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Home My WebLink AboutS2021-0288 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 a Permit Counter Phone (949)644-3288 u a"�ri'nLLttiis ` .lob Address: 2500 SIERRA VISTA Floor: Suite: Bldg: 1 Description of Work:SFR NEW POOLISPA 510 SF W/ DRAINAGE Inspector Area: 3 Legal Description: N TR 1801 LOT 15 Owner: KEEFER RYAN & JACQUIE Address: 2500 SIERRA VISTA NEWPORT BEACH, CA 92660 Phone: Applicant: TEKTON GROUP Address: 2744 SATURN ST BREA, CA 9281 Phone: 949-573-7090 Building Rear: Setbacks: Front: Left: Right: Construction Tvoe Construction Valuation: $50,000.00 Building Permit Fee : $440.00 Permit Issuing Fee: $0.00 Investigation Fee: $0.00 Building Green Fee: $2.00 Plan Dept Plan Check: $0.00 Building Dep Plan Check: $396.00 Building PC Investigation : $0.00 Plan check Ext. Fee : $0.00 WQ Compliance Insp Fee: $0.00 TOTALFEE: $1 PROCESSED BY: ZONING *S2021-0288* Plan Check No: Code Edit: Contractor: TEKTON GROUP INC Address: 2749 SATURN ST BREA CA 92821 Phone: 949/573-7090 Con State Lie: 1083703 Lie Expire: 11/30/2023 Bus Lie: BT30077339 Lie Exp Date: 11/30/2022 Worker's Compensation Insurance Carrier: STATE COMP INS FUND Policy No: 9139164 Expiration: 08/04/2022 FEES POOLPermit: S2021-0288 Project No : 3008-2021 Inspection Requests Phone (949)644-3255 3008-2021 2019 Architect: Address: Phone Engineer: LACHER TODD Address: 1201 N TUSTIN AVE ANAHEIM CA 92807 Phone: 714-630-6100 Special Conditions Issued Date: 04/06/2022 State Lie: .... • °••• State Lic:C-067656 •. • , ° ° °• • • Record Management: $6.00 Water Quality-- Drainage Permit Fee : $237.00 Building Dept Inspection Fee: $0.00 Drainage Plan Check: $199.00 Water Quality Dept Insp Fee: Building Dept WQ Plan Check: $0.00 Grading Consultant Fee : $0.00 Others $0.00 Additional Fee : $0.00 $0.00 $0.00 _ Plan Check Fee : $595 00 Fee Due at Permit Issuance : $685.00 PLAN CHECKED BY:: 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) '.ction 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, priorto 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 ffessions 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 ($500). 1201 N TUSTIN AVE I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U portions Jsiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, throe: Iprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of c (proved for the purpose of sale). ] I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7( )ply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contra ] I am exempt from licensure under the Contractors' State License Law for the following reason: y my signature below I acknowledge that, except for my personal residence in which I must have resided for at least c 311 a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.l ignature of Pro (g%Owner or Authorized Agent ICENSED CO•IJIUACTOR'S DECLARATION hereby affirm Linder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 Rdl?17$ct. LicensaClass License No Dat •.•. dORKERS' COMPENSATION DECLARATION ARWO FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL P'. DST OF COMPENSRIT(Mt gAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. her ebynffirm urfftP penalty of perjury one of the following declarations: •• •. �lbave and tl avCmantain a certificate of consent to self -insure for workers' compensation, issued by the Direct e p 9nce ofthe Rork forwhich this permit is issued. Policy No. and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for It is&ance carnet and policy number are: 1y6� _ _ • • • Policy Number certify that, in the performance of the work forwhich this permit is issued, I shall not employ any person in any . if I should become subject tqthe workem;G=-pensat5 visions of Section 3700 of the Labor Code, I shall nature of Applicant / Lit — CLARATION REG DI STR ION LENDING AGENCY :reby affirm under penalty of perjury that there is a construction lending agency for the performance of the work f 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 correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this cityor count to a the abov - ified rty for inspection purposes. Y S. — . _.. _ _,_. ,..___. .. ..........:_,.a �..e.,. / 9� � ,/sl Print Property Ownel DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDEI REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE PERMITEXPIRED ❑(SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED EPA POOL ALARMS I PR PASBESTOS OSED DEMOLITION. IS NOT APPLICABLE TO INSTALLED A r e A // the work, and the structure is not Intended or offered for sale (Section 7044, employees' or personal effort, builds or improves the property, provided that the pletion, 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 of the improvements covered by this permit, I cannot understand that a copy of the applicable law, Section 7044 of the Business and Date of Division 3 of the Business and Prof�ns Code, and Vicense is in full force L Contractor Sig nature,o� 1-TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE of Industrial Relations as provided for by Section 3700 of the Labor Code, for performance of the work for which this permit is issued. My workers' Date ar so as to become subject to the workers' compensation laws of California, and agre, vith comply with those provisions. L Date rich this permit is issued (Section 3097, Civil Code). Authorized Agent's Name t:olj J I S oM D r-l� 17' Da e 'i -� ' Z� FOR OFFICE USE ONLYAII required alarms,latche5 gates & fences which serve barrier, shall be in place prior to approval to fill Pool/spa & shall remain in place & be maintained for X th jf of epoo(/sp_Zs, rLv