HomeMy WebLinkAboutS2019-0085 - PermitsCity
100 Civic Center Newport Beach ch. CA Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIINIIIIIIIIIIIIIIIIIIIIIIII
Permit Counter Phone (949)644-3288
Job Address: 611 CLIFF DR Floor. Suite: Bldg: 1
Description of WOrk:SFR POOL/SPA REPLASTER 250 SF
Inspector Area: 2
Legal Description: N TR 1218 LOT 88
0
Plan Check No: 2944.2018
Code Edit: 2016
P001 -Permit: S2019-0085
Project No: 2944-2018
Inspection Requests Phone (949)644-3255
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woes. CONNER ALICE B
Address: 611 CLIFF
Contractor:
INFINITY POOL SERVICE
NEWPORT BEACH CA 92683
Address:
9121 ATLANTA AVE #638
Architect:
Address:
Phone:
HUNTINGTON BEACH CA 92646
Phone:
714-262-9164
Applicant: THOMAS THOMAS
Phone: State Lia
....
°
Address: 22312 WALLINGFORD LN
Con State Lic:
891370
....
HUNT7.8687 BEACH CA 92646
Lic Expire:
02/28/2021
Engineer:
Address:
• ° ° °
Phone: 714-587.8687
Bus Lia
ST30053051
.. °
Lic Exp Date:
12/31/2019
Building Rear.
Phone: State Lic:
°
Setbacks: Front:
Worker's Compensation Insurance
......
Left:
Carrier:
STATE COMP
Special Conditions:
Right:
Policy No:
9159411
0000
0000
Construction Type:
Expiration:
05/20/2019
Issued Date:
°
0511412019
0
°000co
uction Valuation: $12,000.00
0000
g Permit Fee : $264.00
PermitIssuing Fee:
FGreen
Record Management
$2.00
$0.00
Fee: $0.00
Water
Quality-
g Green Fee: $1.00
Drainage Permit Fee :
$0.00
Building Dept Inspection Fee:
ept Plan Check: $0.00
Drainage Plan Check:
$0.00
Water Quality Dept Insp Fee:$0,00
$0.00
Dep Plan Check: .$229.68
Grading Consultant Fee :
$0.00 Others :
Building Dept WQ Plan Check:
$0.00
PC Investigation : $0.00eck Ext. Fee
Additional Fee :
$294.00
:
WQCompliance Insp Fee: $0.00
$0.00
$0.00
TOTAL FEE: 579n as
PROCESSED BY:
ZONING APPROV,
Plan Check Fee: $0.00 Fee Due at Permit Issuance
$790.88
PLAN CHECKED BY:: 1�
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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OWNER -BUILDER DECLARATION its , R
t that requires a permit to construct, alter, improve, demolish, or repair any
comme tore, prior
to tion 7000 of D vision 3 of the Business cant land
1 hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable items)
action 7031.5, Business and Professions Code. Any city or coun y q ❑
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter
ofessions 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 o
le
ion
It more than five hundred dollars ($500). will do (_) all of or (_) portions of the work, and the structure is not intended or offered for seithat the4, Business
as owner of the property, or my employees with wages as their sole compensation,
Id 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
id Professions
ovements 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
i roved for the purpose of sale).
ly contracting with licensed Contractors to construct the project (Section 7044, Business and Professicn
I, as owner of the property, am exclusives Code: The Contractors' State License Law does no
ppl1, 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).
I am exempt from licensure under the Contractors' State License Law for the following reason: of the applicable law, Section 7044 of the Business and
'.y my signature below I acknowledge that, except for my personal residence in which I must have resided far at least one year prior to completion of the improvements covered by this permit, I cannot lege
ell a structure that I have built le an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy Da
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http:l/www. leginfo.ca.gov/calaw.html.
signature of Property Owner or Authorized Agent!cense is in full farce
_ICENSED CONiff%ACTOR'S DECLARATION tractor Signatur
m wd
hereby affrel•penalty of perjury that I am licensed unDate Con
License visions of Chapter 9 (commencing with Section 7 f IV i n of the Business and Pro as oCO
apggeffoct. Llrwe&lass
O THE
NORKERS' �OWTOENSATION DECLARATION
OST•10F COMPENSATIONFAILURE
SE UREPAMWOR AS S' COOED SATION IN SECTION COVERAGE70510E THErLA500. CODE, INTEREST, AND ATTORNEY'S FEES. 3700
PENALTIES AND CIVIL FINES UP TO ONE HON REO THOUSAND DOLLARS 1$100, 00), IN ADDITION T
6ereb affirm eRdafTpgnalty of perjury one of the following declarations:
nollftve and W6 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
pe 1france of thG§94 for which this permit is issued. Policy No.
I•h�I 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 10
to R ,e carrierand policy number are: Expiration Date
•... • Policy Number phone #
Carrier
IQM9 of.Agent
• • •I shall forthwith comply with those provisions.
I certify that, in'tM19 diA:ncoj, the work fcom hensation provi=s=o ssof Selction11not 3700 of the LaboP Code,in any manner so as to become subject to the woDrk[ rs' mpensation laws of California, an athat, if I should becameo t dceTs' pSignature of ApplicantST UCTION LENDING AGENCYDECLARATION REGAI hereby affirm under py of perjury that there is a construction lending agency fo Lthe endeer'rformance rf Adnanedress of the work for which this per
is issued (Section 309 ,Civil Code).
Lender's Name
By 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. building
laws I agree to comply with all applicable city and co my o din b and late
fled property nspect on purposes. ate
P Y
I authorize representatives of this city or count to e t Print Pro erty Owner's or Authorized A ant's Name
S! nature of Propert Owner or Authorized Agent
DATE BY RA OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
ACTION REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
23-/91 M37
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