HomeMy WebLinkAboutS2020-0214 - PermitsCity of Newport Beach - Building Division 11111111111111p11111111111111111p11111p11111111111
AQ� 100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 2 0 0 2 1 4
Permit Counter Phone (949)644-3288
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erlYn11N�:
.lob Address: 536 SEAWARD RD Floor:
Description of Work:SFR POOLISPA 490 SF
Inspector Area: 5
Legal Description: N TR 1237 LOT 182
Owner: LEVINE DANIEL
Address: 1515 ANTIGUA WAY
NEWPORT BEACH CA 92660
Phone:
Applicant: ELLISON PAUL
Address: 25108 MARGUERITE PKWY #A79
MISSION VIEJO CA 92692
Phone: 949-367-9710
Building Rear:
Setbacks: Front:
Left:
Right:
Construction TvDe : VB
Construction Valuation: $60,000.00
Building Permit Fee : $430.00
Permit Issuing Fee:
$0.00
Investigation Fee:
$0.00
Building Green Fee:
$2.00
Plan Dept Plan Check:
$0.00
Building Dep Plan Check:
$387.00
Building PC Investigation :
$0.00
Plan check Ext. Fee:
$0.00
WQ Compliance Insp Fee:
$0.00
TOTAL FEE : $819.00
POOLPermit : S2020-0214
Project No: 2389-2020
Inspection Requests Phone (949)644-3255
Suite: Bldg:1
Plan Check No:
2389-2020
Code Edit:
2019
Contractor:
BLUE PACIFIC POOLS SOUTHERN
CALIFORNIA
Architect;!
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Address:
25108 MARGURITE PKWY #A79
Address:
S
MISSION VIEJO CA 92679
Phone:
949.310.3196
Phone:
State Lic:
Con State Lic:
923454
Engineer:
LACHER TODD
Lic Expire:
1013112022
Address:
1201 N TUSTIN AVE
Bus Lic:
BT30073923
ANAHEIM CA 92807
Lic Exp Date:
01131/2022
Phone:
714-630-6100 State Lic:C-067656
Workers Compensation
Insurance
Special Conditions:
Carrier:
STATE COMP INS FUND
DRAINAGE PERMIT X2020-0964, LANDSLIDE
Policy No:
9126143
FUEL. MODIHAZARD REDUTION ZONE
Expiration:
02128/2021
Issued Date:
0212412021
FEES
Record Management:
$0.00
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 : $387.00
PROCESSED BY: � t PLAN CHECKED BY::
ZONING APPROVAL: Vr 1v" APPROVALTOISSUE:_
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Fee DueatPermit Issuance : $432.00
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 items)
;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
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 U all of or U 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
im 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
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).
❑ 1 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 its 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 at the following Web site:hftp://www.leginfo.ca.gov/calaw.htmi.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000),of ivi ion of the Business and Profession�'s Q e, an lic Be is in full force
and effect. License Class License No Date Contractor Signature ,/,� ..�/
WORKERS' COMPENSATION DECLARATION
WARNING: 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 S100,000), IN ADDmON TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
I"' I 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 th
art rmance of the work for which this permit is issued. Policy No.
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'
carrier and policy number are:
is of Agent
certify that, in the performance
, if I should become subject toj
Policy Number
Date
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
'kers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant �'4-1y16—��l�
CLARATION REGAKOInGCCONSTRUCTION LENDING AGENCY
•reby 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).
.ender's Name Lender's Address
3y 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 ordman as and state laws relating to building construction.
I authorize representatives of this city or countK to linter t above=dentife party for inspection purposes.
/ ^
Signature of Property Owner or Authorized Agent Print Property Owners or Authorized Agent's Name
ACTION
DATE
BY
DEC RATION OF COMPLIANCE WITH CODE OF FEDERAL
VEGU
FOR OFFICE USE ONLY
LATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
- Af'dr_Ms a C 2S' ' '
PERMIT EXPIRED
I SUBMITTED ASBESTOS NOTIFICATION TO
gates & fences W6i(-f1 $erv'e,
PERMITCANCELLED
OEPA
- as Dart Of pool / Spa'
barrier, shall be in place
prior t0 approval to fill
PERMITEXTENDED
QMD
POOL ALARMS
t'i
ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO
INSTALLED
f
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PROPOSED DEMOLITION.
pOJ;/apa & shall remain iq
SIGNATURE:
place $r bo ma'.nt3irer for
IS f+2—
PERMIT FINAL
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