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Home My WebLink Abouts2020-0080 - Permits$ City of Newport Beach - Building Division o 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 1027 DOLPHIN TER Floor: Suite: Bldg: 1 Description of Work:SFR POOL & SPA REMODEL 420 SF Inspector Area: 2 Legal Description: N TR 5130 LOT 7 Owner: MEYER HOLDINGS LLC Address: 4320 VON KARMAN AVE NEWPORT BEACH CA 92660 Phone: Applicant: LILLYWHITE SCOTT Address: 27832 HOLLY OAK LN MISSION VIEJO, CA 92691 Phone: 714-900-5708 Building Rear: Setbacks: Front: Left: Right: Construction Construction Valuation: $25,000.00 S 2 0 2 00 0 80��iii Plan Check No: 1102-2020 Code Edit: 2019 Contractor: LILLYWHITE POOLS INC Address: 27832 HOLLY OAK LANE MISSION VIEJO, CA 92691 Phone: 714-900-6708 Con State Lie: 621490 Lie Expire: 1113012021 Bus Lie: BT30073111 Lie Exp Date: 1013112021 Worker's Compensation Insurance Carrier: WESCOINSURANCE Policy No: WSD6048370 Expiration: 05/2212021 Building Permit Fee: $501.00 Record Management: $8.00 Permit Issuing Fee: $0.00 Investigation Fee: $0.00 Drainage Permit Fee : $0.00 Building Green Fee: $1.00 Drainage Plan Check: $0.00 Plan Dept Plan Check: $0.00 Grading Consultant Fee : $0.00 Building Dep Plan Check: $435.87 Building PC Investigation: $0.00 Additional Fee: $0.00 Plan check Ext. Fee: $0.00 WO Compliance Insp Fee: $0.00 TOTALFEE: FEES Architect: Address: Phone: POOLPermit : S2020-0080 Project No: 1102-2020 Inspection Requests Phone (949)644-3255 4411181') aom.o• • • State Lie: ..... • Engineer: BIEDENBACH CHRISTOPHER .... Address: 1201 N TUSTIN °,.°•° ANAHEIM CA 92807 Phone: 714-630-6100 State Lic:C-074003 Special Conditions: m°.m Issued Date: 1010512020 ° ° ° ° • Water Quality Building Dept Inspection Fee: $0.00 Water Quality Dept Insp Fee: $0.00 Building Dept WQ Plan Check: $0.00 Others $0.00 $0.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $945.87 PROCESSED BY: C%J�/ PLAN CHECKED BY:: D ZONING APPROVAL: l / 1C../ APPROVAL TO ISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION • m • °. ° m.om• .mmQ•. • • ° me•• 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) ;action 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 e 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 ofessions 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 A more than five hundred dollars ($500). 1201 N TUSTIN ❑ as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business )d 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 (proved for the purpose of sale). 1 1, 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 )ply 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 I am exempt from licensure under the Contractors' State License Law for the following reason: I 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 legall) III a structure 41W 144ve 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 ofessions Code, is afailable upon request when this application is submitted or at the following Web site:http://www. leginfo.ca.gov/calaw.html. oveUile of Propa*.Owner or Authorized Agent Date CENSED CbAMACTOR'S DECLARATION feleffyaffirm uncipr penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 ) of Division 3 of the Business and Pro io od t&se I force Id effect. Licegs e.Qlass License No DContractor Signature 4DRKgRS' C'QVP9NSATION DECLARATION \RNRA: FAILURE J%SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUND D THOUSAND DOLLARS45700,000). IN ADDITION TO THE V4 GE COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. iP913y1affirm under penalty of perjury one of the following declarations: L0have and wdl maiptain 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 thI Irformance of *a �vmgfor which this permit is issued. Policy No. 13?4and will"aiatain 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 sV se cariel'"WIlticy number are: wrier Policy Number Expiration Date Vame of Agent Phone # :11 certify that, in the pWJect f the�work for w is th' permit -ssued, I shall not employ any person in any manner so as to become subject to the workers' mpensation laws of California, and agre hat, if I should become ' co a Ion pro s of Section 3700 of the Labor Code, 1 shall forthwith comply with those provisions.Signature of Applicant J Date DECLARATION REGATRUCTI N L ING AGENCY hereby affirm under pry that there is construction lending agency for the performance of the work for which this permit is issued (Section 3097, ivi 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 information I have provided is correct. I agree to comply with all applicable city and c un ord' anc " and at a r o building construction. I authorize representatives of this city or coun t en th o e-i ' ed r y for inspection purposes. 3ignature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name"e� Z(Lc <l.1 -- D �0-S -�/>d ACTION DATE BY XCLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY 1 REGULATIgNS PARff 61 OF TITLE 40 AND AQMD RULE PERMIT EXPIRED SUBMITTED ASBESTOS NOTIFICATION TO gates & fences which serve as part of a pool / spa barrier, shall be in place prior to approval to fill pool/spa & shall remain in place & be maintained for life of the ool/sPa PERMITC4NCELLED EPA PERMIT EXTENDED MAID POOL ALARMS \ INSTALLED / / / SBEST N IFA ATICnIS NOT AP ICABL PROP EDION.�L�- SIGNATURE: fi PERMIT FINAL 7- Athe X