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S2019-0161 - Permits
City of Newport Beach - Building Division III VIII IIIIIIIIIIIIII IIII IIIIIIIII I P001 -Permit: S2019-0161 II II ti. 100 Civic Center Drive, Newport Beach, CA 92660 'g S 2 0 1 9 0 1 6 1 Project No: 2163-2019 F` Permit Counter Phone (949)644-3288 �A'YYk1F Inspection Requests Phone (949)644-3255 Job Address: 2507 ALTA VISTA DR Floor: Suite: Bldg:1 Description of Work:SFR -ADD T SPA TO (E) POOL; REMODEL POOL - - Inspector Area: 8 Plan Check No; 2163-2019 Code Edit: 2016 Legal Description: N TR 4893 LOT 104 - Owner:. 2507 ALTA VISTA NEWPORT BCH LL Contractor: BLUE FOUNTAIN POOLS AND SPAS INC Architect: Address: 17620 FITCH #220 Address:. 1151 S GRAND AVE Address: IRVINE -CA92614 - GLENDORA CA 91740 Phone: Phone: 909-648-4882 Phone: State Lie: Applicant: ERIC/BLUE FOUNTAIN POOLS Con State Lie: 1004654 Engineer: Address: 1151 S GRAND AV Lie Expire: - 06130/2021 : Address: GLENDORA CA 91740 - Bus Lie: BT30065960 Phone: 626-335-0006 Lie Exp Date: 02104/2020 Phone: . State Lie: Building Rear: Worker's Compensation Insurance Special Conditions: Setbacks: Front:. Carrier: STATE COMP. INS Left: Policy No: 9231003 Right: Expiration: 05/08/2020 Issued. Dater 10/01/2019 Construction Type`. FEES r%'Or Construction Valuation: $25,000.00 1 1 Building Permit Fee: $472.00 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: $410.64 - $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 : $887.64 Plan Check Fee : $887.64 ee D at Permit Issuance : $0.00 PROCESSED BY: a o a a °,PO4\PCHECED-BY:: ZONING APPROVAL: -./ °;, ' ° °o �ArIIROVAlt, "0 ISSUE: PERMIT EXPIRES 160 DAYS AFTER ISSUANGE ©RELASOWkL`ID INSPECTION u° b Goo GO° 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 items) ... (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). - 1, 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, 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, asowner 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). ❑ I am exempt from licensure under the Contractors' State License Law for the fallowing 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 permitettannot legally 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 Gsiness and Professions Code, is available upon request when this application is submitted or at the following Web site:http://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 700 ) of Div "on of the Business and P f ons Code, nd m icense is in ull force and effect. License Class License No Date Contractor Signatl WORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUN DRE THOUSAND DOLLARS 1$100,0001, IN ADDITION TO THE COST 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: 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 3erformance of the work for which this permit is issued. Policy No. TThave and will maintain workers' compensation insurance, as re d by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatiol France carrier and policy number are: Tier Policy mber Expiration Date me of Agent Phone # certify that, in the performanc f he w k for whic is permit is issued, I shall n t employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree I, if I should become subje t the wor rs' compe ation provisions of Section 3' 00 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant Da �C7 CLARATION REGARDIN13 CON R E b G AGENCY Irebyaffirm under penalty of perjury that there is a construction lending agency far the performance of. the work for which this permit is issued (Section 3097, Civil Code). ider's Name L er's A ress my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner' behalf. 7 I have read this application and the information I haveyaided i correct. / I agree to comply with all applicable city and countypfdinances nd state I ws rate in t, building construction. I authorize representatives of this city or county to Onterthe a ,ve-identi ed pr/o�perty f r inspection purposes. nature of Prooertv Owner or Authorized Aoent O Y --I' Print Property Owner's or Authorized Apent's Nam Date ACTION DATE BY L/`DECLARATION OF COMnIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY R GULATIONS PART 61 OF TITLE 40AND AQMD RULE. 1403 •.• PERMITEXPIRED U I SUBMITTEDASBESTOS NOTIEICA-004 TO ••• • �` (Ilf"rn.>f'. C ��B,.Ji+r'a. pw(k ✓"� I ®^�� PERMITC4NCELLED EPA • • °� :• s • • • fM,tOOcf�'S 5 /gyp(-�( r 'I gL"wv 5J. PERMITEXTENDED QMD ' • -�z ✓t��c" yJ� TO ALARMS ASBESTOS NOTIFICATION IS NOT APPLICABLE TO �( QQ - yy_) r / INSTALLED "Ii� L PROPOSED OEM011Tj00j.••.• • • ••• 5.1�t� Y4r✓L �i IVe. I.IAOf/S SIGNATURE: + • • • • • /��'� G �J �- '/ V PERMIT FINAL • • s