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Home My WebLink AboutS2021-0143 - PermitsI>r�, City of Newport Beach - Building Division *S2021-0143* POOLPermit : S2021-0143 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 1377-2021 Permit Counter Phone (949)644-3288 1N, gPT��`�?Z. - @'.U5 %S P �' � F R-1 Inspection Requests Phone (949)644-3255 °•• •aoa .lob Address: 1815 PORT BARMOUTH PL Floor: Suite: Bldg: 1 °°•° o„°•o Description of Work:SFR NEW POOL & SPA 258 SF W/ DRAINAGE o Inspector Area: 4 Plan Check No: 1377.2021 •, °°•° a Code Edit: 2019 ° °°•° • Legal Description: N TR 6622 LOT 92 •° ° °°° • ° ° ° Owner: BLAKE Contractor: COAST LINE CUSTOM POOLS UNLIMITED Architect: ° ° ° ° • ° ° ° ° ° Address: 1815 PORT BARMOUTH PL Address: 21520 YORBA LINDA BLVD G-430 Address: • ° ° ° ° ° NEWPORT BEACH, CA 92660 YORBA LINDA, CA 92887 a • • ° ° ° ° ° Phone: Phone: 714-585-3294 Phone: State Lic: a °°•° ° Applicant: ELLISON PAUL Con State Lic: 425723 Engineer: LACHER TODD a • ° ° o • •°°ea• • Address: 21520 YORBA LINDA BLVD #G-430 Lic Expire: 08/31/2022 Address: 1201 N TUSTIN AVE ° ° ° ° ° YORBA LINDA, CA 92887 Bus Lic: BT30075610 ANAHEIM CA 92807 Phone: 714-585-3294 Lic Exp Date: 06/30/2022 Phone: 714-630-6100 State Lic:C-067656 Building Rear: Worker's Compensation Insurance Special Conditions: Setbacks: Front: Carrier: EXEMPT Left: Policy No: Right: Expiration: Issued Date: 0712312021 Construction Type FEES Construction Valuation: $44,000.00 Building Permit Fee : $440.00 Record Management: $0.00 Water Quality -- Permit Issuing Fee: $0.00 Building Dept Inspection Fee: $0.00 Investigation Fee: $0.00 Drainage Permit Fee : $237.00 Water Quality Dept Insp Fee: $0.00 Building Green Fee: $2.00 Drainage Plan Check: $199.00 Building Dept WQ Plan Check: $0.00 Plan Dept Plan Check: 10,00 Grading Consultant Fee : $0,00 Others Building Dep Plan Check: $396.00 $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: ZONING APPRO\r I Plan Check Fee: PLAN CHECKED BY:: APPROVAL TO ISSUE PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Fee Due at Permit Issuance : OWNER -BUILDER 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 le 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 rofessions 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 of more than five hundred dollars ($500). 1201 N TUSTIN AVE I, as owns; M%property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, usiness and PIbtESsions 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 pprpirements are-r" 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 npro0ed for 4 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 poll 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). Porn exemptfrornlicensure under the Contractors' State License Law for the following reason: ymy 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 NNestructurd thal Rave 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 rp);gssions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. i89iltyre of Property Owner or Authorized Agent IEEIISED (,ONMCTOR'S DECLARATION -' herEL�byy affirm IMtler denalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section ) ofjDivi ion 3 of the Business and Pro*snsCo n y li nse is in full force nd eifact. License Olass License No Date Contractor Signature ✓ORKERS' COMPENSATION DECLARATION / ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED TH usv n DOLLARS ($100,000), IN ADDITION TO THE DST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm under penalty of perjury one of the following declarations: I 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 performance of the work for which this permit is issued. Policy No. I have 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' compensatiol isurance carrier and policy number are: )arrier Polic ber Expiration Date me of Agent Phone # that, in the pWperjury or hi thi ermit is issued, I shall not employ any person in any manner so as to become subject to the workers' c mpensation laws of California, and agre t, if I should becomactmp n Ion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /J/ oignature of Applicant DatL). �' —'3 �� )ECLARATION REGA LENDING AGENCY hereby affirm under pe is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, .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 beh I have read this application and the information I have p ed is Corr I. I agree to comply with all applicable city and c nt dinan d tate I s relating to building construction. I authorize representatives of this city or count ter th above de led arty for inspection purposes. / signature of Property Owner or Authorized Agent Print Property Owners or Authorized Agent's Nam 4L. ACTION DATE BY DE ATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REG LATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMITEXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO Ail required alarms,latches PERMITCANCELLED EPA gates & fences which serve as part of a pool / spa PERMIT EXTENDED AQ barrier, shall be in place POOLALARMS! p- - BESTCLI[TN PLICABLE TO prior to approval to fill INSTALLED ROPO ED D pool/Spa.& Shall remain in SIGNATURE: place & be maintained for