HomeMy WebLinkAboutS2021-0091 - PermitsCity of Newport Beach - Building DivisionI IIIII2 IIIIIIIIIIIIIIIIIIIIIIIIIVIIIIIIIIIIIII�IIII II POOLPermit : S2021-0091
100 Civic Center Drive, Newport Beach, CA 92660 P 0 2 1 0 0 9 1
Project No :0765-2021
Permit Counter Phone (949)644-3288
S2 -02-I -UUCI I
Inspection Requests Phone (949)644-3255
.lob Address: 1848 PORT KIMBERLY PL
Floor: Suite: Bldg: 1
Description of Work:SFR SPA 81 SF WI DRAINAGE
Inspector Area: 4
Plan Check No: 0765.2021
Code Edit:
2019
Legal Description: N TR 7029 LOT 29
Owner: HYKES AMY
Contractor:
INSTANT POOLSCAPES
Architect:
Address: 1848 PORT KIMBERLY PL
Address:
833 DOVER DR #24
Address:
NEWPORT BEACH, CA 92660
NEWPORT BEACH CA 92663
Phone:
Phone:
949-795-0648
Phone: State Lie:
Applicant: WRIGHT JC
Con State Lie:
1009644
Engineer: LACHER TODD
Address: 633 DOVER DR #7
- Lie Expire:
12131/2021
Address: 1201 N TUSTIN AVE
NEWPORT BEACH CA 92663
Bus Lic:
BT30053469
ANAHEIM CA 92807
Phone: 949-795-4881
Lie Exp Date:
1213112021
Phone: 714-630-6100 'Statelic:C-067656
Building Rear:
Worker's Compensation Insurance
Special Conditions:
Setbacks: Front:
Carrier:
WC EXEMPT
Left:
Policy No:
(NO EMPLOYEES)
P i
Rig
Exp ration:
Issued Date: 04/0
Construction Type
FEES
Construction Valuation: $45,000.00
a -
Building Permit Fee : $430.00
Record Management:
$4.00
Water Quality -
Permit Issuing Fee: $0.00
Building Dept Inspection Fee:
$0.00
Investigation Fee: $0.00
Drainage Permit Fee :
$232.00
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: $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 : $1,055.00
Plan Check Fee:
$0.00 Fee Due at Permit Issuance
: $1,055.00
PROCESSED BY: °c° °..••-•°.._
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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
to 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
of more than five hundred dollars ($500). 1201 N TUSTIN AVE
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,
lusiness 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
nprovements 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
nproved 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
only 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:
ly 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 legall7
ell 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:http://www.leginfo.ca.gov/calaw.html.
signature of Property Owner or Authorized Agent ate
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000)x0 Qivi ion of the Business and P fessions C d-myl n IiDree-_
nd effect. License Class License No Date `7 ZS G Contractor Signatu
VORKERS' COMPENSATION DECLARATION
DARNING: 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 ($700,000), IN ADDITION TO THE
OST 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:
7 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
erformance of the work for which this permit is issued. Policy No.
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'
rance carrier and policy number are:
Policy Number
Agent
Date
_tl c rtify that, in the performance of wow k for wwil his permit is ' all not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
khat I should become su ject to the workers' n provisions of Section 3700 of the or Code, I shall forthwith comply with those provisions. ��,�{{ .�
Signature of Applicant. Da —_f-1!
)ECLARATION REGA IN CONSTRUC 1 G -A@
hereby affirm under penalty of perjury th ere is onstruction 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 toe a 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 a orrect.
I agree to comply with all applicable city and count orJinances a d state laws relating to building construction.
I authorize representatives of this city or county t enter the ab tified pro a'nspeetien-purposes---
Signature of Property Owner or Authorized Agent Print PropertyOwner's or Authorized Agent's Name W ` Date
ACTION DATE BY N OF COMP WITH CODE OF FEDERAL FOR OFFICE USE ONLY
T 61 OF TITLE 40 AND AQMD RULE
PERMIT EXPIRED
POOL ALARMS
INSTALLED
NOTIFICATION TO
NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
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