HomeMy WebLinkAboutS2021-0144 - PermitsCity of Newport Beach - Building Division I IIHIII 111141111111111111111111111111113111111111111111
A 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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Job Address: 23 PINEHURST LN Floor:
Description of Work:NEW POOL AND SPA ?"
Inspector Area: 4
Legal Description: N TR 7223 LOT 52
Suite:
Date:
1
POOLPermit : S2021-0144
Project No : 1401-2021
Inspection Requests Phone (949)644-3255
Plan Check No: 1401-24 applicable: �r
` ❑ 80% or ❑ 100% refur
Owner: SEAHORSE HOLDINGS LLC C ac D N rchitect:
Address: 2601 MAIN ST STE1200 A ras,ac' O ddress:
IRVINE, CA 92614 S to whom:
Phone:U Phon 714- - 22 Phone: State Lic:
Applicant: RICK DORN CONST Ffol, 3 eer: LACHER TODD
Address: P O BOX STE 1 s: 1201 N IM CA 280
AVE
WESTMINSTER CA 92685 30 ANAHEIM CA 92807
Phone: 714-585-7322 at 8 22 IRED 714-630-6100 State Lic:
Building Rear: Worker's Compensation Insurance Special Conditions:
Setbacks: Front: Carrier: a STATE COMP INS. Left: pl@.iv No:g�^�
Right: Ia 1 n 1 026 a n ® I ue is ca rd0/2r i!
Construction Type
Wor S a e FEES
Construction Valuati�$60,000.00
� Note: _71
Building Permit Fee : $440.00
Permit Issuing Fee:
$0.00
Investigation Fee:
$0.00
Building Green Fee:
$3.00
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 : $1,533.00
PROCESSED BY:
ZONING
Management: $22.00 Water
a'
56
$0.00
$0.00
$0.00
Grading Consultant Fee : $672.00 Others
$0.00
Additional Fee: $0.00 $0.00
Plan Check Fee : $387.00 Fee Due at Issuance : $1,146.00
P0
PLAN CHECKED BY::
APPROVAL TO ISSUE:
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 item(s)
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 (Chapter 9 (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 Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
more than five hundred dollars ($500). 1201 N TUSTIN AVE
I, 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,
,iness 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
rovements 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
roved 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
ly to an owner of grope J&F*,tprojects the Contrac ors ra e�qcense Law).
I am exempt from lice,
my signature below I a�
a structure that I, have
�fessions Code, is avail
natum of Property Owr
I h=rebv affirm Under pe
snd elffeut. License Cla
WORKERS'C,OMP&
bARNINGi FAILURE 10 SEC
COST OF COMPENSATOI, D,
Ir hereby affirm undrr psi
4- I have and will mair
rp urmaoce of th'o work
/--"(I hi-e and will maint
IDerance carrier Hindi pe
ie of Agent
certify that, in the p,
if I should become
lature of Aoolicant-'
under the Contractors'
'IgegB.that,:except for I
completion of the impro ments covered by this permit, I cannot
it a copy of the applicalolk law, Section 7044 of the Business and
e upon request when this applicafon is submitted or at the following Web site:http:/(aoyv�,,I 6 o.ca T fta yf,}(ruq F
or Authorized Agent U tjUU�O �i LJVV �D refund
)R'S DECLARATION
of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0 of Division 3 of the Business and P
License No r-sy D VQi} _ ^� � r ^rr��r� Signaku
TION DECLARATION}-
ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDI
ESA ROVIOEDFLR INS ] FMEC ODrIN1V 4,AND'ATTORNEY'S FEES.
of km:of
/of the followi_D d'farations
a consent to el sure for workers' compensation Issued by,�e Director of Industrial Relations as provided
vhierNt Is issued. II No.
corkers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which
lumber are:
LENDING AGENCY
hereby affirm under penal) c �4drylh�
Ender's Name
iy my signature below, I c tify to each nforMa
f the following:
I am the property owne or authorizeto act on the
I have read this applica Ion an e on
a'
I agree to comply with all applicable city and county
I authorize representatives of this city or county to e
of Property Owner or Authorized
reason:
st have resided for at
Iued, I shall not employ any perso in nyy��rr�rryy����r ,ppQQme subject to the
of Section 3700 of the Labor Codrd aNYbithWit . those provisions.
Lender's Address
is relating to building construction.
property for inspection purposes.
Print Prooertv Owner's or
ACTION DATE eY /%iA ONS TIONOA T063 OF (IT E 40 AND AgMD RULERAL
PERMIT EXPIRED
JW11
I U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED
0EpA
PERMIT EXTENDED
OMD
POOL ALARMS
INSTALLED
UASBESTOS NOTIFICATION IS NOTAPPLICABLE TO
PROPOSED DEMOLITION.
FOR OFFICE USE ONLY
Date
is in full force
DOLLARS ($100,000), IN ADDITION TO THE
Section 3700 of the Labor Code, for
permit is issued. My workers'
compensation laws of California, and
�2 —zo - z/
Code).