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Home My WebLink AboutS2017-0075 - Permitsxla:r City of Newport Beach - Buildin �e 100 i"Ivic Center Drive, Newport Beach, CA 9U60 F Permit Counter Phone (949)644-3288 .s n r�Glpn1��4 --71im Sllr 11111111111SIT IIIrilnlmm�n I F1III �ll IIII Project No : 0963-2017 Date: �r 1 � � �� If applicable: Inspection Requests Phone (949)644-3255 A IL I 900 ® ❑ 80% or ❑ 100% refur Job Address: 3620 OCEAN BLVD Floor: Suite: Bldg: r..� s" t0 whom: Description of Work:SFR POOL/SPA 114 SF i ® P Inspector Area: 5 1 Legal Description: RESUB OF CORONA DEL MAR LOT 2 BILK 142 N..�.n " D S '�� e,� FT LOT Owner: MILLER GREGG AlA MILLER C4ntr. ctor. PARKS LL Architect: d v ,yI"� , Address: 1130 W TRENTON AVE Addres 1 S QSUM Address: �7 • _ _ ' . S ORANGE CA 92867 j •�-+ Phone: PhP —u �4 S 9 ' 1 ,�ii 1 !f Applicant: ELLISON PAUL Con.Btate Li�c:'83809j1 Engineer: COLLINS RRY'� Address: 1400 S SUNKIST # 190 Lid Expire: 051314wprk Started) Address: 1201 N. Tl� EXg)i,k started) ANAHEI CA 92806 Bu'S Lic: BT30058994 ANAHEIM CA 92807 Phone: Lic Exf�_Dite:- 12/31/2017 Phone: 714-630-6114 State Lic:C-080733 i ! i.ilC Building Rear: Workeris Compensation Insurance Special Conditions: t`c' Setbacks: Front: Carrier; FXr Insp. I-r''�ttu�-- Left: Policy Right: Expiration: Issued Date: 0610212017 Construction Type : V-B FEES r' Construction Valuation: $22,000.00 1"1'V� o� Building Permit Fee : $380.00 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: $1.00 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: $338.00 $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: $727.00 Plan Check Fee : $0.00 Fee Due at � Permit Issuance : $727.00 PROCESSED BY: '5-D'\PLAN CHECKED BY:: 1� � it �) /� ZONING APPROVAL: J^v -� APPROVAL TO ISSUE: SD 1 `l PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION 'dam„ OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable item(s) Election 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 is 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 of more than five hundred dollars ($500). 1201 N. TUSTIN AVE I, 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, lusiness 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 nprovements 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 nproved for the purpose of sale). 1 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 pply 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 exerr,pt from licensure under the Contractors' State License Law for the following reason: 'y 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 legally tll a >tructurP [Fat 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 applicJ la ess a d 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htm]. ignah ire of Proparty Owner or Authorized Agent D .ICENSED CO'4TRACTOR'S DECLARATION hereby affirm u..^.dsr penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with SectionfPLTIE.SAS.L11 3 o the Business and Poin full force nd a.fect. License. Class License No Dat/S:ontractor Signatu JORKERS' l;^MP7NSATION DECLARATION �// AHNING: FAILURE T1 SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMIN C vIL FINES UP TO ONE HUNDND DOLLARS I$100,0001, IN ADDITION TO THE 91' CF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm •.,„derpenalty of perjury one of the following declarations: I have and.will rra!ntain 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 the cr"crl,iance of th6 work for which this permit is issued. Policy No. ]I 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' compensatior Isurance carrier and policy number are: Policy Agent Date rsqrtify that, in the p o ante a ork for hich Ili" li rmit is issued, I shall not employ any person in any manner so as to become subject to the workers' comp nsatio law of California, and agree uld becomes j ct to w rkers' ompens on provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant Date CLARATION REG DIN R N LE DING AGENCY ,reby affirm under enalty f perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). 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 o erty owner's f. I have read this application and the informat1 n I have corn? . ✓ �f I agree to complywithall applicable city and o n ore' c ands e w elating to building construction. //� J // I authorize representatives of this city or coun n the abov a property for inspection purposes. A �,A Date ACTION DATE BY V REGULATIONS PART 610 TARATION OF IITLE 40 AND AQMD RULEFEDERALCE WITH CODE OF FOR OFFICE USE ONLY1403 PERMIT EXPIRED PERMIT EXTENED UAQMD POOLALARMS LJ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO INSTALLED PROPOSED DEMOLITION. r _ _ SIGNATURE: PERMITFINAL