HomeMy WebLinkAboutS2023-0202 - PermitCity of Newport Beach
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Community Development Department- Building Division
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100 Civic Center Drive, Newport Beach, CA 92660
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Permit Counter Phone: (949) 718-1888
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newportbeachca.gov/civic
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Combination Type - SFP
Work Class - Alteration
111111111111111111111111111111111111111111111111111111Pool Permit : S2023-0202
Plan Check No : PC2023-2361
Issued Date
Final Date:
Permit Status: Applied
Inspection Area : 6
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: 11 SHOAL DR
Legal Desc : N TR 8425 BILK LOT 32
Description: SFR -NEW ABOVE GROUND JACUZZI 49 SF
Owner: KLEIN DANIEL L TR THE D & D KLEIN 1998
Contractor :
Architect
FAMILY TR
Address : 11 SHOAL DR
Address :
Address
CORONA DEL MAR, CA 92625
Phone:
Phone:
Phone:
Con State Lie :
State Lie
Lie Expire
Applicant: KLEIN DANIEL L TR THE D & D KLEIN 1998
Bus Lie:
Engineer
FAMILY TR
Address : 11 SHOAL DR
Bus Lie Expire :
Address:
CORONA DEL MAR, CA 92625
Phone:
Phone:
Workers' Compensation Insurance
Carrier :
Owner/Builder : KLEIN DANIEL L TR THE D & D KLEIN
Policy No:
Designer
1998 FAMILY TR
Address : 11 SHOAL DR
W. C. Expire :
Address
CORONA DEL MAR, CA 92625
Phone:
Phone:
Code Edition : 2022
Fire Sprinklers : NO
Construction Valuation
Type of Construction :
Fire Hazard Zone : NO
Added/New/TI sq. ft. Bldg
Occupancy Groups :
No of Units :
Alteration sq. ft. Bldg :
Bldg Height:
No of Stories :
Added/New sq. ft. Garage
Building Setbacks
Flood Zone
Use Zone:
Front: 15, Side: 5, Rear: 15
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PC - Jasmine Creek
PROCESSED BY:
SPECIAL CONDITIONS:
$15,000.00
0
[1]
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OWNER -BUILDER DECLARATION
I hereby affirm under penally of perjury that I am exempt from the Contractors' State License Law for the reasons) 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
ie permit to file a signedstatement that he or sheds licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 affirm Business and
'rofessions 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
of more than five hundred dollars ($500)..
1 I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure Is notintended or offered for sale (Section 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
nprovements are not Intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
n-77proved for the purpose of sale).
1 I, as owner of the property. am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and. Professions Code: The Contractors' State License Law does not
poly to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
I I am exempt from licensure under the Contractors' State License Law for the following reason:
ry my signature below 1 acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this. permit, I cannot legally
oil a structure that I have built as an owner -builder if it has not been Constructed in its entirety by licensed contractors. I understand that a copy of the. applicable law, Section 7044 ape Busi ass and
'rofessions Code, Is availableupon request when this appii$atton is s ed or at the following Web site:http:tiwww.leginfo.ca.govic low.html. y
signature of Property Owner or Authorized Agent. // Date
.ICENSED CONTRACTOR'S DECLARATIOa�'
hereby affirm under penalty of perjury that I am licensed 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
nd effect. License Class License No Date Contractor Signature
VORICERS' COMPENSATION DECLARATION
'ARNING. 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 ($ 00,000L IN ADDITION TO THE
DST Or COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 370E, OF THE LABOR CODE. INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
have and wif 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
ormance 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' compersa
rance carrier and policy number are:
Policy Number Expiration Date
of Agent Phone N _
certify that 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
if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant ",__� Date_
DECLARATION REGARDiN6 CDNBTRUCTION LENDING AGENCY
I hereby 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).
Lenders Name Lender's Address
By 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 and state laws relating to building. construction.
I authorize representatives of this city or county tonttfed property for inspection purposes. I \ _
Signature of Pro arty Owner or Authorized A enl Print Property Owner's or Authorized A ant's Name I \ �) 1 \ �i�l J� Cate
e a above-
ACTION DATE I BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
Y REGULATIONS PART FI OF TITLE. 40 AND AQMD RULE
PEN7,A7r EXPIRED
U 15uBmITTFD ASBESTOS NOTIFICATION TO
PERMIT CAA CELLED
EPA
PERM7T EXTENDED
PERMIT FINAL
O ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO
TO
CERTIFICATE OF
0-21-�9
PJt-�-- PROPOSED DEMOLITION
OCCUPANCYISSUED
? SIGNATURE:
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.
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