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Home My WebLink AboutS2021-0082 - PermitsCity of Newport Beach - Building Division `S2021-0082* mac- 2� 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 u " 01 .lob Address: 1017 SANDCASTLE DR Floor: Suite: Bldg: 1 Description of Work:POOL & SPA 390 SF Inspector Area: 6 Legal Description: N TR 6425 LOT 78 Owner: PEDERSEN NIELS & STEPHANIE Address: 1017 SANDCASTLE DR CORONA DEL MAR CA 92625 Phone: 949-228-2833 Applicant: ELLISON PAUL Address: 24642 VIA RAZA LAKE FOREST CA 92630 Phone: 949-683-9861 Building Rear: Setbacks: Front: Left: Right: Construction TVDe : Construction Valuation: $42,000.00 Building Permit Fee : $430.00 Permit Issuing Fee: $0.00 Investigation Fee: $0.00 Building Green Fee: $2.00 Plan Dept Plan Check: $0.00 Building Dep Plan Check: $387.00 Building PC Investigation : $0.00 Plan check Ext. Fee: $0.00 WQ Compliance Insp Fee: $0.00 TOTALFEE: Plan Check No: 0681-�021 Code Edit: 2019 Contractor: CALIFORNIA POOLS Address: 438 N EL CAMINO REAL SAN CLEMENTE CA 92672 Phone: 949-378-6308 Con State Lie: 1054738 Lie Expire: 06/30/2021 Bus Lie: BT30074820 Lie Exp Date: 03131/2022 Worker's Compensation Insurance Carrier: STATE FUND Policy No: 9255343 Expiration: 06/07/2022 FEES Record Management: $4.00 Drainage Permit Fee : $0.00 Drainage Plan Check: $0.00 Grading Consultant Fee: $0.00 Additional Fee : $0.00 Architect: Address: Phone: POOLPermit: S2021-0082 Project No : 0681-2021 Inspection Requests Phone (949)644-3255 Engineer: LACHER TODD Address: 1201 N TUSTIN AVE ANAHEIM CA 92807 Phone: 714-630-6100 Special Conditions: Issued Date: 0611712021 Water Quality- -- Building Dept Inspection Fee: Water Quality Dept Insp Fee: Building Dept WQ Plan Check: Others : State Lie: State Lic:C-067656 $0.00 $0.00 $0.00 $0.00 $0.00 Plan Check Fee : $387.00 Fee Due at Permit Issuance: $436.00 PROCESSED BY: PLAN CHECKED BY:: ZONING APPROVAL: APPROVAL TO ISSUE: - PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION 0 0 0000mc a o a 0 o m �o 0 m m o o ao 0 eoJoc 0 oomom ooaoom 0 o m a m aV>mJaa o c�ooa 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 '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 owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, Usiness and.ProtltAsions 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 esaanot 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 ypryCed for tho"ipose of sale). I, as owner ohhe property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not ppl9 Jo an ownef of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). Tam exempt frons licensure under the Contractors' State License Law for the following reason: ly rrTy signatMb§lbSf 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 Iegalll el*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 'cofassions lde, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. tjWafhre of Mperty Owner or Authorized Agent Date 4Q5WSED CONTRACTOR'S DECLARATION hereby affir%bnc epenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0 ) of D1 isio 3 of the Business and Prof ons my license is in full force and Act. License @lass License No Date �/ J Z( Contractor Signature •.•• CORKERS .RQMNSATION DECLARATION IARNING: FAILURE TO SLCURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINI PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S 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 elfofrnance of the work for which this permit is issued. Policy No. 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' carrier and policy number are: Policy Number of Agent Date I 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' mpensation laws of California, and agre It, if I should becom s bje t e d� 'compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. (nature of Applicant Dat 16471;y !CLARATION REGA)IZIDIRISZONSTRUCTION LENDING AGENCY ereby affirm under phrialty 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). rider'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 di nces and t to la elating to building construction. 6 I authorize representatives of this city or county o nt r th ove tifie roperty for inspection purposes. (- 4/�S `'� Dat Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name ACTION DATE BY DEC TION OF COMPLI CE WITH CODE OF FEDERAL FOR OFFICE_ USE ONLA11 required alarms,latcheS T REGULATIONS PART 610E TITLE 40 AND AQMD RULE Gates & fences which Serve PERMITEXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO — V.' • v, a puur r 0Va barrier, shall be in place PERMITCANCELLED EPA prior to approval to fill PERMIT EXTENDED XLM, pool/spa & shall remain in POOLALARMS BESTOS NOTI C I OTAPPLICABLE TO place & be maintained for INSTALLED P SED DE 0 the life of the Dool/soa