HomeMy WebLinkAbouts2022-0104 - Permitsyw r, City of Newport Beach - Building Division *S2022-0104`
100 Civic Center Drive, Newport Beach, CA 92660
,, =v Permit Counter Phone(949)644-3288
.lob Address: 20 COLONIAL DR Floor.Suite: Bldg: 1
Description of Work:SFR POOL REPLASTER AND DRAINAGE.
Inspector Area: 4
Legal Description: N TR 15389 LOT 44
Owner: PIETSCH DAVID
Address: 20 COLONIAL DR
NEWPORT BEACH, CA 92660
Phone: 808-282-2313
Applicant: ARTISAN OUTDOOR / ARIA
Address: 1653-B SUPERIOR AVE
COSTA MESA, CA 92627
Phone: 949-235-8058
Building Rear:
Setbacks: Front:
Left:
Right:
Construction
Construction Valuation: $2,600.00
POOLPermit : S2022-0104
Project No : 1156-2022
Inspection Requests Phone (949)644-3255
Plan Check No: 1156-2022
Code Edit: 2019
Contractor: ARTISAN OUTDOOR LLC
Address: 1653-B SUPERIOR AVE
COSTA MESA CA 92627
Phone: 949-424-5870
Con State Lic:
1001086
Lic Expire:
02128/2023
Bus Lic:
BT30055442
Lic Exp Date:
06/3012022
Worker's Compensation Insurance
Carrier: TECHNOLOGY INS
Policy No: TWC3954494
Expiration: 02/06/2023
Building Permit Fee :
$130.00
Record Management:
$4.00
Permit Issuing Fee:
$0.00
Investigation Fee:.
$0.00
Drainage Permit Fee :
$237.00
Building Green Fee:
$1.00
Drainage Plan Check:
$199.00
Plan Dept Plan Check:
$52.00
Grading Consultant Fee :
$0.00
Building Dep Plan Check:
$113.10
Building PC Investigation :
$0.00
Additional Fee :
$0.00
Plan check Ext. Fee:
$0.00
WQ Compliance Insp Fee:
$0.00
TOTAL FEE : $736.10
PROCESSED BY: �--� (1���
ZONING APPROVAL: lfi
FEES
Architect:
Address:
Phone: State Lie:
Engineer:
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Special Conditions:
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Issued Date: 05/06/2022
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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 : $364.10
Fee Due at Permit Issuance : $372.00
PLAN CHECKED BY:: VC/
APPROVALTOISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE 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 icensure 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).
I, 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
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-Builderwill 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 owrier 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 COMT.RACTOR'S DECLARATION
hereby�affirm u'wjp; penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of ivis on 3 of the Business and Profession e, Cans is in full f e
y nc+eect. Ligeple Class License No Date Contractor Signature
IIVORJKERS' d0%PI!NSATION DECLARATION r
�ARNIN& FAILURE Tp 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 8F COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
Ireby affirm �e`rpenalty of perjury one of the following declarations:
•-.,
0 I lhave4nd AII,giaintain 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
�B,e,and
nce cr tlTe wade for which this permit is issued. Policy No.
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wig 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' compensatioccarrigr aV policy number are:
r:arriar '__• • Policv Number Expiration Date
is of Agent.
certify that; Ih the pI
if I should become
of
ice 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
to kers' compensat on rovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
77Date _
JONS UCTI L DI GENCY
Ireby 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)
Ider'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 ordinances and state laws relating to building construction.
I authorize representatives of this city or county to nter theme/,¢bove= le p rty for inspection purposes. / ��t1 �/I/I I
nature of Property Owner or Authorized Aoent // _.. Print Property Owner's or Authorized Agent's Nal;, / 1 K;rA Y 1' w b)
ACTION DATE BY REGULATIONS OART610 OF 40 AND AQ OF FEDERAL
ULE AL FOR OFFICE USE
PERMIT EXPIRED
I__I I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED
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PERMIT EXTENDED
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POOLALARMS
INSTALLED
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ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE:
PERMITFINAL
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