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Home My WebLink AboutS2021-0253 - PermitsCity of Newport Beach - Building Division POOLPermit: S2021-0253 (9) 100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 2 1 0 2 5 3 Project NO : 2642-2021 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Job Address: 280 EVENING CANYON RD Floor: Suite: Bldg: 1 Description of Work:SFR POOL & SPA 243 SF W/LLRr'F Inspector Area: 5 Legal Description: N TR 1116 LOT 62 Owner: MENDELL STEVE Address: 280 EVENING CANYON RD CORONA DEL MAR, CA 92625 Phone: Applicant: ELLISON PAUL Address: 24642 VIA RAZA LAKE FOREST CA 92630 Phone: 949-683-9861 Building Rear: Setbacks: Front: Left: Right: Construction Construction Valuation: $55,000.00 Building Permit Fee : $440.00 Permit Issuing Fee: $0.00 Investigation Fee: $0.00 Building Green Fee: $3.00 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 : $1,007.00 7 Plan Check No: 2642-2021 Z-1 Code Edit �( pp��''`�' 2019 Of a ppliCca�J�'�NSPECI 0G ► -Contractor ELITE CUSTOM -POOLS & SPAS ; Arehitect E FEU% Or ❑ 1 00% refund Address: 71 VICAR WAY Address. - LAKE FOREST CA 92630 Phone: t11-�6-4007 Phone'„ =, State Lic: VWr 1 i�jf0 OIT1: Con State Lic: 529870 Engineer: LACHER TODD _ Lc ETre 05/31/2022 sc 'Bp " Address. 1201 N TUSTIN AVE ANAHEIM CA 92807 j L(� Dupe 03/31i2022 ._,; s ' -630.6100 State Lic: C-067fi5fi Phone: - 714nizI xp `: . Workers Compensation Insurance Special Conditions: Carrier: STATE FUND Policy No 1137574 plratlpTi . O6i/011/20222 e d DOW � 1111'}11612021 c^a .�, Lvew� FEES RVCY84ol6rregemen4: - Sig no tNafprQuality- Building Dept Inspection Fee $00 •- _ ,,, , Drama a Permit Fee $0.00 Water Quality Dept Insp: Fee: 152 6' Drainage Plan Check---SCftding Dept WQ Plan Check - $0 0 ----Others Additional Fee : $0.00 $&..00 PROCESSED BY: l I1 N ZONING APPROVAL: Plan Check Fee : $396.00 Fee Due at Permit Issuance : $611.00 PLAN CHECKED BY:: APPROVAL TO ISSUE:�A PERMIT EXPIRES 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) ction 7031.5, Business and Professions Code: Any city or county that requires a pemlit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for 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 fessions 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 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 U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, iiness 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 rovements 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 roved 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 ly to an owner of property who builds or-improvev4hw w-,-4 d Who•eontraetsqdr5 U I am exempt from licensure under t e Contractors' State Ic n Law for he follow ng reason: By my signature below I acknowledge tIat, a Dt�fiorS{wly pers al a Je ce 1n v�lich at have resided for at least one ye� gfj¢rfil IjUgbfLuul'of the improvements cc red-_bM this permit, I cannot legal) sell a structure that I have built as an o ner- Ar"YPit" earn-xsenDrer9'b'9Dlammed-clntract rs. I undersfan fiat a copy of the applicable law, Sect! n 70of the Business and Professions Code, is available upon re q Est when this application is ubmitte or at the following Web site http://www.leginfo ovlcalaw.ht 0 c Signature of Property Owner or Authorized A 0 - - 1 e u-,n 9at &- LICENSED CONTRACTOR'S DE ARATION I. I hereby affirm under penalty of perjury at I � licensed under provisions of Chapter 9 (comrn ding with edtfo 0 iv 3 of the Bus ss nd Pr if ns o n y license is in full force and effect. License Class License No�! «; j"ggntrac r WORKERS' COMPENSATION DECLARkrm .e.� WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND D LLA,v.S.1$100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIpED FcFqW§#I!F-`f ON 3706 0k FHE5Ae0R CODS INTEREST ANTD ATiORN�V'S'.FEE5 I hereby affirm under penalty of perjury Ine o he f wing declarations. - have and will maintain a certifica of ns at t self insure for workers' compensation lssuPd by the Dire_5 f Industrial Relations as provided for by Sectio 3700rof the Labor Code, for th ormance of the work for which this rmlt `' 401!Gy No ""' Ed will maintain workers' copensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is i k ued.._:. My workers' compensatio urance carri'dI aria policy number are _ Carrie r=lis P N ' pt Da Name of Ageiit @@ r rPhp'�e QI ce tify that, ir. the perf nce of w rk r th! permµ( is issued+,PS II not employ any person in any mar}ner so as to ¢ecome subject.to the workers' comper ti� law3 California, and ogre (that, ,F I should hecoma jec th r er ompensati 1pryi�vli3io(y � i n 3700 of the Labor Code, I shall fort(iG%G'3d&Kol�yi'witsthose. provisions. // / Signature of Alocicapt Da 'DECLARATION FLGP DI G fflA ENDING AGENCY oereo" affirm incur penal t of perjury t_ a� IL+fL4,• a his-penTntis-issDed-(Section 3 Iv o e). _o,.oer's Name Lender's Address 9; -r.y signature Belo^t; I certify to each of the following — r I an, the property oVner or authorized to ac on the ro B 6 have read this application and the information I h,Ave provided. is cor act. agree to comply With all applicable city and co -tr� n�ces an state laws relating to building construction. I authorize representatives of this city or c t e tert�ie abo -identified property for inspection purposes. Signature of Property Owner or Authorized Age Print Property Owner's or Authorized Agents me ACTION DATE ry \b`ECIAKATIO COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULA S PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED L1 I SUBMITTED ASBESTOS NOTIP CATION TO PERMITCANCELLED UEPA PERMIT EXTENDED 13AQMD POOLALARM5 ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO INSTALLED PROPOSED DEMOLITION.