HomeMy WebLinkAboutS2020-0103 - Permits£ A City of Newport Beach - Building Division 11�1111111111111111111111111111111111111111111p11111 POOI_Permit : S2020-0103
'+� 100 Civic Center Drive, Newport Beach, CA 92660 Project NO : 1301 -2020
Permit Counter Phone (949)644-3288
` ��,er� ,µ Inspection Requests Phone (949)644-3255
Job Address: 850 SAN CLEMENTE DR Floor: Suite: Bldg: 1
Description of Work:COMM POOLISPA 1,0001128 SF "VIVANTE"
Inspector Area: 7 Plan Check No: 1301-2020
Code Edit: 2019
Legal Description: P BK 81 PG 8 PAR 2
Owner: VIVANTE NEWPORT CENTER LLC Contractor: MISSION POOLS OF ESCONDIDO Architect:
Address: 1 MACARTHUR PL #300 Address: 22600 E LAMBERT Address:
SANTA ANA CA 92707 LAKE FOREST CA 92630
Phone
Applicant: ELLISON PAUL
Address: 22600 LAMBERT E-1104
LAKE FOREST CA 92630
Phone: 949-588-0100
Building Rear:
Setbacks: Front:
Left:
Right:
Construction
Construction Valuation: $93,000.00
Building Permit Fee:
$430.00
Permit Issuing Fee:
$0.00
Investigation Fee:
$0.00
Building Green Fee:
$4.00
Plan Dept Plan Check:
$0.00
Building Dep Plan Check:
$387.00
Building PC Investigation :
$0.00
Plan check Ext. Fee :
$66.00
WQ Compliance Insp Fee:
$0.00
TOTAL FEE: $899.00
PROCESSED BY:
ZONING APPRO�,
Phone:
949.588-0100
Phone:
State Lic:
Con State Lic:
326760
Engineer: LACHER TODD
Lic Expire:
12/31/2021
Address: 1201 N TUSTIN AVE
Bus Lic:
BT30049245
ANAHEIM CA 92807
Lic Exp Date:
11/3012021
Phone: 714-630-6100
State Lic:C-067656
Workers Compensation
Insurance
Special Conditions:
Carrier:
FEDERAL INS
Policy No:
54309921
/1T 11
Expiration:
04105/2022
Issued Date: 04/28/2021
'N-PEA
_ 1
V 11
FEES
Record Management:
$12.00
Water Quality ---
Building Dept Inspection Fee:
$0.00
Drainage Permit Fee :
$0.00
Water Quality Dept Insp Fee:
$0.00
Drainage Plan Check:
$0.00
Building Dept WO Plan Check:
$0.00
Grading Consultant Fee :
$0.00
Others
$0.00
Additional Fee :
$0.00
$0.00
Plan Check Fee : $362.00 Fee Due at Permit Issuance : $537.00
PLAN CHECKED BY::
APPROVAL TO ISSUI
P�RiNI'-EXPIFES 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)
(Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, priorto 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 of the Business and
Professions 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
not 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 C_) 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).
�❑ I am exempt from licensure 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 legall
sell a structure that I have built as an owner -builder if it has not been constructed in 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 t following Web site:http://www.leginfo.ca.gov/calaw.html. p
Signature of Property Owner or Authorized Agent t
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of apter 9 (commencing with Section 7 O) of Division of the Business and Professi n e, and F en 'din full force
and effect. License Class License No Date Contractor Signature
WORKERS' COMPENSATION DECLARATION
ING: 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 ($100,000), IN ADDITION TO THE
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:
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 the
rmance of the work for which this permit is issued. Policy No.
ve 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' compensatiol
nce carrier and policy number are:
ier Policy Number Expiration Date
le of Agent Phone #
certify that, in the performanpd'of the//grk for hich this permit is
if I should become subiecl{(to thew ers' mpensation provisic
nature of Applicant
CLARATION REGARDING CONSTRUCTION LENDING AGED
Ireby affirm under penalty of perjury that there is a construction
Ider's Name
my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property o1
I have read this application and the information I have provi
I agree to comply with all applicable city and county ordin ce
I authorize representatives of this city or county to enter t e at
of Prooertv Owner or Authorized
ACTION
PERMITC4NCELLED
PERMIT EXTENDED
POOLALARMS
INSTALLED
PERMIT FINAL
#d shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree
ection 3700 of the Labor Code, I shall forthwith comply with those provisions.
Da<
agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Lender's Address
laws relating bui ing construction.
ed property f spection purposes.
�� Print Prooertv Owner's or Authorized ADent's Name
DATE BY DECLARATION OF COMPLIANCE 1 CODE OF FEDERAL
REGULATIONS PART 610E TITLE AND AQMD RULE
1403
LJ I SUBMITTED ASBESTOS NOTIFICATION TO
EPA
_ — QMD
ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO
PROPOSED DEMOLITION.
I FOR OFFICE USE ONLY
Date