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Home My WebLink AboutS2021-0205 - Permitsoopffiam uqno"" City of Newport Beach - Building Division100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 2001 CENTELLA PL Floor: Suite: Bldg: 1 Description of Work:REPLASTER POOL AND SPA (CITY STANDARD) Inspector Area: 3 Legal Description: N TR 3379 LOT 1 Owner: SACKMAN PAUL Address: 2001 CENTELLA PL NEWPORT BEACH CA 92660 Phone: Applicant: A TO Z POOLS Address: 14312 ADELFA DR LA MIRADA CA 90638 Phone: 562-682-3307 Building Rear: Setbacks: Front: Left: Right: Construction Construction Valuation: $18,800.00 Building Permit Fee : $402.00 Permit Issuing Fee: $0.00 Investigation Fee: $0.00 Building Green Fee: $1.00 Plan Dept Plan Check: $52.00 Building Dep Plan Check: $349.74 Building PC Investigation : $0.00 Plan check Ext. Fee : $0.00 WQ Compliance Insp Fee: $0.00 TOTAL FEE: PROCESSED BY: ZONING POOLPermit: S2021-0205 Project No : 2090-2021 Inspection Requests Phone (949)644-3255 Plan Check No: 2090-2021 Code Edit: 2019 Contractor: A TO Z POOLS Address: 14312 ADELFA DR LA MIRADA CA 90638 Phone: 5621682-7307 Con State Lie: 1067185 Lie Expire: 07/31/2022 Bus Lic: BT30076552 Lic Exp Date: 09/30/2022 Worker's Compensation Insurance Carrier: WIC EXEMPT Policy No: Expiration: Record Management: Drainage Permit Fee : Drainage Plan Check: Grading Consultant Fee Additional Fee: FEES Architect: Address: Phone: Engineer: Address: Phone: Special Conditions: Issued Date: 0911012021 State Lie: State Lic: $2.00 Water Quality- — Building Dept Inspection Fee: $0.00. $0.00 Water Quality Dept Insp Fee: $0.00 $0.00 Building Dept WQ Plan Check: $0.00 $0.00 Others $0.00 $0.00 $0.00 Plan Check Fee : $0.00 PLAN CHECKED BY:: APPROVALTOISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Fee Due at Permit Issuance : $806.74 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 pe; nit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for :he 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 crofessions 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 Tot more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the 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 '.mprovements 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). ❑ 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 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). ❑ I 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.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION � I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 ivi io 3 of the Business and Profe ons nd m lieQ In full force and effect. License Class License No Date / Contractor Signatur NORKERS' COMPENSATION DECLARATION NARNING: 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 ($100,000), IN ADDITION TO THE COST 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: ❑ 1 have air' 01 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 the ierformance of the work for which this permit is issued. Policy No. nave and -.vill 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' ance car-hr end policy number are: Policy Number of Agert - - - Date Wartify that, in the performance of the work for which thi ermit 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 Iat, if I should become subjt ie rkers' compenpeffon provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Dat Iippare of Applicant � / I 2 m )ECLARATION REGARDI G ONSTRUCTION LENDING AGENCY "ereLy 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 ly my signature below, I certify to each of the following: I am the property uwner or authorized to act on the property owners behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and counttyy In noes and state laws relating to building construction.n/ / L I authorize representatives of this city or countyj6 r a 4ove,41anV15d property for inspection purposes. signature of Property Owner or AL ACTION DATE PERMIT EXPIRED PERMITCANCELLED PERMITEXTENDED POOLALARMS INSTALLED f PERMIT FINAL Print Property Owner's or Authorized Agent's Name / DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY All requ ren a arm ' & fences which serve REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE gate$ f spa 1403 as part of a Pool I SUBMITTED ASBESTOS. NOTIFICATION TO barrier, st),111 De In place prior to approval to fill EPA pool/spa & shall remain in nvD place a alntained for the a pined f ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION. X� SIGNATURE: