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Home My WebLink AboutS2021-0058 - PermitsY,anrrt.�. City of Newport Beach - Building Division 11111111111111111p11p1111111111111111111111111111111 100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 2 1 0 0 5 8 Permit Counter Phone (949)644-3288 Job Address: 4621 ORRINGTON RD Floor: Description of Work: POOL & SPA 544 SF Inspector Area: 5 Legal Description: N TR 3357 LOT 67 Owner: WELLING GLEN & LAURI Address: 4621 ORRINGTON RD CORONA DEL MAR, CA 92625 Phone: Applicant: ELLISON HUNTER Address: 24642 VIA RAZA LAKE FOREST CA 92630 Phone: 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 TOTAL FEE: $998.00 PROCESSED BY:, ZONING APPROV Suite: Bldg:1 Plan Check No: 0451-2021 Code Edit: 2019 Contractor: MERIDIAN CUSTOM POOLS INC Architect: Address: 23905 CLINTON KEITH RD 186-114 Address: WILDOMAR CA 92595 Phone: 800-616-7946 Phone: Con State Lic: 775011 Engineer: Lic Expire: 0212812022 Address: Bus Lic: BT30076346 Lic Exp Date: 0813112022 Phone: POOLPermit: S2021-0058 Project No : 0451-2021 Inspection Requests Phone (949)644-3255 State Lic BIEOENBACH CHRISTOPHER 1201 N TUSTIN ANAHEIM CA 92807 714-630-6100 State Lic:C-074003 Worker's Compensation Insurance Special Conditions: Carrier: EXEMPT Policy No: No employees Expiration: Issued Date: 08/20/2021 FEES Record Management: $8.00 Water Quality- — Building Dept Inspectio Fee: $0.00 Drainage Permit Fee : $0.00 Water Quality Dept Inspee: $152.00 Drainage Plan Check: $0.00 Building Dept WQ Plan Check: $0.00 Grading Consultant Fee : $0.00 Others $0.00 Additional Fee: $0.00 $0.00 Plan Check Fee : $0.00 PLAN G IECKED BY::, APPROVAL rO ISSUE: - Fee Due at Permit Issuance : $998.00 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST "AI ID IN.;P,!C—ICN - 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 is 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 U all of or U 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 nproved for the purpose of sale). 1 1, 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). I am exempt from licensure under the Contractors' State License Law for the following reason: ry 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 legal) 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. Iignature of Property Owner or Authorized Agent ate .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000)� of the Business and Profes ons o e, nd is s in full force nd effect. License Class License No Date Contractor Signatute 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 T USAND DOLLARS ($100,000), IN ADDITION TO THE -OST 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 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( )erformance of the work forwhich this permit is issued. Policy No. :1I 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 nsur ce carrier and policy number are: rr Policy Number Expiration Date of Agent Phone # """��, I rtify that, in the performan a oft e k w ch s rmit is issued, I shall not employ any person in any manner so as to become subject to the workers' compery�a�lon la s of California, and agref f I ould become subject o the o er cc pe a' n provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 2� -., / C�,tl(/� ature of Applicant _D CLARATION REGAR G LENDING AGENCY hereby affirm under penalty of p rjury that there is a construction lending agency forthe 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 h vided is a f. I agree to comply with all applicable city and cou ordi es d to I s ating to building construction. p I authorize representatives of this city or county t en the ab ve' entifi d perty for inspection purposes. / �`b / Signature of Property Owner or Authorized Agent - Print Property Owner's or Authorized Agent's N m Date ACTION DATE e FCLA ATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED _ ; SUBM071 ED ASBESTOS NOTIFICATION TO PERMITCANCELLED fPA - PERMIT EXTENDED qM D POOLALARMS ASBESTOS NOTIFICATION IS NOT APPLICABLE TO INSTALLED PROPOIED DE VIOUT,GN. SIGNATUREf PERMIT FINAL _