HomeMy WebLinkAboutS2022-0136 - PermitsCity of Newport Beach - Building Division *S2022-0136*
100 Civic Center Drive, Newport Beach, CA 92660
t; Permit Counter Phone (949)644-3288 _
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POOLPermit : S2022-0136
Project No : 1524-2022
Inspection Requests Phone (949)644-3255
.lob Address: 534 CATALINA DR Floor:
Suite: Bldg: 1
Description of Work:SFR REPLASTER (E) POOL & RELOCATE EQUIPMENT
Inspector Area: 3
Plan Check No:
1524-2022
Code Edit:
2019
Legal Description: FIRST ADD TO NEWPORT HEIGHTS BLK 31 LOT 9
Owner: DENOON
Contractor:
OUTDOOR CONCEPTS
Architect:
Address: 534 CATALINA DR
Address:
28241 CROWN VALLEY PKWY, F293 Address:
NEWPORT BEACH, CA 92663
LAGUNA NIGUEL CA 92677
Phone:
Phone:
949-363-7932
Phone: State Lic:
Applicant: LOUIS THOMAS GABRIEL
Con State Lic:
831378
Engineer:
Address: 28241 CROWN VALLEY PKWY, F293
Lic Expire:
02129/2024
Address:
LAGUNA NIGUEL CA 92677
Bus Lic:
BT30060506
Phone: 949-363-7932
Lic Exp Date:
09130/2022
Phone: State Lic:
Building Rear: 5
Worker's Compensation
Insurance
Special Conditions:
Setbacks: Front: 20
Carrier:
BENCHMARK INS CO
Left: 4
Policy No:
CST5021783
Right: 4
Expiration:
0611812022
Issued Date: 06/14/2022
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FEES
Construction Valuation: $9,000.00
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Building Permit Fee :
$232.00
Record Management:
$2.00
Water Quality ---
Permit Issuing Fee:
$0.00
Building Dept Inspection Fee:
$0.00
Investigation Fee:
$0.00
Drainage Permit Fee:
$0.00
Water Quality Dept Insp Fee:
$0.00
Building Green Fee:
$1.00
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:
$201.84
$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:
PROCESSED BY: R S
ZONING APPROVAL: C L
Plan Check Fee
PLAN CHECKED
APPROVALTOI
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Fee Due at Permit Issuance : $436.84
0 C
OWNER -BUILDER DECLARATION
1 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).
I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) 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 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 1 must have resided for at least one year prior to completion of the improvements covered by this permit, 1 cannot legalh
sell a stru, NT&e Nt 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 Blfde, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of alopgrty Owner or Authorized Agent Date
(SENSED bONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Divis n 3 of the Business and Profession d m Cense is in full force
• aqd'effect. license Class License No DateX Z- (6�/-�>'v' Contractor Signature �/
° WORKERS'MAAPENSATION DECLARATION (�
%%RNING: FAI6LX.TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDREDTH AND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATKINI, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
' f hemby affirm under penalty of perjury one of the following declarations:
° L 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
ffp—e�rformance ef�tbd work for which this permit is issued. Policy No.
Ul-W ve and 411 rrrf*tain 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
ipgu,rance came(and policy number are:
Carrier Policy Number Expiration Date
Name of Agent Phone #
certify 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
that, if I should become subject�'��.e��he or kers'���000mpe�nsja�von provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. / !/
Signature of Applicant ` , !Ai Date C 7
DECLARATION REGA DIN NSTRUCTIO G AGENCY
I hereby affirm under penalty cWperjury that there is a onstruction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Lender's Name Lender's Address
By 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 en e a enro for inspection purposes.
Signature of Property Owner or Authorized Agent nt}'fled Print Property Owner's or Authorized Agent's Name P Date v
ACTION DATE BY E RATION OF COMP IANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
GUL ATIONSS PART 61 OF TITLE 40 AND AQMD RULE
1403 All reouired alarms latches
PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO gates & fences which serve
PERMITCANCELLED LJEPA as part of a pool / spa
PERMITEXTENDED aQMD barrier, shall be in place
POOLALARMS ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO prior approval to fill
INSTALLED PROPOSED DEMOU N. pool/spaa & shall remain in
place & be maintained for
SIGNATURE:
_ _ _ the fife of the pool/spa