HomeMy WebLinkAboutS2020-0181 - Permitsa
City of Newport Beach - Building Division llllllllllPOOLPermit: S2020-0181
100 Civic Center Drive, Newport Beach, CA 92660Project No :1791-2020
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255 ,
Job Address: 1612 HIGHLAND DR Floor: Suite: Bldg: 1
Description of Work:SFR POOL & SPA 502 SF $ YARD DRAINAGE
Inspector Area: 3 Plan Check No: 1791-2020
Code Edit: 2019
Legal Description: N TR 3800 LOT 8
Owner:
AMBER GREGGIREBECCA
Contractor:
SALT AND SEA POOLS
Address:
1612 HIGHLAND DR
Address:
22 KENDALL ST
NEWPORT BEACH, CA 92660
Building Dept Inspection Fee:
LAGUNA NIGUEL CA 92677
Phone:
$0.00
Phone:
949-910-6125
Applicant: GREGG REBECCA
- Con State Lic:
1044957
Address:
1612 HIGHLAND DR
Lie Expire:
09130/2022
$0.00
NEWPORT BEACH CA 92660
Bus Lie:
Grading Consultant Fee:
Phone:
Others :
Lie Exp Date:
Building Dep Plan Check:
Building Rear:
Setbacks: Front:
Left:
Right:
Construction Tvoe :
Construction Valuation: $50,000.00
Worker's Compensation Insurance
Carrier: NO EMPLOYEES
Policy No:
Expiration:
FEES
Architect
Address:
Phone: State Lie
Engineer: BIEDENBACH CHRISTOPHER
Address: 1201 N TUSTIN
ANAHEIM CA 92807
Phone: 714-630-6100 State Lic:C-074003
Special Conditions
Issued Date: 11/10/2020
Building Permit Fee:
$430.00
Record Management:
$8.00
Water Quality ---
Permit Issuing Fee:
$0.00
Building Dept Inspection Fee:
$0.00
Investigation Fee:
$0.00
Drainage Permit Fee:
$232.00
Water Quality Dept Insp Fee:
$0.00
Building Green Fee:
$2.00
Drainage Plan Check:
$195.00
Building Dept WQ Plan Check:
$0.00
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
,
TOTAL FEE: $1,254.00
Plan Check Fee :
$0.00 Fee Due at Permit Issuance
: $1,254.00'
PROCESSED BY:
OD 400 0G0 O
f00 L
-
PLAN CHECKED BY::
ZONING APPROVAL:
APPROVAL TO ISSUE: - (--!
-.
'
'PERMIT EXFIRGS' 18E1 DAYS LIFTER ISSUANCE
o00 roc w v t, o00 oc�
OR LAST 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 11
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 legalh
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 Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0 )tof ivision 3 of the Business and Pr fess' s ode,�ra se' 'r'full force
and effect. License Class License No Date l 0WContractor Signatu L 6�_
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 HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3703 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
:11 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
3erformance of the work for which this permit is issued. Policy No.
❑1 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' compensatioi
'nsurance carrier and policy number are:
Policy Number
Date
me of Agent -rnone s
I�pertify 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 agre
t, I should becom�,bjo he workerGa ens'on provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.nature of ApplicaCLARATION R ASTRUC ON LENDING AGENCY
rreby affirm and 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).
rder's Name Lender's 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 provided is correct.
I agree to comply with all applicable city and county ordin nces and state laws relating to building construction.
I authorize representatives of this city or cou e r e fieHgaperty for inspection purposes.
nature of Property Owner or Authorized Agent 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
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