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Home My WebLink AboutS2019-0172 - Permits' City of Newport Beach - Building Division I IIN III P001-Permit: S2019-0172 D 100 Civic Center Drive Newport Beach, CA 92660 5 2 0 1 9 0 1 7 2 Permit Counter Phone (949)644-3288 Project NO : 2305-2019 Inspection Requests Phone (949)644-3255 Job Address: 1991 PORT TRINITY CIR Floor: Suite: Bldg: l Description of Work:SFR DEMO (E).POOLISPA &REPLACE W/NEW POOLISPA 480 SF Inspector Area 4 Plan Check No: 2305-2019 Code Edit: 2016 Legal Description: N TR 7031 LOT 14 00 Owner COHEN MICHAEL Contractor: BAYLESS JEFF ENTERPRISES - Architect: 'Address: 1991 PORT TRINITY CIR Address: 108 AVE BUENA VENTURA #B Address: 66T,,J�. NEWPORT BEACH, CA 92660 SAN CLEMENTE, CA 92672 Phone Phone: 951.830-6264 Phone: State Lie: r"1 Applicant: BAYLESS JEFF Con State Lie: 371092 Engineer: BIEDENBACH CHRISTOPHER Address: 108 AVE BUENE VENTURE #B. Lie Expire: 1013112020 Address: 1201 NTUSTIN SAN CLEMENTE CA 92672 Bus Lic: BT30063918 - ANAHEIM CA 92807 Phone 951-830-6264 Lie Exp Date: 02/28/2020 Phone: 714-630-6100 State Lic:C-074003 Building Rear: 10' : Worker's Compensation Insurance Special Conditions: Setbacks. Front: 20' Carrier: STATE COMP X2018-3649 YARD DRAINGE Lek: 5' Policy No: 9092149 Right: 6' Expiration: 03/11/2020 Issued Date: 1012112019 Construction Type : - FEES Construction Valuation: $50,000.00 Building Permit Fee: $418.00 Record Management: $16.00. 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: $2.00 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: $373.00 - $0.00 Building PC Investigation : $0.00 Additional Fee : $294.00 .. $0.00. Plan check Ext. Fee: $0.00 WQ Compliance Insp Fee: $0.00 -TOTAL FEE : $1,092.00 Plan Check Fee : ..$0.00 Fee Due at Permit Issuance : $1,092.00 PROCESSED BY:. _ ;000 o m .ed V4N CHECKED BY. ZONING APPROVAL <c I �. _m y`a c aE jPPROVALTO ISSUE: m o oc PERMIT EXPIRES 180�17)G:YS AFTER ISS UAW;E°OE PAST 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) (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). 1201 N TUSTIN I, 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 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 improved 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 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). ❑ 1 am exempt from licensure under the Contractors' State License Law for the following 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 permit, I cannot 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 Business and Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Signature of Property Owner or Authorized Agent D e LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 f DJyI��i ioqq f the Business and Profe s o y lic nse full force and effect. License Class License No Dat -�4 / Contractor Signatur WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOU AN LLARS ( 100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: I 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 th, pert rmance of the work for which this permit is issued. Policy No. ZI 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' compensatiol rsurance carrierpAd. �3/ipyymmar g., �11''RR1l��l��// �/ I0 FlnliQviNumber Expiration Date ne of Agent V ..... .. certify that, in the perform nce w rk hich thi pe is sued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre I, if I should become Dbje to rker nsat n pr isi s of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant D CLARATION REG RIDING C I N LEN NG AGENCY Ireby affirm under penalty o e ' ry at there is a co struction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Ider's Name Lenders Address 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 pr, vl d is correct I agree to comply with all applicable city and county Ord' c s and state ws relating to building construction. � P`�` ry/ 1 I authorize representatives of this city or county,(o At boko�r11ifiipr ert for inspection purposes. _ Y � Y�-r�-J 47G�-, -Ri6 \n �2 C_� ACTION DATE BYT F COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY t G NS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMITEXPIRED SUBMITTED ASBESTOS NOTIF TIONWO .• • : ° PERMITCANCELLED EPA • - • e • i i • • • • • •• PERMIT EXTENDED QMD POOL ALARMS ASBESTOS NOTIFICATION IS NOT APPLICABLE TO INSTALLED PROPOSED DEMOLITION. ••o ••• • • ••• ATURE: PERMIT FINAL TCJ'rw' 71-10 � • • u