HomeMy WebLinkAboutS2019-0063 - Permits (3)4 City of Newport Beach - Building Division IIIIII�IIIIIIIIIIIIIIIIIIII�IIIUIIIIIIIIIIII�
II POOLPermit : S2019-0063
j
a. 100 Civic Center Drive, Newport Beach, CA 92660
S 2 0 1 9
0 0 6 3
Project No: 0795-2019
� Permit Counter Phone (949)644-3288
I
Inspection Requests Phone(949)644-3255
Job Address: 8 LUCERNE FloorSuite:
Bldg: 1
Description of WorR:SFR REMOVE (E) FIBERGLASS SPA, INSTALL NEW SHOTCRET SPA 38 SF
-
Inspector Area: 4
Plan Check No, 0796-2019
Code Edit:
2019
Legal Description: TR 9859 LOT 1 UNIT 24 OF. PROJECT LOCATED ON AP.461-121-07
TOGETHER
Owner STIRBGJAMES -
..Contractor::
BACKBAY CUSTOM POOLS
Architect:.
om°o
Address: 8 LUCERNE
Address:
2153-BSAN MICHEL
Address:
.:.°
NEWPORT BEACH, CA 92660
COSTA MESA CA 92627
°°°°
°-°BB9°
Phone: -
Phone .:
949-412.0447 -
Phone: State Lic:
Applicant: CHUCKIBACKBAY CUSTOM POOLS
Con State Lic
813938
Engineer: LACHER RONALD
Address: 2153 B SAN MICHEL E
- Lic Expire:
10/31/2020 :
Address`. 1201 N TUSTIN AVE
7
COSTA MESA, CA92627
Bus Lic
BT30055011
- ANAHEIM CA 92807
Phone: 949.412-0497
Lic Exp Date:
1013112019
Phone:. 714-630-6100. State Lic:C-020949
Building - Rear.
Worker's Compensation
Insurance
Special Conditions:
Setbacks: Front:
Carrier:
WC EXEMPT
Left:
Policy No:
(NO EMPLOYEES)
Right:
Expiration:
Issued Date: 04/0912019
Construction Type
FEES
Construction Valuation: ' $5,800.00
Building Permit Fee. $405.00
Record Management:
$4.00
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:
$118.00
Others
Building. Dep Plan Check: $361.00
$0.00
Building PC Investigation :. $0.00
Additional Fee :
$0.00
-
$0.00
I'I
Plan check Ext.Fee: $0.00.
WQ Compliance Insp Fee: $0.00
TOTAL FEE : $889.00
Plan Check Fee;.
$0.00 Femme Due at Permit suance
: $889.00
PROCESSED BY:
-
PLAN CHECKED BY..
ZONING APPROVAL:
APPROVAL TO ISSUE:
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
ie 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
Irofessions 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
7 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,
lusiness 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
nprovements 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
nproved 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
pply 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).
7 I am exempt from icensure under the Contractors' State License Law for the following reason:
ly�. 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 improve ents c v d b this permit, I cannot legal
ell 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 applicabl law, Se on 7 of the Business and
Irofessions Code! R2�railable upon request when this application is submitted or at the following Web site:hftp://www.leginfo.ca.gov/calaw.htmi.
'ignature of Proper.jc®wner or Authorized Agent Dat
S£EN&D CONTRACTOR'S DECLARATION rr
I affirm undgc'{1eDalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) If the Business and Pro ssions and my license is in full force
,pt1.effllgt. Licensg Class License No Date tt,,,333 ppp Contractor Signature
COKKERS' CQMPENSATION DECLARATION
6AAWINC:FAILURE`7b%E&J1E WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER To CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO TH.
OST 01PCOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
Lieaa-Sy affirm Ma er penalty of perjury one of the following declarations:
�L ....
J'PRgve and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for tl
rKtrlh, lce of the work for which this permit is issued. Policy No.
51 have and w1l`maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatir
(sLtgh'c$ carrier Arid pgjicy number are:
;afde4` ' ' / \ Policy Numb Expiration Date
of Agent
in the performance of the wor for w*h this permi is Is ed, I shall not employ any person in any manner so as to become subject to
become subjectxo the workers' ompensation provi 'o96 of Section 3700 9LIbe-Labor Code, I shall forthwith comply with those provisic
ignature of Applicant / —
IECLARATION REGAR NG CONSTRUCTION LE GENCY
hereby affirm under penalty of perjury that there is a construction lending
enders Name
ly my signature below, I certify to each of the following: /
I am the property owner or authorized to act on the prope r's
I have read this application and the information I have vided is c rr
I agree to comply with all applicable city and county o inances and
I authorize representatives of this city or county to ent the above -id
;ignature of PrODertv Owner or Authorized Acent � 77
ACTION
PERMIT EXPIRED
PERMITCANCELI
PERMIT EXTENDI
POOL ALARMS
INSTALLED
PERMIT FINAL
r the performance of the work for which this permit is issued (Section
Lender's Address
relating to building construction.
Print
DATE BY ! I DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
I SUBMITTED ASBESTOS NOTIFICATION TO
LJASBESTOS NOTIFICATION IS NOTAPPLICABLE TO
PROPOSED DEMOLITION.
FOR OFFICE USE ONLY
Name
workers' compensation laws of California, and agre
- Dat� C '-y—t
Civil Code).