HomeMy WebLinkAboutX2022-0017 - Permits��EWPpRT City of Newport Beach
p d Community Development Department- Building Division
F. y 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 644-3288
fir. S Inspection Requests Phone: (949) 644-3255
newportbeachca.gov/inspections
Combination Type -
Work Class - Other
II II I II I II I II II III I II II COMB Permit : X2022-0017
IPlaed e09/t Check
:0018-2022
022
Inspection Area :5
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: 11 OFFSHORE
Description : SFR DEMO (E) POOL/SPA
Owner: ANDREW STUPIN
Address : 215 5TH ST STEA
HUNTINGTON BEACH, CA 92648
Phone
Applicant: ELITE CUSTOM POOLS & SPAS
Address: 25871 VICAR WAY
LAKE FOREST, CA 92630
Phone: (714)606-4007
Owner/Builder :
Address :
Legal Desc :
Contractor: ELITE CUSTOM POOLS & SPAS
Address : 25871 VICAR WAY
LAKE FOREST, CA 92630
Phone:
(714)606-4007
Con State Lic
: 529870
Lic Expire :
05/31/2024
Bus Lic:
BT30031210
Bus Lic Expire : 03/31/2023
Workers' Compensation Insurance
Carrier: STATE COMP
Policy No: 1137574
W. C. Expire : 6/1/2023
Architect:
Il
Address
Phone:
C--?.
0
State Lic
Engineer:
PETROV PLAMEN
Address :
28161 CASITAS CT
LAGUNA NIGUEL, CA 92677
Phone:
(714)717-7542
Designer
Address
Phone: Phone
Code Edition : 2019 Fire Sprinklers : NO Construction Valuation : $5,000.00
Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 0
Occupancy Groups : U No of Units : 0 Alteration sq. ft. Bldg :
Bldg Height : No of Stories : Added/New sq. ft. Garage: 0
Building Setbacks
Flood Zone
Use Zone :
PROCESSED BY:
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasom(s) indicated below by the checkmark(s) I have placed next to the applicable item(sl
Section 7031.5, Business end 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
io 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 rcensure and the basis. for the alleged exemption. Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of
of more than five hundred dollars ($500).
1, 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,
;Ufar s 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
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, ant exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
poy to an owner of property who builds or improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
I I am exempt from Iicensure under the Contractors' State License Law for the fallowing reason:
,y 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 lagally
oil a structure that I have built as an owner -builder it it has not been constructed in its entirely by licensed contractors. I understand that a copy of the applicable 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:fiwww.leginfo.ca.gov/colaw.htmi.
,iGnature of Property Owner or Authorized Agent Date
ACENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commending with SectiQQ�A 7JJ((0 ) Of Division 3 of the Business and P mien and my tic a is In lull force
no effect. License Class License No Dal(3/ Zr 22- Contractor signal
VORKERS' COMPENSATION DECLARATION k{x\i7a 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMI AL PE LTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARS (E100,000), IN ADDRION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR 1N SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
7 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
gr�ofmsnce 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:
Policy Number
Date
lame of Agent Phone If
It certify that, in the performance of the work t permit' issued, shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and ogre
rat, if I should become ubject io the work o ensattcn pr Isions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
iynature of Applica _ _ - Dat
rECI_ARATION REG ING CONSTRUCTION LENDING AGENCY
hereby affirm under p na perjury that there Is a construction lending agency for the performance of the work for which this permit Is issued'. QSecfl n 309 , C vil Code}.
enders Name Lender's Address
y 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 have provided is rrect.
agree to comply with all applicable city and cotY rdinances an sta vs rela'ng to building construction.
I authc-lze rep-e`,entalives of this city or county tdL¢nter the e miffed pro rty for inspection purposes. C xlSj 6 r'I „,,.,f „f Q'—ri n.,,,.a," a uh..,;,.H A. I 1l ❑n,.I a..,, 1, .., e.,o P. &I—
AC, ION
EYPIREO
PF,i,A,T LX, ENDED I
PE,bMIT Fh- AL
CE,3,1 EOf
OCCIVq 1r7CY ISSUE.n
DATE I BY DECLARATION. OF COMPLIANCE WITH CODE OF FEDERAL + FOR OFFICE USE ONLY
REGULATIONS PART 610E TITLE 40 AND AQMD RULE J
I SUBMITTED ASBESTOS NOTIFICATION TO
C..IASBESTOS NOIIFICAIION 15NOTAPPLICABLE TO
PROPOSED DEMOLITION