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Home My WebLink AboutS2022-0123 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 rata"rSIYK�� .lob Address: 1119 DOLPHIN TER Floor: Suite: Bidg: 1 Description of Work:NEW POOL & SPA W/BAJA STEP 920 SF *CHANGE OF CONTRACTOR" Inspector Area: 2 Legal Description: N TR 1700 LOT 1 POOL -Permit: S2022-0123 Project No : 1355-2019 Inspection Requests Phone (949)644-3255 Plan Check No: 1355-2019 Code Edit: 2016 Owner: GUPTA NARENRA Contractor: OWNER/BLDR Address: 1119 DOLPHIN TER Address: GUPTA NARENDRA CORONA DEL MAR, CA 92625 Phone: Phone: 949-698-2256 Applicant: MITCHELL JACK Con State Lic: 0/B Address: PO BOX 7178 Lic Expire: DANA POINT CA 92624 Bus Lic: Phone: Lic Exp Date: Building Rear: Worker's Compensation Insurance Setbacks: Front: Carrier: Left: Policy No: Right: Expiration: Architect Address: Phone: State Lic Engineer: PASOL DAWN Address: 1411 N BATAVIA STE 208 ORANGE CA 92867 Phone: 714-363-3585 State Lic:C-061163 Special Conditions Issued Date: 06/01/2022 Construction Type FEES Construction Valuation: $0.00 Building Permit Fee : $0.00 Record Management: $0.00 Water Quality--- Building Dept Inspection Fee: $ 0.00 Permit Issuing Fee: Investigation Fee: $0.00 $0.00 Drainage Permit Fee : $0.00 Water Quality Dept Insp Fee: $0.00 $0.00 Building Green Fee: $0.00 Drainage Plan Check: $0.00 Building Dept WQ Plan Check: Plan Dept Plan Check: $0.00 Grading Consultant Fee : $0.00 Others: $0.00 Building Dep Plan Check: Building PC Investigation $0.00 : $0.00 Additional Fee : $38.00 $0.00 Plan check Ext. Fee : $0.00 WQ Compliance Insp Fee: $0.00 - FEE: $38.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $38.00 TOTAL PROCESSED BY: 0�1 PLAN Cl IECKED BY:: ZONING APPROVAL: APPROVAL TO ISSUI PERMIT EXPIRES 180 DANS. FTEk ISSL-AI-CF OR LAS-,. VALID INSPECTION 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 the 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 Professions Code) or that he or she is exempt from Iicensure 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 not more than five hundred dollars ($500). 1411 N BATAVIA STE 208 ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business 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 improvements 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 improved 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 ap 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 anl exempt from Iicensure under the Contractors' State License Law for the following reason: y my gnature 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 legally sell a ructure 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, Sectio 7044 of the Business and Prof Sion' Code, is available upon request when i application is su mitts or at the following Web Site :http:11www. Ieginfo.ca.govLcalaw. html. nature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATI t hereby affirm under penalty of perjury that am licensed under provisions o Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No Date C,ntrctrSgnature 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 THOUSAND DOLLARS ($100,000), IN ADDITION TO THE 30ST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS 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 for which this permit is issued. Policy No. 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' rance carrier and policy number are: of Agent of Policy Number Expiration Date 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 agre become subject to th/e��w �k/e/�s' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. plicant // \ ��C//y La /(r DD ;reby 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). ider's Name Lender's Address 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 correct. I agree to comply with all applicable city and county ordinances a d state laws relating to building construction. I authorize representatives of this city or r' count enter /}� entified property for inspection purposes. nature of Property Owner or Authorized Agent; Ix I Y �.-�/� Print Prooertv Owner's or Authorized Anent'.R Nam 7 V FG ACTION DATE BY - DECLARATION OFCOMPUANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 LJ I SUBMITTED ASBESTOS i401 I FICATIOG T0_ LJEPA _ PERMIT EXPIRED PERMIT CANCELLED PERMIT EXTENDEDLJAQMD POOLALA.RMS 71 ASBESTOS NOTIRCATION IS NOTAPPLICABLE TO INSTALLED PROPOSED DEMOLITION. SIGNATURE: PERMITFINAL ��wtv r City of Newport Beach - Building Division a drt 100 Civic Center Drive, Newport Beach, CA 92660 ... ,., n. Permit Counter Phone (949)644-3288 Job Address: 1119 DOLPHIN TER Floor: Suite: Description of Work: NEW POOL R SPA W/BAJA STEP 920 SF Inspector Area: 2 Legal Description: N TR 1700 LOT 1 Owner: GUPTA NARENRA Address: 1119 DOLPHIN TER CORONA DEL MAR, CA 92625 Phone: Applicant: MITCHELL JACK Address: PO BOX 7178� V DANA POINT CA 92624' Phone: x�e Building Rear: �a Setbacks: Front:' Left, Right: Construction Valuation Building Permit Fee: Permit Issuing Fee: Investigation Fee: Building Green Fee: Plan Dept Plan Check: Building Dep Plan Cock - Building PC Inv gation Plan check .Fee : WQ Compl nce Insp Fee: FEE: $1 PROCESSED BY: ZONING APPRO\ Iluiiiiiiii1iiii II P001-Permit : S2019-0106 Project No : 1355-2019 Inspection Requests Phone (949)644-3255 Bldg: I P eck No: '45-2019 e�updk w� ode Edit: ` GAb16 OGO'O C r Contractor: JACK W MITCHELL rr0'0 9rchitect: AdVd ssr 2902 CALL RALDO Address: .w SAN ENTE, CA 926, Phone: -498-31217� �hOattdne: ` FiT F.. C ate Lic: 9 �� Engineer: PASOL DAWN is Expire: 0 01-- Address: 1411 N BATAVIA STE 206 Bus 300 4 ORANGE CA 92867 EFate0°F 0 Phone: 714-363-3585 <ers Compensation Insurance Special Conditions: ier. WC EXEMPT y No (NO EMPLOYEE ratiom Issue 12019 I .00 05. ecord Management: `�$1 P00 $0.0 1��J, $0.0 rains P 5 ` $0.00 $3.00 rai n RRRR teal $0.00 $0.00 di IItt Cnnt`Foi $4Y�.0� 00 (J/ $0. 0 itional ///5u.00 FEE, Water Quality-- \o" 3 ing Dept QQG�ao{ion Water Qua�'ty ep ee: Buildia<f6ep Ian Check: Check Fee : $361.00 PLAN CHEC APPROVAL INSPECTOR ate Lic: a\Lic:C-061163 $0.00 $0.00 $0.00 $0.00 $0.00 Fete Due at Permit Issuance : $890.00 BY:: A I/`_ PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION 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 items) ction 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 permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Ch (commencing with Section 7000) of Division 3 of the Business and fessions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of ;se IL .5 by nySpplicant for a permit subjects the applicant to a civil penalty of more than five hundred dollars ($500). 411 N BATA ,,E 208 y. El I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of portions of the work, a tH�structure is not intended or offered for sale (Section 7044, ;mass and Professions Code: The Contractors' State License Law does not apply to an owner of pro who, through employees' or on feffiort, builds or improves the property, provided that the rovements are not intended or offered for sale. If, however, the building or improvement is so In one year of completion, the f]>,vM1a- uiill have the burden of proving that it was not built or roved for the purpose of sale). ,.ram, �e. �e{u\�t I, as owner of the property, anrexclusively contracting with licensed Contractor onstruct the pp��pp��erep�ection��BtlSiness and Profe i �yCode: The Contractors' State License Law does not ly to an owner of property who builds or improves thereon, and who contr or the proje4s'py,$11glicensed SIRE 0, pursuant to the_Cont Ct 'State License Law). J I am exempt from licensure under the Contractors' State ly my sinrature below I acknowledge that, except for my pe ell a structure that I have built as an owner -builder i it 'rofesslpns Code, is available upon request whe - applit iignature of Property Owner or Authorized .ICEN3E6 CONTRACTOR'S D I N hereby affirm under penalty ury th I li e under provlsiori5 oY Chap2'or 9 (co'm`rMcing with Section 7000 o visi of the Business nd effee. License CI _License No Date "l Contractor Si ATIO )MPEN TION AGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRI AL PENALTIES AND CIVIL FINES U%4 ONE 9D S INN 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. ` oiie of the following declarations. )te of consent to self Insure for workers' compensation, issued by the DirectoE4f�tl u�s ial elations prc permit is issued. Policy No. /'► DST OF CO" NSA hereby affir - n have a', Id, ertnrmai of t 11 have and WT. eu-ance carrier Agent __ ) y that, in the pe Ihould become of Applicant AS Of QCF[LIHN (relay affirm under penalty �Ip ame `` ider's N my signature below, I certify I am the property owner or a I have read this application aI I agree to comply with all app I authorize representatives of ACTION I DATE PERMIT EXPIRED PERMIT CANCELLED PERMIT EXTENDED are the following reakn: O% ` t whit I must ha��''[[ or at least one ye for to completion :t ' its entirety bkJiLensed contraytors derstand that a copy of or at pensation insurance, as required by' Section 3700 of the Poligy Number e of the"" rk for which this permit is is h s' compens vi Ic RUCTIOpLyE4YDf C jury the uctioP,li iorizVErto act on thb property owner's the information I have provide cc `ble city and county or ' CA and not employ any person in any 3700 of the Labor Code, I shall for the pe¢arrfiance of law, Section 7044 of the Business and Date is in full force DOLLARS IS100,0001, IN ADDITION TO THE 3700 of the Labor Code, for is issued. My workers' to bGQ�i�S�'S"fi6je e workers' compensation laws of California, and agree I�wRA tho visions. � i permit is issued (Section 3097, Civil Co e). g to building construction. for inspection purposes. '__Print Prooertv Owner's or Authorized OF COMPLIANCE WITH CODE OF FEDERAL PART 61 OF TITLE 40 AND AQMD RULE 1403 SUBMITTED TTED ASBESTOS POOL ALARMS PROPOSED DEMOLITIONNOTIFICATION IS NOTAPPLICABLE TO FOR OFFICE USE ONLY