HomeMy WebLinkAboutXR2023-1177 - PermitsP City of Newport Beach COMB Permit :XR2023-1177
Community Development Department - Building Division ��I(�Iflf�ll[1f1f1111lllllllllll�lllllllllllllllll��lllll��`I
100 Civic Center Drive, Newport Beach, CA 92660
Plan Check No: PC2023-0778
Permit Counter Phone: (949) 718-1888 Issued Date 0510512023
11W newportbeachca.govfcivic Inspection Area: 6
Combination Type - SFP
Work Class - Other
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: 416 HAZEL DR Legal Desc c N TR.L 6733L.K B LOT 42
Description: DELTA 1 -ADD 6'X 11'3" WALL TO TOP OF SPA BOND BEAM (RtV.2423-0839).
Owner:
STEVE DUSABLON
Contractor FLUID DYNAMICS POOL & SPA
Architect
Address
416 HAZEL
Address. 620 E WALNUT AVE, #B
Address
CORONA DEL MAR, CA 92625
FULLERTON, CA 92831
Phone
-Rhone: (714) 213-8047
Phone
Con State Lic: 809954
State Lic
Lip Expire 12/31/2024
Applicant:
FLUID DYNAMICS POOL & SPA
Bus Lic BT30055899
Engineer:
Address
620 E WALNUT AVE, #13
Bus Lic Expire: 07131/2023
Address
FULLERTON, CA 92831
Phone:
(714) 213-8047
Workers' Compensation Insurance
Phone:
Carrier.: INSURANCE COMPANY OF THE WEST
CHRISTOPHER JAMES BIEDENBACH
1201 N TUSTIN AVE
ANAHEIM, CA 92807
(714) 630-6100
Construction Valuation :
AddedlNewITI sq. ft. Bldg
Alteration sq. ft. Bldg :
Added/New sq. ft. Garage:
TOTAL sq. ft. :
$5,000.00
0
0
0
I hereby affirm umber penalty of perjury that I am exempt from the Cont€actors`;State License L w for the reason(sy indicated below by the dheckrnark(s) I have planed next to the applicable, Item(s)
Sedon 7031- , Business and Prcf dens Code: Any city or countythat requires, perfrlit; to construct, alter, arnprove, demolish„ orrepair any structure, prior to: its issuance, also requires the applicant f r
the per m- ft to file a signed statement that he or she is licensed pursued(to; the pr�Msicans of the gbntractors" Stata License Law (Chaapter g (o6mmencifig with Section 7€ ob) �f Clms on 3 of the Business and,
t�rafessions. csciv) r'ti t he r she is exempt frarn Iicerisure anc ilia basis.fbF the aliegeci'i�xemption Arty halation ofSection 7i33'i. by any appficantfoe a pemitsubje is the.appli ntto a civil erlal#y of
c
not more than five hundred dollars ($500
i, as owner of the prbperty, be my employees with wages as their srie.compensation. grill do U, all of or U portioias of the work, and the strdcture'is not intended or afferad fir sale (Ssction 7044,
Business and Professions Code: the Contractors' State License Law does not apply to an ov' of er of property who, through emplcayees'. or personal effort, builds or imprbves the property, provided that the
improvernanis are race int6nded Or o fered for sale. If, trowever, th6 build,°ng or impr6vement is sold tntithin One year of completion, the Owner=Suildervjill have The burden of proving that Xwas not built. or
improved for the pulse of sale.
0 t, as Owner of the property, am exclusively contracting with licensed Contractors to construct the pz€aject ('8, ecticn 71t44, Business and F`r•ofessions Code, The Contractors' state License Lanz does not
apply to an o+avr ar of prdp�r—,who builds or €mproves thereon, and)Aft contracts for the faro ects iMth a licensed Contractor pursuant to the Contractors' 'State Lfeanse Lava,
tarn exempt from Ilcenslrreruoder° the Contractors' Mate License Laver for the following reason.
S y sign,attlre tydow # ankri-owledge that; except for my personal residence in Which I must have resided for a't leas one year prior tp cttenpletion Of the irrtprover€ren covered €�y fihis parrnit I canl�ot laga ly
self d structr re that I have: built as an Own!er�tuilder it it has not boen constructed in its entirety by licensed ntraciors. t understand that a copy of the: applicable, law, Section 7044 of the Susinoss and;
PeofessiohsI Code, is alUble up6n raqu6st vrhen this application is submitted carat the following Web site htto.-I ii""W.tegirrfb,o.�ov„r'cala .htn t.
Signature of Property 9wrier or Authorised Agent mate.
iIG NSED CONTRACTOR'S DECLARATION
I hereby affirm under penatty'of penury thaf l aria licensed udder provisions of Chapter q nlerlcing With Secwn 7000of Nisi n 3 ofthe Bustn ss and f ss iti s3s i .arse is 'in full farce
and effect, License Glass I i License.ly o Date S ContractorSignat r
9RKERS' O FE fSAT ION DECLARATION
WARNING: FAf -URE TO SECURE 's ORIMRS' COMPENSATION COVERAOE IS. UNLAWFUL. AND SRALL St MMCT AN EMPLOYER TO CRMINALLABNALMS A�S 100,04{YI�ECi�i�z L�ctjIN AiIt3ITIf3N To THE
COST .OF COPAPENSATrON:DAMAOFSAS,PRGVMM FOR IN sECTION Mr -of` THE LABOR CODE„ MTEREST„ AND ATTORNErS PEES.
I hereby affirl:n under pen ,tIy,pf pej.ury one of tiro followving declarations'
t €Iave 'at d vviil mmiiutblrri la certificate of consent to self -,€Issue fdr worketV compen.�Wri, Issued by':_the Director of Industrial Relations as provided for by Section 37oo, of the. Labor Code, for tltl
pe orrnance of the -:brio for which this permit is issued, Policy talo,
i ave and mil mat t�si r Workers, compensation insurance, as required by Section 3700 of the Labor Cam. for the perform of work far which this, permit is issued. �tY orict rs` arrapensatior
i su: nce corner and n't mberare,
rarer Policy Number I�xpiratian Date
Name of Agent Phone
I oertify that, in the performance ref the work for :,Aftch this per ,it as issued, I shail not e pioy erly poison In any.rnanner so as to become sutlect to the wormers' c*mpensation lays of California, -and agre,
that, if t should become subject e V cornperrsation provisions of Section 3700 df, the Labor Code,' I shelf •foathvrilh drarnply rnth those provisions.
Signature of Applicant
�Tt IV E A I t TICI LENDING AG
i has by affirrla under penalty'of parku€y that there is a coc�structlo Ianding agency for the performarice of the work f6r which this permit Is issued (Section 3097,. Civ]I Code-).
Lender's Narfae. L&idef's'Addrass.
13y my slpature below, i certify, to each of the following'
l arb the property oviner of authorized to act on the property owner's bebalf.
I have read this application.andthe information I have provided is correct.
I agree to comply ,€thy all, epplicalatercity and county,ca riances and stag taws re lating to building construction.
t cauthoritte rep€e ritaiives of this city or I otirniy to=c#entiflerf piopertg for inspection purposes.
Sigltaiure of Property€ i�nier;tt€ AuEi�orized e: t Print. Property Ca+� ner's or Authoetzed A `ent;s Name Date �3
AC-nON i 'RATE BY IREGLARFIMROFCM9PLiANCEVs�ITHC DE OF FEDERAL OR OFFICEU$E:ONLf
ULAT16NS PART 5t OF TrrLE 40 AND ACOAD MULE
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PEAM i r FXPfRj5D ?0 1Si1O,firMOASMMSNOT! F1GAVONTo
PERPIPTCAMCEILED
FEis°i'v11rFMAL � ASSEST0 5 NOT1FIEATIONJi NOT APPLI SLE TO
CE M'CAiE � g PRi PI Et LiEI4t I ITl3 f ,
OCCUPtiNCYISSUED i StGffiATURE.