HomeMy WebLinkAboutS2021-0250 - PermitsCity of Newport Beach - Building Division 111111111111111ININ
100 Civic Center Drive, Newport Beach, CA 92660
,w r Permit Counter Phone (949)644-3288
.lob Address: 6 WHITESANDS DR Floor: Suite: Bldg: 1
Description of Work:REPLASTER POOL AND SPA (REPLACE EXP PERMIT S2013-0088)
Inspector Area: 6
Legal Description:
Plan Check No: 2110-2013
Code Edit: 2010
Owner:
SIERRA YOLANDA & GERARDO
Contractor:
ORANGE COUNTY POOLS INC
Address:
6 WHITESANDS DR
Address:
960 6TH ST 101A-148
NEWPORT BEACH CA 92651
NORCO CA 92860
Phone:
Phone:
714-225-2907
Applicant: MARINO SHAWN
Con State Lic:
839719
Address:
39695 REDONDA MESA RD
Lic Expire:
06130/2022
MURRIETA CA 92562
Bus Lic:
BT30072637
Phone:
714-926-9121
Lic Exp Date:
08/31/2022
Building
Rear:
Worker's Compensation Insurance
Setbacks:
Front:
Carrier:
W/C EXEMPT
Left:
Policy No:
Right:
Expiration:
Construction Type
11
FEES
Construction Valuation: $0.00
Building Permit Fee :
$0.00
Permit Issuing Fee:
$0.00
Investigation Fee:
$0.00
Building Green Fee:
$0.00
Plan Dept Plan Check:
$0.00
Building Dep Plan Check:
$0.00
Building PC Investigation :
$0.00
Plan check Ext. Fee:
$0.00
WQ Compliance Insp Fee:
$0.00
TOTAL FEE:
PROCESSED
ZONING APP
Record Management
Drainage Permit Fee :
Drainage Plan Check:
Grading Consultant Fee
Additional Fee :
POOLPermit : S2021-0250
Project No: 2110-2013
Inspection Requests Phone (949)644-3255
Architect:
Address:
Phone:
State Lic:
Engineer:
PASOL DAWN
Address:
650 E PARKRIDGE AVE #110
CORONA CA 92879
Phone:
951-734-0978 State Lio:C-061163
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Special Conditions:
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Issued Date:
11/01/2021
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$11.00
Water Quality ---
Building Dept Inspection Fee:
$0.00
Water Quality Dept Insp Fee:
$0.00
_ Building Dept WQ Plan Check:
$0.00
Others
$204.00
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$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee : $0.00 - -- Fee Due at Permit Issuance : $215.00
PLAN CHECKED BY::
APPROVALTOISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 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). 650 E PARKRIDGE AVE #110
❑ 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,
iprovided 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
iwas 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).
❑ I 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.html. 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 o hapt 9 (commencing with Section 7000) of sion 3 of the Business and
Professions Codey and my license is in full force and effect. License Class License No Date .v— { Contractor
Rinnature
VXRS' COMPENSATION DECLARATION
ING:1FAILURE46E®NRE 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
o6COMPENSATION, DAMAGES As PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
ipi %ffirm under penalty of perjury one of the following declarations:
•...
hV 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 IN
alrance of t[Mkdork for which this permit is issued. Policy No.
''% and vfII; iMain 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' compensatiol
tAce carrier and policy number are:
'I = Policy Number Expiration Date
of Agent"!
Pf that, is 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
should be"c&Mfl subct to the ers' ompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant
CLARATION REGARDING CONSTRUCTION LENDING AGENCY
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 counity,,ordinances and state laws relating to building construction.
I authorize representatives of this city or county enter;4b entified property for inspection purposes. i /j .A
Signature of Property Owner or Authorized Agent v wner's or Authorized Agent's Name oofE r r' �' J / y— ate en '-
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY 11 I
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
gates IL fences which serve
1403
as part of a pool / spa
PERMITEXPIRED
0 I SUBMITTED ASBESTOS NOTIFICATION TO
Carrier, S a Lie in pizi
prior to approval to fill
PERMITCANCELLED
EpA
pool/spa & shall remain in
PERMIT EXTENDED
QMD
place & be maintained for
the life of the poo pa
POOLALARMS
D ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
INSTALLED
PROPOSED DEMOLITION.
X
SIGNATURE:
PERMITFINAL