HomeMy WebLinkAboutS2021-0275 - Permitstwo+ry City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIII II POOLPermit : S2021-0275
r a 100 Civic Center Drive, Newport Beach; CA 92660 S 2 0 2 1 0 2 7 5 Project No : 2927-2021
'; ��.., : n.. Permit Counter Phone (949)644-3288
is C
r,�fl. R µ�,.,, Inspection Requests Phone (949)644-3255
Job Address: 949 SANDCASTLE DR
Floor: Suite: Bldg: 1
....
Description of Work:SFR NEW POOL &SPA 434 SF
Inspector Area: 6
Plan Check No:
2927-2021.,
r
Code Edit:
2019
4�'J
Legal Description: N TR 6425 LOT 91
Owner: MORIN PETER B
Contractor:
LEGACY CUSTOM HOMES INC
Architect:
t
Address: 949 SANDCASTLE DR
Address:
1000 QUAIL ST, STE 220
Address:
CORONA DEL MAR CA 92625
NEWPORT BEACH CA 92660
Phone:
Phone:
949-887-4750
Phone: State Lie:
Applicant: RIELLY BLAKE
Con State Lic:
986194
Engineer: BIEDENBACH CHRISTOPHER
0
Address: 1000 QUAIL ST #220
Lie Expire:
08/31/2023
Address: 1201 N TUSTIN
NEWPORT BEACH CA 92660
Bus Lie:
BT30045036
ANAHEIM CA 92807
Phone: 949-887-6232
Lie Exp Date:
10/31/2022
Phone: 714-630.6100 State Lic:C-074003
Building Rear:
Workers Compensation
Insurance
Special Conditions:
Setbacks: Front:
Carrier:
OAK RIVER INSURANCE CO
LANDSLIDE AREA
Left:
Policy No:
LEWC219928
Right:
Expiration:
12/02/2022
Issued Date: 01/2612021
Construction Type : VB
FEES
Construction Valuation: $55,000.00
Building Permit Fee : $440.00
Record Management:
$0.00 Water Quality-
--
$0.00
Permit Issuing Fee: $0.00
Building Dept Inspection Fee:
Investigation Fee: $0.00
Drainage Permit Fee :
$0.00
Water Quality Dept Insp Fee:
$152.00
Building Green Fee: $3.00
Drainage Plan Check:
$199.00
Building Dept WQ Plan Check:
$0.00
Plan Dept Plan Check: $0.00
Grading Consultant Fee :
$0.00 Others
$0.00
Building Dep Plan Check: $396.00
$0.00
Building PC Investigation : $0.00
Additional Fee :
$0.00
Plan check Ext. Fee : $0.00
WQ Compliance Insp Fee: $0.00
.
TOTAL FEE : $1,190.00
Plan Check Fee : $396.00
Fee Due at Permit Issuance : $794.00
PROCESSED BY:
ZONING APPROV
PLI\N CHECKED BY:: Pi
APF ROCAL TO ISSUE:_
PERMIT EXPIRES 180 DABS AF7EH ISSI IANCE OR LA37 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 ofthe 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). 1201 N TUSTIN ❑
1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or (_) 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
apply 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).
❑ 1 am exempt from Iicensure under the Contractors' State License Law for the following reason:
By 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 legally
sell 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
Professions Code, is available upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section ) of Div)'sio 3 of the Business an rofe ns d my license is in full force
and effect. License Class License No Date Lb Z+T:-Contractor Signat
WORKERS' COMPENSATION DECLARATION
WARNING: 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 ($1 00(, IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I 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 th,
perfperEiance of the work for which this permit is issued. Policy No.
1 have and willUiLaintain 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' compensation
insurance cam an olicy nu'�)are:
Carrier _ vre 1 �� olicvlNumber Expiration Date
ie of Agent "C11-J ,
certify that, in the performance A the work
. if I should become subiect to the worker
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
1 provision 1 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant �r-�� D�
CLARATION R G C ST 10 NDING AGENCY
areby affirm un er trialty of perju 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
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 have provided is corn
agree to comply with all applicable city and county ordinances an ate laws relating to building construction.
authorize representatives of this city or count "to nt - property for inspection purposes.
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized A
ACTION I DATE I BY N OF COMP CE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART 6f OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED
I__I I SUBMITTED ASBEST% NOTI °ICATIO?I TO
PERMITCANCELLED
UEPA
QMD
PERMIT EXTENDED
POOL ALARMS
INSTALLED
EIASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE: - - -
PERMITFINAL
---.
All required alarms,latches
as part of a pool / spa
barrier, shall be to place
prior to approval to fill
pool/spa & shall remain in
place & be maintained for
the life of the poo)(spa