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Home My WebLink AboutS2022-0125 - PermitsCity of Newport Beach Community Development Department- Building Division 04", 100 Clvlc Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 644-3288 Inspection Requests Phone: (949) 644-3255 newportbeachca.gov/inspections lsi iZ 1 E 9 COMB Permit : S2022-0125 Plan Check No : 1419-2022 Combination Type : Work Class : Alteration Issued Date : Inspection Area : (� 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 : 50 SEA PINE LN Legal Desc : Description: MFR ALT (E) POOL & SPA: R/R SUPPLY & RETURN LINES, .POOL -DECK, &DRAINAGE Owner : JAN ESTERHOIZEN Contractor: WATER SAVERS COMPANY - Address : 22982 LA CADENA, 221 LAGUNA HILLS, CA Address : 16570 ASTON STREET IRVINE, CA 92653 92606 Phone: (949)305-1166 Phone: (949)955-1233 Con State Lic: 561852 Applicant : DOSS TIMOTHY Lic Expire : 11/30/2022 Address : 5154 SIERRA ROAD SAN BERNARDINO, CA Bus Lic: BT30079215 92407 Phone: (714) 728-7284 Bus Lic Expire : 07/31/2023 Workers' Compensation Insurance Carrier: SECURITY NATIONAL Policy NoCOM 383807 W. C. Expire :.4/1/2023 Code Edition : 2019 Fire Sprinklers : NO Type of Construction : Fire Hazard Zone 'N Occupancy Groups : No of Units : 1 Bldg Height : No of Stories : 0 Building Setbacks Flood Zone Use Zone : Processed By: Zoning Approval: Grading Approval: 85 SW Architect : DOSS TIMOTHY Address : 5154 SIERRA ROAD SAN BERNARDINO, - CA 92407 Phone: (714)728-7284 •••• State Lic • - - Engineer Address Phone : INSURANCE Designer: - Address Phone: Construction Valuation : $85,obo.(W . Added/New sq. ft. Bldg : 0 Added/New sq. ft. Garage : 0 Public Works Approval: Plan Check By: rr Approval To Issue: SPECIAL CONDITIONS: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors* State License Law for the reasons) indicated below by the checonark(s) I have placed next to the applicable fterne) (Section 7031 i5, 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 the permit to fll'II..e a. signed statement that he or she is licensed pursuant to the provisions of the Contractors' Stale License Law (Chapter 9 (commencing -with Section 7000)of Division of trio Business and Professions Code) or that he or she is exempt from licensure:and the bases for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars Iwo). ❑ I, Be owner of the property.; or my employees with wages as their sole compensation, will do (--) all of or (_) portions of the work,and the structure Is not Intended or offered for sate (Section 7044, Business and Professions Code: The Contractors' State license Law does not apply to anowner of property who through employees'' or personal effort, builds or improves the property, provided that the improvements arenot 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 if was nor built. or improved for the purpose of sale). ❑ I, as owner of [he property, am exclusivelycontracting with licensed Contractors 90 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 theprojects with a licensed Contractor pursuant to the Contractors State License Law). ❑ I am exempt from lioansure under the Contractors'Stafe License Law for the following reason: _ _ By my signature fiolow -I acknowledge that, except for my personal residence in which I musthaverasttlpd 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 nes not been constructed in its entirety by licensed contractors. j 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 Weh site;:hltJJi/1w w,lagigfo.ca.govIGaIaw.htmL Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I herebyaffirmunder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 q[,D' I�3.of the Business and Professlonst6ade�pnd: li s s In full force and effect. License Class License No Date C V Contractor Signature tJ JS J WORKERS' COMPENSATION DECLARATION / WARNING; FAILURE To SECURE WORKERS' COMPENSATION COVERAGE. IS UNLAWFUL, AND. SHALL SUBJECT AN EMPLOYERTO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS t1106,000I, IN ADDITION TO THE COST OF COMPENSATION, WMAGES AS PROVIDED FOR IN SECTION 370&.OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. I hereby Pfffrm under penalty of perjury one of the following declarations; I have;. and gill ,nalmain a cenlficate 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 IN por`ommance of the work for which this permit Is issued. Policy No. have and will maintain workers' compensationinsurance, as required by Section 3100 of the Labor Code, for the performance of the work for which: this permit is Issued. My workers' compensatfo (rablonba carrier'a,i6 pui,cy number are: Carrie, _ _ Policy.. Number Expiration Date Nmad o, Agent phone If certify that, In the performance of the work for which fhis e Is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agra fhet, f I should become P is act. to j��a woe ko ens r Isions of Section 3700 of the Labor Code; I shall forthwith comply with those provisions. 2 Signature of AppBcanl `�' J Date . 2;7— DCCLAR.ITION RGA�G CONSTRUCTION LENDING AGENCY I herebyaffirm under penally, ofperjury thatthere is a Construction lending agency for the performance of tips work for:which this permit is issued (Section 3097, Civil Code);. Lender's Name Lender's Address Sy my signature below, I certify to each of the following: I am the property owner or authorized to act on the properly owner's behalf. I have read this application and rho information I have provided is correct I agree to comply with all applicable city and county ordinances and stale lasys- elating tobuilding construction. I authorize representatives of this city or county to a the /v tiff -party for Inspection purposes, Si nature of Property Owner or Authorized A ant4 Print Property Owner's or Authorized Agent's Narne ACTION DATE By DECIARATION OF COMPLIANCE WITH COpF.Or FEDCRAI, FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE An AND.AQMD RULE 1403 PERMITEXPIR£p 1 SUBMITTEOASBESTOS NOTIFiCAT10N.TO P€RMITCANC€LLED - - Epp - All required alarms, latches gates and fence's which serve as part of a pool/spa banner,. shall PERMIT EXTENDED QMD be In place prlar to approve o fill pooI/spa &shall remain In place & be maintained for the PERMIT FINAL �,, /j3 ASRESTOS NOTIFICATION IS NOT APPLLIICA TO life of the pool. cErrrIrOCCUPANCY Arf or SIGNATURE:E xlTlt�A( �dN OCCUPAFICY ISSUED l )