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Home My WebLink AboutS2021-0001 - Permits��, r., City of Newport Beach - Building Division II��i111111111111111p11111Ilm11111p111p11111111 POOLPermit : S2021-0001 G 100 Civic Center Drive, Newport Beach, CA 92660 Ilr S 2 0 2 1 0 0 0 1 Project NO : 0008-2021 Permit Counter Phone (949)644-3288 u ! qr � vN" Inspection Requests Phone (949)644.3255 .lob Address: 1206 PEMBROKE LN Floor: Suite: Bldg: 1 Description of Work:SFR NEW POOL/SPA W/ DRAINAGE 324 SF `STOP WORK' Inspector Area: 3 Plan Check No: 0008-2021 Code Edit: 2019 Legal Description: N TR 3607 LOT 8 Owner: KALEM LLC Contractor: AMPLE CONSTRUCTION Architect: Address: 1206 PEMBROKE Address: 3857 BURCH ST 4333 Address: NEWPORT BEACH, CA 92660 NEWPORT BEACH, CA 92660 Phone: Phone: 714-454-4305 Phone: State Lic: Applicant: AMPLE CONSTRUCTION Con State Lic: 957060 Engineer: LACHER TODD Address: 3857 BURCH ST #333 Lic Expire: 01131/2023 Address: 1201 N TUSTIN AVE NEWPORT BEACH, CA 92660 Bus Lic: BT30057810 ANAHEIM CA 92807 Phone: 714-454-4305 Lic Exp Date: 06130/2021 Phone: 714-630-6100 State Lic:C-067656 Building Rear: 10, Worker's Compensation Insurance Special Conditions: Setbacks: Front: 20' Left: 4o Policy: NATIONAL No: A9WC1246281ABILITY&FIRE 1c Right: 4' Expiration: 07/12/2021 Issued Date: 0412212021 ►� `-' Construction Type : FEES Construction Valuation: $60,000.00 Building Permit Fee : $430.00 Permit Issuing Fee: $0.00 Investigation Fee: $430.00 Building Green Fee: $3.00 Plan Dept Plan Check: $0.00 Building Delp Plan Check: $387.00 Building PC Investigation : $0.00 Plan check Ext. Fee: $0.00 WQ Compliance Insp Fee: $0.00 Record Management: $4.00 Water Quality -- Building Dept Inspection Fee: $0.00 Drainage Permit Fee : $232.00 Water Quality Dept Insp Fee: $0.00 Drainage Plan Check: $195.00 Building Dept WQ Plan Check: $0.00 Grading Consultant Fee : $336.00 Others $0.00 Additional Fee : $0.00 $0.00 11 TOTAL FEE : $2,017.00 Plan Check Fee : $682.00 Fee Due at Permit Issuance : $1,435.00 11 PROCESSED BY: ZONING APPRO� PLAA CHECKED BY::__r1 APPROVAL TO ISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUAN;E OR LAST VALID INSPECTION OWNER -BUILDER 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 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). 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, 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 im roved 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:hftp://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 7000) of Divisiorl, 3 of the Business and Professions Code, a d my license is in full force and effect. License Class License No D 2 Z-Contractor Signatul� ��E — WORKERS' COMPENSATION DECLARATION i WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND 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. I hereby affirm under penalty of perjury one of the following declarations: 0 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, er r rmance of the work for which this permit is Issued. Policy No. lave 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 Ins anc�eAAca_rrrlfier and Do ley number are: f1 p' o- ler IVI f3t1'rFJ /t�� Policy Number H- { G �, L 2 o Expiration Date �%i / 1 Name of Agent r Phone # 131 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 agree that, if I should become subject to/the�Xorkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant 4, / /— — DECLARATION REGARDING CPWIRUGTION LENDING AGENCY I hereby 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 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. 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 tD enter a bove-identified property for inspection purposes. // ,�/ signature of Property Owner or Authorized Agen Print Property Owner's or Authorized Agent's Name QFK /S�a///7J Date ACTION DATE BYW N DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 _ PERMIT EXPIRED I St'BNJTTEC ASBESFOS NOTIFICATION1 TO gates & fences which serve as (Dart Of a pool / spa barrier, shall be in place prior to approval to fill PERMITCANCELLED EPA ' ' PERMIT EXTENDED _ QMD POOLALARMS /f S% S ASBESTOS NOTIFICATION IS NOT APPLICABLE TO INSTALLEDf PROPOSED DEMOLITION. pool/Spa & shall remain In SIGNATURE: _ _ _ place & be giaintained for the JAI/s PERMITFINAL