HomeMy WebLinkAboutS2021-0272 - PermitsCity of Newport Beach - Building Division
Tb. 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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Job Address: 1821 TAHUNA TER Floor: Suite: Bldg
Description of Work:SFR POOL & SPA 380 SF W/ 8 CAISSONS (X2021-3342).
Inspector Area: 2
Legal Description: N TR 2813 LOT 107
Owner:
RIGHEIMER WILL & BONNIE
Address:
1821 TAHUNA TER
CORONA DEL MAR, CA 92625
Phone:
9491975-0123
Applicant:
WRIGHT JC
Address:
833 DOVER DR #7
NEWPORT BEACH CA 92663
Phone:
949-795-0648
*S2021-0272" POOLPermit : S2021-0272
Project No:2906-2021
Plan Check No: 2906-2021
Code Edit: 2019
Contractor:
INSTANT POOLS LLC
Architect:
Address:
116 SENCILLO PL
Address:
RANCHO MISSION VIEJO CA 92694
Phone:
949-795-0648
Phone:
Con State Lic:
1009644
Engineer:
Lic Expire:
07/31/2023
Address:
Bus Lic:
BT30053469
Lic Exp Date:
12131/2022
Phone:
Inspection Requests Phone (949)644-3255
State Lic
KOLODZIEJ KENNETH J ,
400 E ESTHER PLACE
PLACENTIA CA 92870
714-996-1219 State Lic:C-064768 ,
Building Rear: Worker's Compensation Insurance Special Conditions:
Setbacks: Front: Carrier: WC EXEMPT
Left: Policy No: (NO EMPLOYEES)
Right: Expiration: Issued Date: 02117/2022
Construction Type
FEES
Construction Valuation: $40,000.00
Building Permit Fee : $440.00
Permit Issuing Fee:
$0.00
Investigation Fee:
$0.00
Building Green Fee:
$2.00
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:
PROCESSED BY:
ZONING APPRO\,
Record Management:
$20.00
Water Quality--
Drainage Permit Fee :
$0.00
Building Dept Inspection Fee:
$0.00
Drainage Plan Check:
$0.00
Water Quality Dept Insp Fee:
$152.00
Grading Consultant Fee :
$0.00
Building Dept WO Plan Check:
Others
$0.00
Additional Fee :
$0.00
$0.00
$0.00
Plan Check Fee :
$396.00 Fee Due at Permit
Issuance : $614.00
PLAN CHECKED BY:: t t
APPROVAL TO ISSUE:_
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
_R-BUILDER DECLARATIory
-reb affirm under penalty of perjury License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
that I am exempt from the Contractors' State License Law for the reasor,(s) Indlcatsd below by the checkmark(s) I have placed next to the applicable item(s)
s
appl
v
flan 7o3f .5, Buivil penalty Of
siness and Professions code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, pfl0r t0 Its issuance, also requires the Busmen or
Ic
.ne permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State 400 E ESTHER PLACE
Professions Cade) or that he or she is exempt from licensure and the basis for the alleged exemption. Anyviolation
of or
of Portions of the THEork, and the structure is not me dednt for a permit ts the or offered lfornsale (Section 7044.
not more than five hundred dollars (S500).
I, as owner of the property, or my an with wages as their sole compensation, will do U U
Business
adare 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
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, provide a e
improvements
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 no
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).
not
I am exempt from licensure under the Contractors' State License Law for the following reason:
Bell ay signature
Shatll have acknowledge built athat. a-bueder�f i hasnotbelen constructed residence in in it ich ( must hi entirety by licensed contractors. I understand that a copy of the happl cahle law, Section 7044s covered by tof the Buhis lsinessnandlega
, is available upon request when this application is submitted or at the following Web site:http:l/www.Ieginfo.ca.gov/calaw.htm .
Date
Profess!ons Code
.signature of Prnpert,, Owner or Authorized Agent Ions Code, my li rce
LICENSED COIvTR.vCTOR'S DECLARATION 3� Business an
Date "c Ignatur
I hereby affirm under penalty of perjury that I am licensed and cease INo ns of Chapter 9 (commencing with Section) 0 f Digi ' nr
and effect. License Class
WCRK�RS' COMPENSATION DECLARATION
WFUL AND SHALL DREG TH OLLARS ($100,000), IN ADDITION TO THE
WARNINGnOMI URL T � .L DAMAGES AS WORKERS'
OMPE FOR IN SEC ER GE3TOis F THE LAaOR CODE, NTE EBTEAND ATTORNEY'S FEES.
CT AN EMPLOYER TO Los r RIMINAL PENALTIES AND CIVIL FINES UP T
N.
DED
I' hereby affirm under penalty of perjury one of the following declarations:
: hare 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 Cade, for t
performance of the wor" for which this permit is issued. Policy No.
for the performance of the work for which this permit is issued. My workers' compensatio
I have and wil, ma�nain workers' compensation insurance, as required by Section 3700 of the Labor Code, i
insurance carriera,ld policy number are: Expiration Date
Policy Number phone IF
of Agent
in the pertorm
become sgb. ct to
ct to the workers' compensation laws of California, and agree
issued, I shall not employ any person in any manner so as to become subje
provisions of Section 3700 of the Labor Code, 1 shall forthwith Comply with those provisions. ey—
Date rt'
iature of Applicant D GENCY
:LARATION REG
:rely affirm under ena y o erjury that t e i onstruction lending agency fo Lendee's Address of the work for which this permit is issued (Section 3097, Civil Code).
Ider's Name
my signature below, I certify to each of the fallowing:
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 pray rrect.
I agree to comply with all applicable city and county ordin nces and s e laws relating to building construction A��I.D Dat
I authorize representatives of this city or county t e ter th above-ideI pant Property Owner's or Authorized Agent's Na
)nature of Property Owner or Authorized Agent
:TION DATE BY LARATIO F MPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
RFGULATI RT 61 OF TITLE 40 AND ACMD RULE
PERMIT
INSTALLED
15 NOT APPLICABLE TO