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Home My WebLink AboutS2019-0186 - Permits}� City of Newport Beach - Building Division I 11pilIII11111111111111111111111111111111111111111111111 100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 1 9 0 1 8 6 _ Permit Counter Phone (949)644-3288 xtt Job Address: 7 TIBURON BAY DR Floor: Suite: Description of Work:SFR POOL/SPA REMODEL 220 SF Inspector Area: 4 Legal Description: N TR 7510 LOT 48 Owner: LOBEL GARY DEAN Address: 1150 N MAGNOLIA AVE ANAHEIM, CA 92801 Phone: Applicant: ERIC/FUSION POOL Address: 603 SEAGAZE DR #900 OCEANSIDE, CA 92054 Phone: 760.519-0135 Building Rear: Setbacks: Front: Left: Right: Construction Tvoe : Construction Valuation: $80,000.00 Building Permit Fee : $973.00 Permit Issuing Fee: $0.00 Investigation Fee: $0.00 Building Green Fee: $4.00 Plan Dept Plan Check: $0.00 Building Dep Plan Check: $846.51 Building PC Investigation : $0.00 Plan check Ext. Fee : $0.00 WQ Compliance Insp Fee: $0.00 PROCES ZONING TOTAL FEE: $2,123.51 Bldg: 1 Plan Check No: 2635-2019 Code Edit: 2016 Contractor: FUSION POOL & SPA Address: 603 SEAGLAZE DR #900 Bus Lic: OCEANSIDE CA 92054 Phone: 760-519-0135 Con State Lic: 842363 Lic Expire: 07131/2020 Bus Lic: BT30061028 Lic Exp Date: 10/3112020 Worker's Compensation Insurance Carrier: SIRIUS AMERICA INS Policy No: WC19583 Expiration: 10/01/2020 Record Management: Drainage Permit Fee: Drainage Plan Check: Grading Consultant Fee Additional Fee: FEES Architect: Address: Phone: Engineer: Address: Phone: P001 -Permit: S2019-0186 Project No : 2635-2019 Inspection Requests Phone (949)644-3255 Special Conditions: Issued Date: 12/0312019 $6.00 'S1 L•irr•6e0d11`1% e n $0.00 em ° mo••om $0.00 Building Dept WQ Plan Check: $0.00 m •• $294.00 e ° CARLSON JAMES e • e ee n 2300 CLIFF DR oeee•° ° m NEWPORT BEACH CA 92663 •see e • n •• v 949-645-3051 State Li¢C013773 oe oo m eemom e oommo° e m m o mmmmmm m v State Lic: ° •• m m e m000� oeoom Special Conditions: Issued Date: 12/0312019 $6.00 Water Quality --- Building Dept Inspection Fee: $0.00 Water Quality Dept Insp Fee: $0.00 Building Dept WQ Plan Check: $0.00 Others $294.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance PLAN CHECKED BY:: APPROVALTO PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION $0.00 $0.00 $0.00 $0.00 $0.00 123.51 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) lection 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 e 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 "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 of A more than five hundred dollars ($500). as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business 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 that the iprovements 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). I, as owner) ihe4operty, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not )ply town 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.l... ani exemptiroai licensure under the Contractors' State License Law for the following reason: II my signature b8lowl 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 Ilba 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 'ofessions Code, -it available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. t patbria of Pr8R%V Cwner or Authorized Agent Date CIMSED C(MRACTOWS DECLARATION Wre ft affirm ar1dB4 p8nalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 of Division 3 of the Business and Professioq Co nd my li nse is in full force od,@N ct. License Class License No Date Contractor Signature qRK€RS' CQ6ELNSATION DECLARATION %RNINGr FAILURB?O 30RE 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 :STD16OMPENSATIOI DAMAGES AS PROVIDED FOR IN SECTION 3703 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. lip4gyy'affirm Wft%p4nalty of perjury one of the following declarations: .. I have and w.ill* 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 thi !rfVmance of the work for which this permit is issued. Policy No. 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' carrier policy number are: Policy Number Expiration Date of Agent ]I certify that, in the Performa a 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' ompensation laws of California, and agre lat, if I should become subje to the workers' compensation r visions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignature of Applicant D e �� ' 7 Za rr DECLARATION REGARD G CONSTRUCTION LENDING AGENCY hereby affirm under pena y 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 y 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 hav provided is correct. I agree to comply with all applicable city and count ordinances and state laws relating to building construction. t2_' I authorize representatives of this city or countyt enter the bove-identified property for inspection purposes. di ionature of Propertv Owner or Authorized Agent l� Print Property Owner's or Authorized Agent's Name ate ACTION DATE BY DECLARATION OF IREGULATIONS PARTO610 TIITLE 40 AND QMD RULECE WITH CODE OF FOR OFFICE USE ONLY NOTIFICATION TO PERMIT CANCELLED PERMIT EXTENDED POOLALARMS 0 /n^ 40 PROP BESTO EN O IFI OATS?/S NOT AP CABLE TO INSTALLED i (N PV