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Home My WebLink AboutS2021-0156 - Permits�wx•i'(};,T City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II POOLPermit : S2021-0156 t{ M 100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 2 1 0 1 5 6 Project No : 1503-2021 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Job Address: 363 NEWPORT GLEN CT Floor: Suite: Bldg:1 Description of Work:SFR SPA 200 SF W/YARD DRAINAGE Inspector Area: 3 Plan Check No: 1503-2021 Code Edit: 2019 Legal Description: N TR 9776 LOT 7 Owner: WILLIAMS DAVID Contractor: BRIAN POTTER CONSTRUCTION Architect: Address: 363 NEWPORT GLEN CT Address: 35 CREEKVIEW RD Address: NEWPORT BEACH CA 92660 COTO DE CAZA CA 92679 Phone: Phone: 949-285-6330 Phone: State Lic: Applicant: POTTER BRIAN Con State Lic: 377907 Engineer: LACHER TODD Address: 35 CREEK VIEW RD Lic Expire: 07/3112023 Address: 1201 N TUSTIN AVE CORO DE CAZA CA 92679 Bus Lic: BT30076079 ANAHEIM CA 92807 Phone: 949-285-6350 Lic Exp Date: 07/3112022 Phone: 714-630-6100 State Lic:C-067656 Building Rear: Worker's Compensation Insurance Special Conditions: Setbacks: Front: Carrier: STATE FUND TA Left: Policy No: 9207357 �� -,,,_ 0 1 � Right: Expiration: 12/12/2021 Issued Date: 07/28/2021 s - `'�• 1., �S, (. Y d 1i b!' �VIISII OIANII IYPU. vo FEES Construction Valuation: $10,000.00 Building Permit Fee : $440.00 Record Management: $4.00 Water Quality -- Permit Issuing Fee: $0.00 Building Dept Inspection Fee: $0.00 Investigation Fee: $0.00 Drainage Permit Fee : $237.00 Water Quality Dept Insp Fee: $152.00 Building Green Fee: $1.00 Drainage Plan Check: $199.00 Building Dept WQ Plan Check: $0.00 Plan Dept Plan Check: $0.00 Grading Consultant Fee : $0.00 Others Building Dep Plan Check: $396.00 $0.00 Building PC Investigation : $0.00 Additional Fee : $0.00 $0.00 Plan check Ext. Fee : $0.00 WO Compliance Insp Fee: $0.00 , TOTAL FEE : $1,429.00 Plan Check Fee : $595.00 Fee Due at Permit Issuance : $8: PROCESSED BY: V.}� PLAN CHECKED,, 6..--. '^a ZONING APPROVAL: Yy� APPROVAL TO ISGUE PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSFECTION - 3 Y 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 1e 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 'rafessions 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 3 I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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 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 nproved 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 Iicensure under the Contractors' State License Law for the following reason: ly 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.ieginfo.ca.gov/calaw.htm]. 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 SectiV70JJQ1 o�Division 3 of the Business and Prpfegsion de and my license is in full force nd effect. License Class License No D '/c-`7�Jq � Contractor Signatarr�`/ VORKERS' COMPENSATION DECLARATION ARMING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS I$100,000I, 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: 7 Ova 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 thI rmance of the work for which this permit is issued. Policy No. T have 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 urance carrier and policy number are: :arrier Policy Number Expiration Date Jame of Agent Phone # :1I 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' compensation laws of California, and agree hat, if I should become subjeclt-t'ffT� workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. .�a 7 Signature of Applican(�/,q� 1 D�[&/__ 7 11/ � [.�� )ECLARATION REGARDING CONSTRUCTION LENDING AGENCY �v hereby 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). -ender's Name Lender's Address 3y 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 odmaqkQqs and state laws relating to building construction. I authorize representatives of this city or county to enter b ve-identified property for inspection purposes. Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name 'D Date 7� ACTION DATE BY bECLARATON OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE All required alarms latches 1403 PERMITEXPIRED J I SUB:m I-, TEU AS NOTIFICATION TO as part Of a pool / Spa PERMIT CANCELLED UIEPA barrier, shall be in place PERMIT EXTENDED QMO prior to approval to fill POOL ALARMS ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO pool/spa & shall remain in INSTALLED PROPOSED DEMOLITION. place & aint a for ! SIGNATURE: th - PERMIT FINAL I V X