HomeMy WebLinkAboutS2023-0169 - Permitso�
City of Newport Beach
Community Development Department- Buildiing Division
r
100 Civic Center Drive, Newport Beagh, CA 9266D
Permit Counter Phone: (949)718-1888
newportbeachca.gov/civic
Combination Type -
Work Class - Other
iiiiiiiiiii II
Pool Permit : S2023-0169
Plan Check No :
Issued Date : 08/116/2023
Final Date:
Permit Status: Issued
Inspection Area : 2
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 : 1416 DOLPHIN TER Legal Desc : N TR 1700 BILK LOT 24
Description: SFR DEMO (E) POOL AND SPA PER CITY STANDARD PLAN (METHOD B).
Owner:
DAVID & JANA EWLES
Address :
1416 DOLPHIN TER
NEWPORT BEACH, CA 92625
Phone:
(714)270-7605
Applicant:
DAVID & JANA EWLES
Address :
1416 DOLPHIN TER
NEWPORT BEACH, CA 92625
Phone:
(714)270-7605
Owner/Builder: DAVID & JANA EWLES
Address : 1416 DOLPHIN TER
NEWPORT BEACH, CA 92625
Phone: (714)270-7605
Contractor :
Architect
Address :
Address
Phone:
Phone:
Con State Lie :
State Lie
Lie Expire
Bus Lie :
Engineer
Bus Lie Expire :
Address
Phone:
Workers' Compensation Insurance
Carrier :
Policy No :
Designer
W. C. Expire:
Address
Phone:
Code Edition : 2022
Fire Sprinklers :
Type of Construction :
Fire Hazard Zone
Occupancy Groups : U
No of Units :
Bldg Height :
No of Stories
Building Setbacks : Front: 10, Side: 4, Side: 4, Rear: 10
Flood Zone : X
Use Zone : R-1 - Single -Unit Residential
PROCESSED BY: (31
SPECIAL CONDITIONS: CITY STANDARD PLAN METHOD B
NO Construction Valuation : $25,000.00
NO Added/New/TI sq. ft. Bldg : 0
Alteration sq. ft. Bldg :
Added/New sq. ft. Garage : 0
OWNER -BUILDER DECLARATION
hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Law for the reasons) indicated below by the checkni (s) I have placed next to the applicable fterri
(Section 7031.5, Business and Professions Code: Any city or County that requires a permit to construct, altar, 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 &;coon 7000) of Division 3 of the Business and
Professions Code) or that he or she is exempt from licensors 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),
❑ 1, as 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 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
Vmpr ad for the purpose of sale).
I, as owner of the property. am exclusively contracting with licensed Contractors to construct the prefect (Section 7044, Business and. Professions Code: The Contractors' Slate License Law does not
apply to an owner of properly who builds or improves thereon,, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
LI I am exempt front Ijoensure under the Contractors' State License Law for the following reason:
By my signature below I acknowledge that, except for try personal residence in which I must have residedfor at least one year prior to completion of the improvements covered by this permit I cannot legal
sell a structure that I have built as an owner -builder if it has not been construclad 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 in p a' s mi at the following Web site:http:/iwww.leginfo.ca,govlcalaw.htmi,
Signature of Property Owner or Authorized Agent _ Date r�] l! ` 'f/f• a�+7
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of penury that. I am 11celI under provisions of 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 Contractor Signature
VORKERS' COMPENSATION DECLARATION
rARNING: 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 (SID0,000), IN ADOPTION TO THE
:OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
I 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 In
performance of the work for which this permit Is issued. Policy No.
:1I have and will maintain workers' compensation insurance, as required by Section 370D of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatiol
isurance carrier and policy number are:
Lanier Policy Number Expiration Date
Jam e f Agent Phone N
certify that, in The pedo nee 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 Califomta, and agre
tat, if I should become ublect the modgiri eompensabon provisions of Section 3700 of the Labor Code, Ishall forthwith comply with those provisions.
tgnature or Applicant Date
IMfi AOATInk! DCr�A fill _ P: IA I IPTIr1 AI t GRIr11uf• Ar3CNIPV � — rrV
aroby 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).
ides 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 con r nances and state le relating to building construction.
I authorize rebresantatives of this city or count to t �r/.herabbfidide led property for inspection purposes. , A r L {{%
"cTION
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F&F,lrr FINAL
CS;I, ICATE OF ,rr
CC:J"t ACT, ISSUED I/`
DATE BY P DECLARATICN OF COMPLIANCE WITI-1 CODE OF FEDERAL
: RFGWATIONS PART 61 OF TITI F 40 AND AQMD RULE
3403
L-JiSOBMITTFDASBFSTCSNCTIFICATIC)NTO
ASBESTOS NO] IFICATION 15 NOT /�p,PklCiSttt£ TO
FOR OFFICE USE ONLY
All required alarms, latches gates and fences which serve as part of a pool/spa barrier, shall
be In place prior to approval to fill pool/spa & shall remain in place, & be maintained for the
life of the pool.