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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).