HomeMy WebLinkAboutS2022-0038 - Permits$ t � City of Newport Beach - Building Division 111111III IIIIIpIII IIIII1111111111p111p1p1111111111POOLPermit : S2022-0038
.' O� 100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 2 2 0 0 3 e Project No : 0296-2022
', n Permit Counter Phone (949)644-3288
0u
o''urna+'`b - Inspection Requests Phone (949)644-3255
.lob Address: 2601 BLACKTHORN ST Floor: Suite: Bldg:1
Description of Work:SFR NEW POOLISPA 512 SF. CITY STANDARD DRAINAGE
Inspector Area: 4 Plan Check No: 0296-2022
Code Edit: 2019
Legal Description: N TR 4893 LOT 90
Owner:
GIGLIA BRYAN
Address:
2601 BLACKTHORN ST
NEWPORT BEACH, CA 92660
Phone:
Applicant: HOLDER AARON A
Address:
1276 E COLORADO BLVD
PASADENA CA 91106
Phone:
Building Rear:
Setbacks: Front:
Left:
Right:
,onsrrucnon
Construction Valuation: $30,000.00
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 :
Contractor:
AIDEN POOLS
Address:
1276 E COLORADO BLVD
PASADENA, CA 91106
Phone:
626-261-0825
Con State Lic:
1053685
Lie Expire:
05131/2023
Bus Lie:
BT30076622
Lie Exp Date:
09130/2022
Worker's Compensation Insurance
Carrier: EMPLOYERS PREFERRED
Policy No: EIG282852702
Expiration: 04/0112022
FEES
Architect:
Address:
Phone: State Lie
Engineer: BIEDENBACH CHRISTOPHER
Address: 1201 N TUSTIN
ANAHEIM CA 92807
Phone: 714-630-6100 State Lic:C-074003
Special Conditions
1�r1%r T tN .•— s+�
Issued Date: 02/0412022 I' , �.d � �
Record Management:
$4.00
Water Quality --
Building Dept Inspection Fee:
Drainage Permit Fee :
$237.00
Water Quality Dept Insp Fee:
Drainage Plan Check:
$199.00
Building Dept WQ Plan Check:
Grading Consultant Fee :
$0.00
Others :
Additional Fee : $0.00
Plan Check Fee:
$0.00
$152.00
$0.00
$0.00
$0.00
Fee Due at Permit Issuance : $1,430.00
PROCESSED BY: J I ... ... + PLAN CHECKED BY:: J'—L
ZONING APPROVAL: A F : •. : • ° ° • ° • ° APPROVAL TO ISSUE:
•: "; PEPaMIT•EXPIRES.190 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
• V •• • y y ° y
OWNER -BUILDER DECLARATION
I hereby affirm under penally 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 fof
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).
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). ,
I am exempt from licensure 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 legall}
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 Cade, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
lignature 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 Section 7 00) of Division 3 of the Business and Professi s Code, an y li se is in full force
nd effect. License Class License No Date Contractor Signature
VORKERS' COMPENSATION DECLARATION
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUND ED THOUSAND DOLLARS ($100,000), 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:
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 Code, for the
efformance of the work for which this permit is issued. Policy No.
3 ave 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 nce rngr and policy ber are'
3a er �iwm i+— ` ,�'^+ t�roatsSt O,C¢olicy Number Af N Z'c6 2lo ✓ Z7UZ Expiration Date /Zy/ ZZ
Vame of Agent I Phone # I
: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 subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
lignature of Applicant Date ,
)ECLARATION REGARDI G CONSTRUCTION LENDING AGENCY
hereby affirm under pena ty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, C i1 Code).
-enders 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 owners behalf.
I have read this application and the information I hav provided is co ect.
I agree to comply with all applicable city and couMP
ces an st to elating to building construction.
I authorize representatives of this city or county tabove-ide tiff party for inspection purposes.
3ignature of Property Owner or Authorized Agent Print Property Owners or Authorized Agent's NameZ Date
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AN D AOM D RULE -
1403
PERMITEXPIRED L1 I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED LJEPA u „
PERMIT EXTENDED ❑AON1p + o
POOLALARMS WaS 0A DASBESTOS NOTIFICATION IS NOT APPLICABLE TO
INSTALLED PROPOSED DEMOLITION. �� u
SIGNATURE:
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