HomeMy WebLinkAboutS2021-0261 - Permits�scer City of Newport Beach -Building Division *S2021-0261*
d 100 Civic Center Drive, Newport Beach, CA 92660 p�
Permit Counter Phone (949)644-3288 INL.Aiz
i9
Job Address: 1033 WHITE SAILS WAY Floor: Suite: Bldg: 1
Description of Work:NEW POOL AND SPA (2281103 SF)
Inspector Area: 6
Legal Description: N TR 2202 LOT 21
Owner: HOUPTJONATHAN
Address: 1033 WHITE SAILS WY
NEWPORT BEACH CA 92625
Phone:
Applicant: DEVORE ERIC
Address: PO BOX 828
SAN JUAN CAP CA 92693
Phone: 949-370-9576
Building Rear:
Setbacks: Front:
Left:
Right:
Construction Tvoe :
Construction Valuation: $70,000.00
Building Permit Fee :
$440.00
Permit Issuing Fee:
$0.00
Investigation Fee:
$0.00
Building Green Fee:
$3.00
Plan Dept Plan Check:
$0.00
Building Dep Plan Check:
$396.00
Building PC Investigation :
$0.00
Plan check Ext. Fee:
$0.00
WQ Compliance Insp Fee:
$0.00
TOTALFEE: $1
PROCEE
ZONING
POOLPermit: S2021-0261
Project No : 2741-2021
Inspection Requests Phone (949)644-3255
Plan Check No:
2741-2021
Code Edit:
2019
Contractor:
DE VORE POOLS &SPAS
Architect:
°
Address:
PO BOX 828
Address:
SAN JUAN CAPSTRNO CA 92693
Phone:
949-547-1366
Phone: State Lie:
°
Con State Lie:
401549
Engineer: PETROV PLAMEN
Lie Expire:
04/30/2022
Address: 28161 CASITAS CT
Bus Lie:
BT97026761
LAGUNA NIGUEL CA 92677
Lie Exp Date:
11/30/2022
Phone: 714-717-7542 State Lic:C-066947
Worker's Compensation Insurance
Special Conditions:
Carrier:
STATE COMP INS
Policy No:
1222520
Expiration:
11101/2022
Issued Date: 12108/2021
0°°°°6
FEES
Record Management:
$16.00 Water Quality
--
Building Dept Inspection Fee:
$0.00
Drainage Permit Fee:
$0.00
Water Quality Dept Insp Fee:
$152.00
Drainage Plan Check:
$0.00
Building Dept WQ Plan Check:
$0.00
Grading Consultant Fee :
$0.00 Others:
$0.00
Additional Fee :
$0.00
$0.00
Plan Check Fee : $344.00
Fee Due at Permit Issuance : $663.00
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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) 1 have placed next to the applicable item(s)
ction 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
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
fessions 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
more than five hundred dollars ($500). 28161 CASITAS CT
I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions
>iness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, throe
movements are not intended or offered for sale. If, however, the building or improvement is sold within one year of c
)roved for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7(
fly to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contre
I am exempt from licensure under the Contractors' State License Law for the following reason:
my signature below I acknowledge that, except for my personal residence in which I must have resided for at least c
a strgpry9 At I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors.
ifessions Cod@, is available upon request when this application is submitted or at the following Web site:http://w .1
nature of Prog rty Owner or Authorized Agent
:ENSED.CONTRACTOR'S DECLARATION
areby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section
1 effect. ,QVpse Class License No Date
)RKERS'.GOMPENSATION DECLARATION
work, and the structure is not intended or offered for sale (Section 7044,
Dloyees' or personal effort, builds or improves the property, provided that the
on, the Owner -Builder will have the burden of proving that it was not built or
Business and Professions Code: The Contractors' State License Law does not
pursuant to the Contractors' State License Law).
e year prior to completion or the Improvements covered by tnls permit, I cannot
understand that a copy of the applicable law, Section 7044 of the Business and
Date
he Business and Pros d€ rrd my license is in full force
Contractor Signaturef
NING: FAIWJRFJO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,00(1), IN ADDITION TO THE
i OF COMPENSA170N, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
teby affirm under penalty of perjury one of the following declarations:
have aad 46maintain 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
ormance ot;the}vork for which this permit is issued. Policy No.
Dave and Aaintai�r 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
Qnce.c I'a'ri}✓Dgf'(cy number are:
Policy Number
I certify that, in the performanc t ork for which this permit is issued, I shall not employ any person in any
I eC o t It, if I should sUbjorkers' compensation provisions of Section 3700 of the Labor Code, I shall
(nature of Applicant L
IECLARATION REGAFDIR6-CONSTRUCTION LENDING AGENCY
hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work foi
Ender's Name Lender's Address
ly 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 ordin ces and state laws relating to building construction.
I authorize representatives of this city or count to en bove-identified property for inspection purposes.
tionahlre of Prnnerty Owner or Authorized Aaent Print ProDertv Owner's
Date
so as to become subject to the workers' compensation laws of California, and agre
i comply with those provisions. ppp ��� ((
Date ��— (/ ��
r this permit is issued (Section 3097, Civil Code).
Authorized Ad
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
All required alarms,latches
1403
qates & fences which serve
PERMITEXPIRED
I SUBMITTED ASBESTOS NOTIFICATION TO
as part of a pool Spa
barrier, shall be in place
prior to approval to fill
PERMIT CANCELLED
EPA
PERMIT EXTENDED
AQMD
pool/spa & shall remain in
POOL ALARMS
EST E TO
place & be maintained for
INSTALLED
�TIFIIS
PROPOSED D IL
the lifeoo�fthe p00 pa
SIGNATURE:
-' x__, 7 ------
PERMIT FINAL
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