HomeMy WebLinkAboutS2020-0035 - Permitsi ¢ City ofcDrive, Newport Be a eh - B Aildi og Division
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Permit Counter Phone (949)644-3288
POOLPermit : S2020-0035
Project No : 0421-2020
Inspection Requests Phone (949)644-3255
Job Address: 46 SEA TERRACE Floor:
Suits: Bldg: 1
Description of Work:SFR REPLASTER (E) POOUSPA & YARD DRAINAGE
Inspector Area: 6
Plan Check No:
0421-2020
Code Edit:
2019
Legal Description: N TR 14581 LOT 37
i
Owner: SWARTZ DAVE & KIMBERLY
Contractor:
LEESE DAVE CONCRETE
Architect:
Address: 46 SEA TERRACE
Address:
16801 ROCKFIELD BLVD
Address:
NEWPORT COAST, CA 92657
IRVINE CA 92618
Phone:
Phone:
949-677-2835
Phone:
State Lic:1
Applicant: ELLISON PAUL
Con State Lic:
656338
Engineer: FORBES DALE L�
iY
Address: 24642 VIA RAZA
Lic Expire:
10/31/2022
Address: 1800 E 16TH ST #B
LAKE FOREST CA 92630
Bus Lic:
BT30058837
SANTA ANA CA 92701
�1
Phone: 949-683.9861
Lic Exp Date:
04130/2021
Phone: 714-835-2800
State Lic:C-030407
Building Rear:
Worker's Compensation
Insurance
Special Conditions:
-
Setbacks: Front:
Carrier:
SECURITY NATIONAL
Left:
Policy No:
SW51000052
Right:
Expiration:
0511412021
Issued Date: 02112/2021
Construction Type: VB
FEES
Construction Valuation: $12,000.00.
Building Permit Fee : $280.00
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: $1.00
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: $243.60
$0.00
Building PC Investigation : $0.00
Additional Fee :
$0.00
$0.00
Plan check Ext. Fee: $66.00
WQ Compliance Insp Fee: $0.00
TOTAL FEE : $1,021.60
PROCESSED BY:
ZONING APPRO�
Plan Check Fee:
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PCANrHECKED BY::
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PERMIT EXPIRES 180 DAU AFTER 1€9111ANCE GR LA-�iT`,VALID INSPECTION
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Fee Due at Permit Issuance :
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 applicableetem(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 malty of
not more than five hundred dollars ($500). 1800 E 16TH ST #B
❑ 1, 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' 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
'mproved 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' Stale 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 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 ) o ivi on 3 of the Business and Pro ss ode, y license is in full force
and effect. License Class License No Date S Contractor Signatu
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 (E100,000(, IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY-S FEES.
hereby affirm under penalty of perjury one of the following declarations:
❑ 1 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
oe rmance of the work for which this permit is issued. Policy No.
ve 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
suran .cam\ nd policy n a are:
Carrier licy umber Expiration Date
Name of Ag Phone #
❑I certify that, in the perfor o he for wh' 's 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 afire
that, if I should become su act t e r ' co a ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant
areby affirm under 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 pro ' ed is corre .
I agree to comply with all applicable city and county or nan a nd ate I s r ng to building construction.l—
I authorize representatives of this city or county to th ove= a ad art ' spection purposes.
mature of Prooerly Owner or Authorized Agent Print Pro ertOwners or Authorized Agent's Name)
ACTION
DATE
BY
DEI ARATTG-N OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
All required alarms,latches
1403 •.• ..♦ ... •
gates & fen ;.; which aANP
PERMIT EXPIRED
U I SUBMITTED ASBESTOS NOHIFICAd10N TO . •
, ` as part of a pool / spa
barrier, shall be in place
prior to approval to fill
PERMIT CANCELLED
EPA
PERMIT EXTENDED
QMD
pool/spa & shall remain in
POOL ALARMS
ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO
place & be maintained for
INSTALLED
PROPOSED DEMOLITION. ,•� "� ••• •`•
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SIGNATURE: " 0` ` ` •
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