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Home My WebLink AboutS2020-0043 - Permitsw City of Newport Beach - Building Division *S2020-0043* a'1 100 Civic Center Drive, Newport Beach, CA 92660 % Permit Counter Phone (949)644-3288 Job Address: 40 BRAEBURN LN Floor: Suite: Description of Work:SFR REPLASTER POOLISPA 1200 SF Inspector Area: g Legal Description: Owner: STONE JEFFERY E Address: 42 BRAEBURN LN NEWPORT BEACH, CA 92660 Phone: 949-922-0244 Applicant: SMITH ALAN POOL PLASTERING Address: 227 W CARLETON AVE ORANGE CA 92867 Phone: 714-628-9494 Building Rear: Setbacks: Front: Left: Right: ..uusuucuuu type. vv Construction Valuation: $20,000.00 Bldg: 1 Plan Check No: 0500-2020 Code Edit: 2019 Contractor: SMITH ALAN POOL PLASTERING Architect: Address: 227 W CARLETON AVE Address: Permit Issuing Fee: ORANGE CA 92867 Phone: 714.628-9494 Phone: Con State Lic: 571196 Engineer: Lic Expire: 06130/2021 Address: Bus Lic: BT00012422 Drainage Plan Check: Lic Exp Date: 0813112020 Phone: Worker's Compensation Insurance Carrier: ARCH INS. CO. Policy No: ZAWC12545401 Expiration: 04101/2021 FEES P001—Permit: S2020-0043 Project No : 0500-2020 Inspection Requests Phone (949)644-3255 11. Special Conditions: Issued Date: 03112/2020 State Lic: State Lic: Building Permit Fee : $395.00 Record Management: $4.00 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: $343.65 $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: PROCESSED BY: ZONING APPROVAL: Plan Check Fee : PLAN CHECKED BY:: APPROVAL TO ISSUI PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Fee Due at Permit Issuance : $0.00 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) 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 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 'rofessions 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). as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business nd 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 notintended 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). ' I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale License Law does not ply 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). lam exempt from licensure under the Contractors' State License Law for the following reason: ly 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 Iegall ell 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 'rofessions Code, is available upon request when this application is submitted or at the following Web site:hftp://www.leginfo.ca.gov/calaw.htmi. 'signature of Property Owner or Authorized Agent Dale .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force nd effect. License Class License No Date Contractor Signature VORKERS' COMPENSATION DECLARATION 'ARNING: 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 1$100,0001, IN ADDITION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 7 1 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 the erformance of the work for which this permit is issued. Policy No. 11 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' compensation isurance carrier and policy number are: Policy Number Date ne of Agent vnone M 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 , if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignature of Applicant Date_ DECLARATION REGARDING CONSTRUCTION LENDING AGENCY 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 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 have provided is correct. I agree to comply with all applicable city and county ordinances and stale laws relating to building construction. I authorize representatives of this city or county to enter the above -identified property for inspection purposes. ianature of Prooertv Owner or Authorized Anent Print Property Owner's or Authorized Agent's Name ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED OEPA PERMIT EMENDED CMD POOL ALARMS 0 ASBESTOS NOTIFICATION IS NOT APPLICABLE TO INSTALLED 411'l � PROPOSED DEMOLITION. SIGNATURE: