HomeMy WebLinkAboutS2022-0233 - Permits (3)e��WPoRr City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II Pool Permit : $2U22-0233
@ Community Development Department- Building Division S 2 0 2 2 0 2 3 3
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2022-2772
0 S Permit Counter Phone: (949) 644-3288 Issued Date : 12/07/2022
a� Inspection Requests Phone: (949) 644-3255 Inspection Area : 3
cgCiFopN�P newportbeachca.gov/inspections
Combination Type -
Work Class - Other
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE
NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS
Job Address : 2507 HOLLY LN Legal Desc : N TR 1702 BILK LOT 4
Description: SFR 450 SF POOL/SPA W/ CITY STANDARD DRAINAGE
Owner: HAYES LAIRD H TR L H & M
Address : 2507 HOLLY LN
NEWPORT BEACH, CA 92663
Phone:
Applicant:
WATERWORX POOLS INC
Address :
202 FASHION LN STE 219
TUSTIN, CA 92780
Phone :
(714) 714-0424
Owner/Builder :
Address :
Phone:
Code Edition : 2019
Type of Construction :
Occupancy Groups: U
Bldg Height:
Building Setbacks : Front: 20, Side: 4, Side: 4, Rear: 10
Flood Zone : X
Use Zone: R-1 - Single -Unit Residential
Contractor: WATERWORX POOLS INC
Address : 202 FASHION LN STE 219
TUSTIN, CA 92780
Phone:
(714)714-0424
Con State Lic
: 1059336
Lic Expire :
10/31/2023
Bus Lic:
BT30074831
Bus Lic Expire : 03/31/2023
Workers' Compensation Insurance
Carrier: NO EMPLOYEES
Policy No: EXEMPT
W. C. Expire:
Architect
Address
Phone :
State Lic
Engineer: LACHER TODD
Address: 1201 N TUSTIN AVE
ANAHEIM, CA 92807
Phone: (714)630-6100
Designer:
Address:
Phone:
Fire Sprinklers : NO Construction Valuation: $50,000.00
Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg: 0
No of Units : 0 Alteration sq. ft. Bldg :
No of Stories : Added/New sq. ft. Garage: 0
PROCESSED BY: _
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjurythat I am exempt from the Contractors' State License Law for the reesari indicated below by the checkmark(s) I have placed next to the applicable items)
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
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
Irefessions Code) or that he or she is exempt from ficensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a cNil penalty of
rot more than five hundred dollars ($500).
Z 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portionsofthe work, and the structure is not Intended proffered for sale (Section 7044,
iustoess and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through amployees' 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
reproved 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
Ipply 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).
1 am exempt from licensure under the Contractors' State License Law for the following reason:
3y 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 legall}
rail a structure that I have built as an nwner-builder if it has not been constructed in its entirely by licensed contractors. I understand that a copy of theapplicable law, Section 7044 of the Business and
'rofesslons Code, is available upon request when this application is submitted or at the following Web site:http:/lwww.leginfo,ca.govfcalaw.html,
dgnatum of Property Owner or Authorized Agent LMIJ
.ICENSED CONTRACTOR'S DECLARATIONhereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (Commencing with Section 7000)Rf D�idn 3 of the Business and Prof my license Is In full force
Ind effect. License Class License No DalContractor Signatur
VORKERS' COMPENSATION DECLARATION
EARNING: FAILURE TO SECURE WORXERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 16/00,0001, IN ADDITION TO THE
:OST OF COMPENSATION, DAMAGES AS PROVIDED FORM SECTION 3706 OF THE LABOR CODE. INTEREST, AND ATTORNEY'S FEE%
hereby affirm under penalty of perjury one of the following declarations:
I 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 Cade, for th
'aidormance of the work for which this permit is issued. Policy No.
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`
carrier and policy number are:
tiler I Policy Number Expiration Date
ie of Agent -------- Phone # _
JI certify that, in the perfor ance of the work fo 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 ag
iat, if I should becomes Joel i he workers' c mpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
7gnature of Appficanj� _ - J to 2/ 7 2 Z
IECLARATION REGARDING _ ION LENDING AGENCY 0t
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
ly my signature below, I certify to each of ilia following:
I am the property owner or authorized to oat on ilia party owner's behalf.
I have read this application and the Information ave prey ed Is correct.
I agree to comply with all applicable city and unty ordmans and state laws rel ing to building construction.
I authorize representatives of this city or count he cry"entiffed pro for inspection purposes \ c� V1b35v�
/ Z/ lianature of Prooerty Owner or Authorized Auer _. Print Prooertv Owner's or Authorized Aeant's Name 1. 1 1 d Date
DECLARATION OF COMPLIANCE WITH CODE OF FEDEI
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERMIT EXPIHPD
LJ I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLE
OEPA
PERMIT EXTENDEDLJAQMD
PERMITFINAL
CERTIFICATE OF
OCCUPANCYISSUEO
ASBESTOS NOTiFICATIONIS NOT APPLICABLE TO
PROPOSED DEMOLITION
SIGNATURE:
FOR OFFICE USE ONLY
A:: ,eduired alarms, latches gates and fences which serve as part of a pool/spa barrier, shall
ba In place prior to approval to fill pool/spa & shall remain in place & be maintained for the
life or the poo•. �yy�j/- 'J 3 C- ^ 23
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