HomeMy WebLinkAboutS2018-0221 - Permitsven� City of Newport Beach - Building Division IIIIL�IIIIIII�IIIIIIII�II�III�IIIIIIII�IIII
II POOLPermit ; S2018-0221
100 Civic Center Drive, Newport Beach, CA 92660
S 2 0 1
8
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Project No'
2894-2018
r1 Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Job Address: 923 SPRING TIDE DR Floor
Suite: Bldg' 1
Description of Work:SFR SPA 130 SF W/ DRAINAGE
Inspector Area: 8
Plan Check No: 2894-2018
Code Edit:
2016
Legal Description: N TR 15243 LOT 41
Owner: AN XU
Contractor:
BLUE FOUNTAIN POOLS & SPAS INC '... Architect:
Address: 923 SPRING TIDE DR
Address:
1151 S GRAND AVE
Address:..
NEWPORT BEACH, CA 92660
-GLENDORA.CA 91740
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Phone: -
Phone'
909-648-4882.
Phone:.
State Lie: +• •
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•
Applicant. MARC/BLUE FOUNTAIN POOLS
Con State Lie.
1004564
- Engineer. LACHERTODD
•
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Address. 1511 S GRAND AVE
Lie Expire
-
0613012019
Address: 1201 N TUSTIN AVE
,
GLENDORA, CA 91740
Bus Lie:
BT30065960
ANAHEIM CA 92807
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Phone: 626335-0006
Lie Exp Date'
02/04/2020
Phone: " 714-630-6100
State LiaC-067656 ....
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Building Rear
Worker's Compensation Insurance.
Special Conditions...
'-� � .. 7
Setbacks Front.
Carrier. - .STATE
COMP. INS
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_
Left:
Policy No:
9231003
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+
Right:
Expiration:
05108/2019
Issued Date: 02106/2019
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Construction Type:
-
•
oao•
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n Es'
FEES
Construction Valuation. $34,000.00
'..
Building Permit Fee: $405 00
Record Management.
- $8.00
Water Quality —
Permit Issuing Fee' $0.00
:Building Dept. Inspection Fee:
$0.00
Investigation Fee: $0.00 -
Drainage Permit Fee'
$312.00
Water Quality Dept Insp Fee:
$0.00
Building Green Fee: $2.00
Drainage Plan Check.
-: $0.00
Building Dept WQ Plan Check:
$0.00
-Plan Dept Plan Check. ` $0.00,
:Grading Consultant Fee'
$708.00
Others
Building Dep. Plan Check: $36*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: $1,840.00
Plan Check Fee :.
$717.00. Fee Due at Permit Issuance : $1,123.00
PROCESSED BY: l -:.
PLAN CHECKED BY:: a
ZONINGAPPROVAL
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 reasons) 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. Section7000) of Division 3 of the Business and.
Professions Code) or that he or she is exempt licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for apermit subjects the applicant to a civil penalty of
not 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 U portions of the work, andthe 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; provided 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 was not built or
improved for the purpose of sale).
111, 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).
❑ 1 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.Ie info.ca.govlcalaw.html. .
Signature of Proq&VONlner or Authorized Agent m Date
UCENS,ED COIITIRACTOR'S DECLARATION
1jIP2b7 affirm under salty of perjury t�iat I am licensed under provisions of C�gpjer�9'(cQm.?gcing with Section 7 0 Divi io 3 of the Business and Pro Sion ode, and my license is in full force
and effect. License Class J 2 License No (i�1 `�' D Date. Contractor Signature
V/OV.eRS' COMPENSATION DECLARATION
WAKyq_N: IN FAILURE TCOMCURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI L PENALTIES AND CIVIL FINES UP TO ONE HUND ED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
cp _O rpMPENSA=I94l,DSkMAGES AS PROVIDED. FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. -
I berebq affirm uri ft.Wnalty, of perjury one of the following declarations:
r•rI ha • ha
0 ve and Will rsrintain 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 Cade, for IN
pe`ormance of the yvork for which this permit is issued. Policy No..
g• I TavP• and wg i'Ippipliin 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' compensatior
i ur ante Carrier and pdicy number are:
C'�[ • • • • Policy Number Expiration Date
Nameof Agent •••• Phone#
I certify that, in the perfor ance of th work for which this permit is issued, I shall not employ any person in any manners o as to become subject to the workers' ompensation laws of California, and agre
that, if I should become su act to the orke ' compensation pro 'SipnLef Section 3700 of the Labor Code, I shall forthwith comply with those
provisions.
2
7
Da ti
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Signature of Applicant
DECLARATION REGA ING CONSTRUCTION LENDING AGENCY
1 hereby affirm under p nalty of perjury that there is a construction lending agency for the performance of the work for which this permit is
issued (Section 30 , Civil Code).
Lender's Name .tender'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 owners behalf.
I have read this application and the information f Pve provided is correct.
I agree to comply with all applicable city and co ty ordi antes and state laws relating to building construction.
I authorize representatives of this city or count o e to a obove-identified property for inspection purposes..
`
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's
Name v(
DMe
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
All Ulfe(ialafmS,IatCI18S
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REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
ga as & fences which serve
1a
PERMITEXP/RED
I SUBMITTED ASBESTOS NOTIFICATION TO
barrier, Shall be In place
prior to approval t0 fill
pool/spa & shall remain in
place & be maintained
PERMITCANCELLED
EPA
PERMIT EXTENDED
QMD
POOLALARMS
BESTOS IFICA ION IS NOT APPLICABLE TO
INSTALLED
POSE D OLITIO
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PERMITFINAL