HomeMy WebLinkAboutX2020-1419 - PermitsCity of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
H _ Permit Counter Phone (949)644-3288
v - Inspection Requests Phone (949)644-3255
r wv T Combination Type - BLDG
COMB Permit: X2020-1419
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Project No: 2012-2019
Issued Date : 06/19/2020
Inspection Area : 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 06/2012023 OR PERMIT IMLL BE INVALID
Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays
Job Address: 2141 INDIAN SPRING LN NB
Description: DELTA 2 -ADD SLIDE TO POOL
Legal Desc.: N TR 6689 LOT 1
Owner:
CHASON CLIFTON
Contractor:
SWAN POOLS OF SOUTHERN CA
Architect:
$4.00
Address:
2141 INDIAN SPRING LN
Address:
24512 BRIDGER ROAD
Address:
$0.00 --
Hazardous Mat
NEWPORT BEACH, CA 92660
Building Green Fee:
LAKE FOREST CA 92630
$0.00
NMUSD Fee:
Phone:
General Service
Phone:
949-859-8466
Phone:
$0.00
Applicant:
RUIZ MICHAEL
Con State Lic:
440333
Engineer:
LACHER TODD
Address:
24512 BRIDGER ROAD
Lic Expire:
03/31/2022
Address:
1201 N TUSTIN AVE
LAKE FOREST CA 92630
Bus Lic:
BT96008994
ANAHEIM CA 92807
Phone:
949.859.8466
Lic Exp Date:
07/3112020
Phone:
714-630-6100
Code Edit: 2019
Type of Construction:
Occupancy Group: U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 0
No of Units : 0
Bldg Height: 0
Bldg Sprinklers:
Construction Valuation:
Building Permit Fee: $167.00
Plan Check Fee: $162.69
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$4.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00 --
Hazardous Mat
$ 90
Building Green Fee:
/$1.00
FEE : $396.19
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Worker's Compensation Insurance
Carrier: STATE FUND
Policy No: 9228545
Expire: 04/0112021
Building Setbacks
Use Zone:
Excise Tax:
Additional Fee:
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
at %:
1 %:
Rear: /
Front: /
Left: I
Right: I
�arkina Spaces
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee
Designer:
Address:
Phone:
Special Conditions:
Planning Department -
Plan check Fee:
Fair Share
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SJH Trans
Fire Inspection:
In -lieu Housing Fee:
$0.00
Public Works Department -
Park Dedication :
$0.00
PAN Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
$0.00
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State Lic:
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State Lic:C-067656 ....
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PUBLIC WOR'S APPROVAL:
PLAN CHECK B
APPROVAL 1O ISSUE.
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Fire Department
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$41.50
Fire Inspection:
$0.00
$0.00
Fire Plan Rev
$0.00
$0.00
Demolition Fee
$0.00
Building Dept Adm
$0.00
General Service
$0.00
Refund Deposit
$0.00
Grading Bond:
$0.00
$0.00
$0.00
-Du® a! Permit Issuance :
$396.19
PUBLIC WOR'S APPROVAL:
PLAN CHECK B
APPROVAL 1O ISSUE.
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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)
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
ie 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
3t more than five hundred dollars ($500).
] I, 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,
usiness 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
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
1proved for the purpose of sale).
1 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
pply 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 following reason:
y 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 Iegalll
s11 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:htip://www.leginfo.ca.gov/calaw.html.
ignature of Property Owner or Authorized Agent Date
ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 000 Mtn 3 of the Business and Pro s'
ALTIEs o a y titan a is in full force
nd effect. Lice R3rdt;llpss License No Date Contractor Signature
lORnRS' COMPENSATION DECLARATION
AMA. FAILURE TQ I&IME WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI AL PENS AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
DST OFtOMPENSATIONFDAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
Htelfyaffirm under penalty of perjury one of the following declarations:
eve and yrljll,pi@Qltain 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
rfor ace of the wont for which this permit is issued. Policy No.
rye nd wyll'mainrein 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' compensatioi
isuran carrier a11C{Solicy number are:
Policy Number Expiration Date
vrovuiryeur . ------- -
I@DT efy that, in jfle�Rerformance of a work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensate n laws of California, and agre
ITat,.iL" ould bet o m subj o the r 'on provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
PP,�
signature of Applicant Dat _ `'G �V
)ECLARATION REGA ]NG CONSTRUCTION LENDINGGENCY
hereby affirm under pe ally of perjury that there is a constru tion lending agency for the performance of the work for which this permit is issued (Section 3097, Civil 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' ehalf.
I have read this application and the information I have provided is or ct.
I agree to comply with all applicable city and county ordinanc s a d s ate laws relating to building construction.
I authorize representatives of this city or county to ante v i I property for inspection purposes. ��ee
signature of Pro ertOwner or Authorized Agent Print Property Owner's or Authorized Agent's Name rVr 1 14t�t Date LC G
ACTION DATE BY DE RATION OF COMPLIAN4 WITH CODE OF FEDERAL FOR OFFICE USE ONLY /
REGULATIONS PART 61 OF TIT E 40 AND AQMD RULE
I SUBMITTED
PERMITCANCELLED
PERMIT EXTENDED
K el
PERMITFINAL r1 ❑ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO
CERTIFICATEOF ll 6I aD 9t \` PROPOSED DEMOLITION
OCCUPANCYISSUED P ®/ �� SIGNATURE: