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Home My WebLink AboutS2021-0265 - Permits0PrOjwt*r City of Newport Beach - Building Division IIIIIIIIIIIIIII�IIIIIII�IIIIIIIIIII II POOLPermit : S2021-0265 m r 100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 2 1 0 2 6 5 Permit Counter Phone (949)644-3288 eCt No : 1974-2021 ��iiSnN�y Inspection Requests Phone (949)644-3255 .lob Address: 22 SHORERIDGE Floor: Suite: Bldg: 1 Description of Work:SFR POOL & SPA 464 SF W/ DRAINAGE "CHGOF CONTRACTOR• Inspector Area: 6 Plan Check No: 1974-2021 Code Edit: 2019 Legal Description: Owner: WOODGRIFT CYNDI Contractor: DYNAMIC SHOTCRETE INCORPORATED Architect: Address: 22 SHORERIDGE Address: 16138 CITRUSTREE RD Address: NEWPORT COAST CA 92657 WHITTIER CA Phone: 949-282-7516 Phone: 714-686-8940 Phone: State Lic: Applicant: ELLISON PAUL Con State Lic: 921276 Engineer: BIEDENBACH CHRISTOPHER Address: 24642 VIA RAZA Lic Expire: 08/31/2022 Address: 1201 N TUSTIN LAKE FOREST CA 92630 Bus Lic: BT30072407 ANAHEIM CA 92807 Phone: 949-683-9861 Lic Exp Date: 0713012022 Phone: 714-630-6100 State Lic:C-074003 Building Rear: Worker's Compensation Insurance Special Conditions: Setbacks: Front: Carrier: INS CO OF THE WEST Left: Policy No: WSD504785902 Right: Expiration: 05/15/2022 Issued Date: 1210312021 Construction Type FEES Construction Valuation: $0.00 Building Permit Fee : $0.00 Record Management: $0.00 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: $0.00 Drainage Plan Check: $0.00 Building Dept WQ Plan Check: $0.00 Plan Dept Plan Check: $0.00 Grading Consultant Fee : $0.00 Others Building Delp Plan Check: $0.00 $0.00 Building PC Investigation : $0.00 Additional Fee : $38.00 $0.00 Plan check Ext. Fee : $0.00 WQ Compliance Insp Fee: $0.00 TOTAL FEE : $38.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $38.00 PROCESSED BY: ` PLAN CHECKED BY:: ZONING APPROVAL: °om ° APPROVAL TO ISSUE:_ ° m o • o m o •° PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAS�%YA6�D, NSPEQPiOAm° ° •° m m o • c ° °o o ° 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 itefn'['J 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 ❑ 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, Business nd 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 n roved 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 licensure under the Contractors' State License Law for the following reason: 1y 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 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 applicable law, Section 7044 of the Business and 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. signature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7ff)gf Di' glon 3 of the Business and Professiog6�Ctlde, ar/u y y license is in full force nd effect. License Class License No Date ✓��Z Contractor Sig nature VORKERS' COMPENSATION DECLARATION _. _ 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE ALTIES 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 ATTORNEYS 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, fi Dr once of the work for which this permit is issued. Policy No. JI ave 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' compensatior Isufance carrier and policy number are: Policy Number Expiration Date Agent certify that, in the performance of the gwork hich this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre I, if I should becomesusub/1/fat/tp the wompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant ^Ir/ Z�/L%— Dat /-- CLARATION REGARDING CONSTRU TON LENDING AGENCY Ireby affirm under penalty 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). Ider's Name Lender's Address 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 cor ct.%f}n 1 agree to comply with all applicable city and county ordinances Late laws relating to building construction. I authorize representatives of this city or county t q)rl€r- a ab entified property for inspection purposes. nature of Prooertv Owner or Authorized Aqent t/ Print Property Owner's or Authorized Agent's Name Date ACTION DATE BY - DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY V REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE All required alarms,latches 1403 PERMIT EXPIRED 0 1 SUBMITTED ASBESTOS NOTIFICATION TO as part of a pool / spa PERMIT CANCELLED FIEPA ••• barrier, shall be in place PERMIT EXTENDED 0AQMD - prior to approval to fill POOLALARMS ASBESTOS •NOTIFI(IATiIOA 15�107A�PISCABLE TO pool/spa & shall remain in INSTALLED PROPQSEDV�MOLITIQN.• • • • place & be maintained for SIGNAtURE: • . ••• the life of the poo pa PFRMIT FINAI _ i�2 * • . • • - x __ o � �