HomeMy WebLinkAboutS2019-0122 - PermitsCity of Newport Beach - Building Division 11111111111111111111111111111111111111111111111111111111
iJ$ 100 Civic Center Drive, Newport Beach, CA 92660 S 2 8 1 9 8 1 2 2
' Permit Counter Phone (949)644-3288
Job Address: 4701 SURREY DR Floor: Suite: Bldg: 1
Description of Work:NEW POOLISPA 684 SF (DRAINAGE W1 X2018-0172)
Inspector Area: 5
Legal Description: N TR 3519 LOT 67
Owner: PLEASANTVILLE RD PTRS
Address: 1 CORPORATE PLAZA DR #110
NEWPORT BEACH CA 92660
Phone:
Applicant: PAULIMITCHELL PARKS
Address: 1400SUNKIST#190
ANAHEIM, CA 92806
Phone: 949.228-1953
Building Rear:
Setbacks: Front:
Left:
Right:
Construction Valuation: $50,000.00
Building Permit Fee:
$405.00
Permit Issuing Fee:
$0.00
Investigation Fee:
$0.00
Building Green Fee:
$2.00
Plan Dept Plan Check:
$0.00
Building Dep Plan Check:
$361.00
Building PC Investigation :
$0.00
Plan check Ext. Fee:
$0.00
WQ Compliance Insp Fee:
$0.00
TOTAL FEE : $1.078.00
Contractor: PARKS MITCHELL
Address:
11. ALLYSSUM
EXEMPT
RSM CA 92688
Phone:
949-279-7193
Con State Lic:
838091
Lic Expire:
05131/2020
Bus Lic:
BT30058994
Lic Exp Date:
05131/2020
POOLPermit : S2019-0122
Project No: 1579-2019
Inspection Requests Phone (949)644-3255
Plan Check No: 1579-2019
Code Edit: 2016
•o
?§fie
Worker's Compensation Insurance
Carrier:
EXEMPT
Policy No:
Expiration:
FEES
Record Management:
$16.00
Drainage Permit Fee :
$0.00
Drainage Plan Check:
$0.00
Grading Consultant Fee :
$0.00
Additional Fee :
PROCESSED BY:
ZONING APPROVAL:,'
$294.00
Architect
Address:
Phone
Engineer: LACHERTODD
Address: 1201 N TUSTIN AVE
ANAHEIM CA 92807
Phone: 714-630-6100
Special Conditions:
Issued Date: 07/15/2019
Water Quality- --
Building Dept Inspection Fee:
Water Quality Dept Insp Fee:
Building Dept WQ Plan Check:
Others :
State Lic:
State Lic:C-067656
•ee
o e
•
oee•om
m
o eom
o m
00
•
m m
mmmomm
o mo
o m
moon
$0.00
$0.00
$0.00
$0.00
$0.00
• •
•eeeoo
0 0
e m
• e e
oe o
• b
e m m
ee b
memoc
e
ommoo
m0000c
m m c
m
mmmoo`
m
oomo
Plan Check Fee : $0.00 Fee Due atPermitIssuance : $1,078.00
PLAN CHECKED BY:: Lc—
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s),
Iction 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicanTfor
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the$usiness and
)fessions 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
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 (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
einess 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
)rovements 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
(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 nor
)ly 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:
my signature't1MoN 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 Iegalh
I a sjructure thaM41ave 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
IftIStions Cede,1%%vailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
nature of Prgp4rty Owner or Authorized Agent Date
:SENSED C014TRACTOR'S DECLARATION
Aeby affirm ynder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 ) o Division 3 of the Business and Profes o C R license' 'n full force
I Affect. License, lass License No Date Contractor Signature
7AKERS'.g9P4lPENSATION DECLARATION
ING: FAILIfE40 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
1'ROF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 5700 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
Ireby affirm udder penalty of perjury one of the following declarations:
I lave ar4wiil4aintain 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
forance of the work for which this permit is issued. Policy No.
.0
*have and vvjljIlleintain 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' compensatiol
trance carrier and policy number are:
Policy Number Expiration Date
IS,mJ of Agent Phone #
to
rtify that, in the perforPe
or which ermit is issued, I shall not employ any person in any manner so as to become subject to the workers' compens lion I s of California, and agreat, if I shouldbecomes jompe Ion provisions of Section 3700 of the Labor Code, I shall forthwith comply withthose provisions.signature of Applicant D e)ECLARATION REG DINN LENDING AGENCY
hereby affirm under p nalt e 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
ly my signature below, I certify to each of the following:
I am the property owner or authorized to act on t rope owner's behalf.
I have read this application and the informatio have prove a co ect.
I agree to comply with all applicable city and c ty ordi ces tat�replati to building construction. �) �ry/�
I authorize representatives of this city or count o e e e-ide ed pr y for ins purposes. // �/ / J e
'I ... Iirn ,.r o....,va„ n,.,.,e. A„{h_A- n.,e.,r oa.,r o.,.sa„ n,.,..e. � ,.. A„ rh—i—A A—V. Nler..e 7 Q a i'— nsr
FOR OFFICE USE ONLY
PART 61 OF TITLE 40 AND AQMD RULE
EXPIRED
PERMITEXTEND eAU QMD
POOLALARMS V1A4 o• / SBESTOS NQFFFIRAn N,Fi-IAP LE TO
INSTALLED P "I� PRn cFnr nII
c
N
a
R
d
Z
V)
w
z
W
U
w
IL
N
Cl)
W
r
Z
O
D
O
w
w
LL
M y
N W
U0
O
U
ni
U
NW
rr
UW
M�
�0
Uy
00
Cl)
U
W
r
LU
Q'
U
z
O
U
O U
m
z
0
CO
CO
CNJ O00_
W
0)
o
0 ❑
MO
D
0)w
0
00 LO
�
N
o
v
F
mU
U
Z z
LU
,LO
roIt
N n O
o
O
0
Lr)
rn
o
LLI
�w(U�
#
# # d r
XwwQ
m
g
N
J
ar
<U
Z
O
EYP
Of U
p
_Luo
7ZU
CO
F.
Q
N
T-
w
yc90
z
FW�
Q
U
r
uw
N
Z
N
06
W
a
-
N_ U
1`
LU
w
Q
Z
O
LL
U❑
d
W U
M_j
w
o
w
<
0
z c
cgaU
o
oo
W
Xkk d'm
W
F W p 111
OD
CD
1-
02Wy
OwCD
Q
Q70P
w
O
a
ILXQ0
O
00
v
1,
aw
cwx
-
LL
Q
¢
Q r g
U
3
0
w
m
❑
0
U
o
zC
a
vm
Q
of c
OUa
a
i
Xx
d0 a
W
w
Q
❑U
�?
g
U
j
x
-i
Z
w
w
❑
Z
O
LU
O 2
F=-
& LL
I
�:
r
cn U
U
W O
0
d
� rJ
�v
az iLL
N
W
o
g
Z O
z
N w r
o
Q
M
W U V
z
o
F 0 o F
LO
y
Z�
Z
wQr�
O
Lu LL C'4 ow
U
2
Z
w0j
w z 2 r
Q 0
U W m V
w
5
#
r
0mUZ
UQ
Zay=Z
r
W
m
U)
COWO<n<0
OJ�
D
�
OFu70
w
H
IN
U
x
N
w
J
a
2
O
U
0
LU
U
0-1
O
D -
w
w
W
m
0
Z
J
x
0
O
d
W
U)
_
F -
z
0
CO
CO
W
F-
0 ❑
❑ Z
0
wQ
F- 0
F
mU
W
LU
U CO
Z4Q
rn
o
J F
U
Z
LUW
F
as
Q
=
ar
<U
Z
U :DLL
LU O
d
Of U
c
N
N
x
y
1`
0
d
o
o
ti
0
M
o
m
OD
CD
00
N
LO
O
O
N
O
00
1
1,
O
-
LL
0
0
0
o
vm
N
j
x
0
o
d
0
r -
o
Ln
M
o
U)
o
LO
E
coco
W
N
O
n
GOO
=
LL
0
O
o
,
d
OD
N
N
x
y
O
O
1-0
C
Lf)m0L
00
co
N
O
W
(OO
_
LL
CL
.N
a
z
F
0
a)
P_
N
w90�
V
p
W
rw
w
LL
x
N
Q
F
w
LL
N
z
P
O�
z
W
Q
Vl
Q
O
W
a
p
W
'Q
0
F
r
W
..
W
N
J
Q
F
c
=
w
r
w
w
Y
c
IL
=
w
2
w
r
N
w
7
2
(=
0'
a'
to
N
0
0
0
Q
U
V
2
V
0
m
U
IN
U
x
N
w
J
a
2
O
U
0
LU
U
0-1
O
D -
w
w
W
m
0
Z
J
x
0
O
d
W
U)
_
F -
LU
W
2
0
m
U)
U
U)
W
J
a
W
O
z
z
CO
CO
W
F-
0 ❑
❑ Z
wQ
F- 0
F
mU
W
LU
U CO
Z4Q
J Z
(7
J F
U
Z
LUW
F
as
Q
=
ar
<U
Z
U :DLL
LU O
d
Of U
N
LU
W
2
0
m
U)
U
U)
W
J
a
W
O
z