HomeMy WebLinkAboutS2020-0188 - PermitsCity of Newport Beach - Building Division IIIII�IIIIIIIIIIIIIIIII��IIIIIIIIIIIIIIIII II
100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 2 0 0 1 8 8
F Permit Counter Phone (949)644-3268
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Job Address: 1830 HIGHLAND DR Floor: Suite:
Description of Work:SFR NEW POOLISPA 288 SF
Inspector Area: 3
Legal Description: N TR 3057 LOT 48
Owner:
ROTHBARD JEREMY
Address:
1830 HIGHLAND DR
Water Quality ---
NEWPORT BEACH, CA 92660
Phone:
714-993.0554
Applicant: PROMONTORY POOLS INC
Address:
17401 IRVINE BLVD STE B
03131/2021
TUSTIN CA 92780
Phone:
714-993-0554
Building Rear:
Setbacks: Front:
Left:
Right:
'unsuucuun
Construction Valuation: $40,000.00
Bldg: 1
Plan Check No: 2099-2020
Code Edit: 2019
Contractor:
PROMONTORY POOLS INC
Address:
17401 IRVINE BLVD STE B
Water Quality ---
TUSTIN CA 92780
Phone:
714-993.0554
Con State Lie:
404194
Lie Expire:
03131/2021
Bus Lie:
BT30043247
Lie Exp Date:
0513112021
Worker's Compensation Insurance
Carrier: EXEMPT
Policy No: NO EMPLOYEES
Expiration:
FEES
Architect:
Address:
Phone
P001 -Permit: S2020-0188
Project No: 2099-2020
Inspection Requests Phone (949)644-3255
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Engineer: THOMPSON MATTHEW
Address: 12021 N TUSTIN AVE
ANAHEIM CA 92807
Phone: 714-630.6100
Special Conditions
Issued Date:
11/1312020
State Lie:
State Lic:C-086051
Building Permit Fee :
$430.00
Record Management:
$10.00
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:
$0.0o
Plan Dept Plan Check:
$0.00
Grading Consultant Fee:
$0.00
Others:
Building Dep Plan Check:
$387.00
$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
PROCES
ZONING
TOTALFEE:
Plan Check Fee: $0.00 Fee Due at Permit Issuance :
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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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). 12021 N TUSTIN AVE
LJ 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,
Business and Professions Code: The Contractors' Stale 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' Stale 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 legal
sagastructure(jlat•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
Profetsions bode, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
Signelure of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirrA Ufld&i enalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0 f Di ision 3 of the Business andkof!es on de, d my li Lnse is in full force
addatTect. License+Class License No Dat 7.0 Contractor Signa
•
MRKERS'_Z(5W1ENSATION DECLARATION
ryAaNWG: FAILURE 10 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
COST SF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
•••
I hereby affirmalhder penalty of perjury one of the following declarations:
r
e and �flivaintain 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 IN
nce oi6the w o Pk 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' compensatior
e carrier and policy number are:
Policy Number Expiration Date
Vame of Agent Phone #
DI certify that, in th pegtf
f t �Drkrich 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 agree
:hat, if I -should beco h w ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applies I D
DECLARATION RE ACTION LENDING AGENCY
hereby affirm unde pejury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 309 , C it Code).
-ender's Name Lender's Address
3y 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 informatio#hav vide co t.
Iagree to comply with all applicable city and es ate taws relating to building construction.
I authorize representatives of this city or coupe o dan'f' roperty for inspection purposes.
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name 44LAZ&4
4�1Did li
ACTION DATE BY - - RATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE '
1403All required alarms,latches
PERMIT EXPIRED jai SUBMITTED ASBESTOS NOTIFICATION TO Yates a femneb Which but vu
as part Of a p001 I Spa
PERMITCANCELLED LIEPA - barrier, shall be in place
PERMITEXTENDED D prior to approval to fill
POOL ALARMS ESTOS T AT OTAP BLE TO pool/spa & shall remain in
INSTALLED ROPO D to place & be maintained for
SIGNATURE: the life Of the poollspa
PERMIT FINAL 1'� } I X dict-
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