: $0.00 Building Dept Inspection Fee: $0.00
Investigation Fee: $0.00 Drainage Permit Fee : $0.00 Water Quality Dept Insp Fee: $0.00
Building Green Fee: $2.00 Drainage Plan Check: $0.00 Building Dept WQ Plan Check: $0.00
Plan Dept Plan Check: $0.00 Grading Consultant Fee : $0.00 Others
Building Dep Plan Check: $428.04 $0.00
Building PC Investigation : $0.00 Additional Fee : $0.00 $0.00
Plan check Ext. Fee: $0.00
WQ Compliance Insp Fee: $0.00
TOTAL FEE : $840.00
PROCESSED BY:
ZONING APPRO\o
Plan Check Fee: $0.00
PLAN CHECKED BY:
APPROVAL TO ISSU
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Fee Due at Permit Issuance : $840.00
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)
iection 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
ie 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 Cade) or t rat 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 ($500). 1201 N TUSTIN AVE
1 I, a.9 owner, of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
Iusiness and P-rofessions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
hrrovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
rn ved,for tir.:purpose of^sale).4 e-
`. I, ar owner c.` the property, am excldsively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
ppl§ to an owne- )' rroperty who build$ or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
1" fain exerfipt `.rD..n l censure undeMe Contractors' State License Law for the following reason:
ly , ny 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
e11 a Ltl ucture 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
�roress(Dns CodL, Is ucailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htm].
'innab,re of Property Owner or Authorized Agent Date
ICENSED CONTRR.CTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Ctl 7000) f Divi io8 3 of the Business and ofe s Code, and my licens i in full force
nd effect. License Class License No ate e - 4ontract ure
IIORKERS' COMPENSATION DECLARATION
ING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIWL FINES UP TO ONE
OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
TO THE
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
'ormance of the work for which this permit is issued. Policy No.
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' compensa
Trance carrier and policy number are:
Policy Number Expiration Date
Phone #
hat,inhe DerformanA 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
if I should become subjec o the workers' comp_ens/atiorLp/cgy�as+err ec Ion Y00 of the Labor Code, I shall forthwith comply with those provision
Stu of Applica / C \
1 ARATinREY;A i . COMRTR11CTiON LENOINr�1 A
I hereby affirm under penally of perju�[ that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Lender's Name `\ Lender's Address
By my signature below, I certify 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 obi nces and state aws lacinZ,,npr'l'ec
ding construction.
I authorize representatives of this city or county to e r t e above-identifl d op y purposes.,Signature of Property Owner or Auth gent t Property Owner's or Authorized Agent's N ai IFYV-9—'—D �}�-v "^S e ? �G
ACTION DAtr BY�-IkCLARAOFCO PLIAN WITH CO EDERAL FOR OFFICE USE ONLY
PART OF TITLE AND AQMD RULE
PERMIT EXPIRED 10 1 SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT EXTENDED LIAQMD
POOLALARMS I ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO
INSTALLED �l V Zl PROPOSED DEMOLITION.
SIGNATURE:
PERMIT FINAL
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