HomeMy WebLinkAboutS2023-0156 - Permits�EwaoRr City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II Pool Permit : S2U23-o15s
4 e Community Development Department -Building Division S 2 0 2 3 0 1 5 6
D y 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-1768
Permit Counter Phone: (949) 718-1888 Issued Date a 07/21/2023
newportbeachca.gov/civic Final Date:
C4C�F00.N�P Combination Type - Permit Status: Issued
Work Class - Other c+'!� t^'w Inspection Area : 5
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE
NO CONSTRUCTION RFl �,Fn NnlcF npceTll??DgU�ippY;:4MkiIG64.DE^Ic T �; LIDAYS IN ALL AREAS
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If applicable:
Job Address
: 6 TIDELINE BLUFF L
Leal Desc :
N TR 16424 BILK LOT 15 r'i y t� �j (}(;0/ ¢'
Description :
SFR CONSTRUCT°�ttl Pd€fi i7Y SPA
C�
104 SF.. ALT SITE DRAINpGE:PER CITY ANDA�D �L Iffy (STCSPiNbi�Tf (�3g�Od
Owner:
BERNARD & KRISTEN SMOKOtP/SKI
,, Contractor:
BRETT STEELE ._ zm to Whom: Architect :
Address :
6 TIDELINE BLF _ -
--" Address :
4921 E LEEDS Address
NEWPORT COAST, CA 92657
ORANGE, CA 92867
Phone :
(714) 920-7424 _: „,, r
--. Phone :
(714)-496 1427, ;;_ Phone
Applicant: SARAH BLATARIC
Address : 31 TESSERA AV
LAKE FOREST, OF
Phone: (949)408-8676
Owner/Builder :
Address :
Phone
Con State Lic : 923975
i Lic Expire . 10/31/2024
z�-^ L. - Bus--Lic :i'BT3004`2152'
Bus Lic Expire : 02/28/2024
92610
,Iote:
Workers' Compensation Insurance
,LL S Carrier: EXEMPT- NO EMPLOYEES
L _ Policy No : EXEMPT
Q Expire
Code Edition : 2022 Fire Sprinklers : NO
Type of Construction : Pire-Wazard Zone': NO
Occupancy Groups: U No of Units: -
Bldg Height: No of Stories
Building Setbacks
Flood Zone
Use Zone :
X
PC - Newport Coast
PROCESSED BY: 203
SPECIAL CONDITIONS: STOP WORK 123-2077
State Lic :
Engineer: THOMPSON MATTHEW
Address : 1201 N TUSTIN AVE
ANAHEIM.A 92807
Phone (714)630 %-6700
Designer: *408
ATARICAddress :RA AVEST,CA 92610
Phone:676
Construction Valuation $40,000.00
Added/New/TI sq. ft. Bldg : (0
Alteration sq. ft. Bldg
Added/New sq. ft. Garage : 0
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 cheekmark(s) I have placed next to the applicable item(s)
Ilion 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
permit to file a signedstatement 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 ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not Intendedor offered for sale (Section 7044,
mess and Professions Code; The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or Improves the property; provided that the
rovemenls are not intended or offered for sale, If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
roved for the purpose of sale). � 1, as owner of the property, am exclusively contracting with licensed Contractors to construct,mthfojggS j - ro essions Coda:Tha Gontraclor't State License Law does not
iy to an owner of property who builds or improves„theyaon..and.,a�ho•corH�scfS'fisr'tiYl€' rpfecks with a licensed Contractor pursuant to the Contractors State License Law).
J I am exempt from licensure under the
,y my signature below I acknowledge tha
ell a structure that I have builtas an Own
'rofessions Code, Is available upon reltiuE
signature of Property Owner or AuthoAz,e,
,ICENS€D CONTRACTOR'S DECL,
hereby affirm under penalty of perry th;
nd effect. License Class
EVIO iI;MMT • •
'ARNING: FAILURE TO SECURE WORXERS' CC
CST OF COMPENSATION, DAMAGES AS PROV
hereby affirm under penalty of perjury
I I have and will maintain a certifict
erformance of the work for which thisi
Slate
T rat amst one
contractors. I L
when this application Is submitted or at the
Agent �_.....—.�_..�..._W .�.::. Date
,RATION
Ili 7,,
1 I am licensed under provisions of Chapter 9 (Comm,ncing vnih 3echon `7;i1 t f pl@$ffa,B"SbUsssaF` E
License No _ - Date=O Contractor Signatur
ARATION
iNSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER 1'OCRMiINIFLB Er, i:rIES AND CIVIL PINES UP TO ONE HUNDRED THOUSAND DC
FOR IN SE.y tOt 37060(r HSLASOR CODE, INTEREST, AND ATTORrvEYSFEES 1 ���
I of N.C.
decl"prau oils i
of nll miiir'e for workers compense n. Issued by,itle IIF f Industrial Relations as provided for by Section
JI have and will maintain workers' corpensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
policy ya Poll
umber - - p Late a .�`r - �surance carrier and olio number are: I ,.
Amer � Poll Number - Ex vafran b'
of Agent
.Phone 9
a: 1
I ertity that, in the performance of the ark - v el`Yifft issued I shall not employ any person in any manner, sErasta t7eFcme subjedktia,Ahe workers' compe
,aL if I should become subj the a 'corn ensatloq f}rov(sipna U$er}g9 yOO of the Labor Code, I shall forthWifh ' mply wiUt those provisions.
VLt EE
Ignafure of Applicant _ Date__
DECLARATION REGA DING 0NSTR TION LENDING AGENCY _ _ ._---------_.---- "-
hereby affirm under pa of perjuryth., ttJM(5oaostructton lendln the�work for which this permit is issued (Section 3097 e:
enders Name f? Lenders Address -
y my signature below, I certify to each oflhe following:
1 am the property owner or authorized ers Shelf
I have read this auplication and the inf
i agree to Dimply with all applicable city and co'
I au"horize representatives of this city or county
naturs of PrcpeAy Owner or Authorized Agent
1_'TIO:! I DATE I BY
✓ERMIT CXPIREO --
rE.P:L; _- I IMAL
CERTWIC'.TE OF
OCOJ-AP'CY ISSUED
and slate taws relating to buildingconstruction.
amidentified property for inspection purposes.
BFCLARAT€ON OF COMPLIANCE WITH CODE OF FEDERAL
REGULATIONS PART SI OF TITLE 40 AND AQMD RULE
1403
LJ ASBESTOS NOTIFICATION IS NUTAPPLICABLE TO
PROPOSED DEMOLITION
SIGNATURE:
FOR OFFICE USE ONLY
"it, I cannot
Business and
is in full force
IN ADDITION TO THE
of the Labor Code, for
My workers'
in laws of California, and
All required alarms, latches gates and fences which serve as part of a pool/spa barrier, shall
be in placeprior to approval to fill pool/spa & shall remain In place & be maintained for the
life of the pool.