HomeMy WebLinkAboutS2022-0089 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIII
100 Civic Center Drive, Newport Beach, CA 92660 S
Permit Counter Phone (949)644-3288
(9)
2 0 2 2
POOLPermit: S2022-0089
0 0 8 9 Project No : 1006-2022
Inspection Requests Phone (949)644-3255
Job Address: 30 WHARFSIDE DR Floor:
Suite: Bldg:1
Description of Work:SFR POOL & SPA 264 SF Wl YARD DRAINAGE.
--
Inspector Area: 5
Plan Check
No: 1006-2022
Code Edit:
2019
Legal Description:
Owner: MANLEY MICHELLE
Contractor:
TESERRA
Architect:
Address: 30 WHARFSIDE
Address:
P O BOX 1280
Address:
NEWPORT COAST CA 92657
COACHELLA CA 92236
Phone:
Phone:
760-398-9222
Phone: State Lic:
�•i
I
Applicant: ELLISON PAUL
Con State Lic:
656128
Engineer: BIEDENBACH CHRISTOPHER
?
Address: 24642 VIA RAZA
Lic Expire:
10/31/2022
Address: 1201 N TUSTIN
=
LAKE FOREST CA 92630
Bus Lic:
BT30070953
ANAHEIM CA 92007
Phone: 949-603-9861
Lic Exp Date:
0613012023
Phone: 714-630-6100 State Lic:C-074003
Building Rear:
Worker's Compensation
Insurance
Special Conditions:
Setbacks: Front:
Carrier:
STARSTONE
Left:
Policy No:
T10200999
Right:
Expiration:
0110112023
Issued Date: 06/0812022
Construction Type :
FEES
Construction Valuation: $39,000.00
Building Permit Fee: $440.00
Record Management:
$14.00
Water Quality --
Permit Issuing Fee: $0.00
Building Dept Inspection Fee: $0.00
Investigation Fee: $0.00
Drainage Permit Fee :
$237.00
Water Quality Dept Insp Fee: $152.00
Building Green Fee: $2.00
Drainage Plan Check:
$199.00
Building Dept WQ Plan Check: $0.00
Plan Dept Plan Check: $0.00
Grading Consultant Fee :
$0.00
Others
Building Dep Plan Check: $396.00
$0.00
$0.00
Building PC Investigation : $0.00
Additional Fee :
$0.00
Plan check Ext. Fee : $0.00
WQ Compliance Insp Fee: $0.00
TOTAL FEE : $1,440.00
Plan Check Fee :
$595.00 Fee DLe at Permit Issuance : $345.00
PROCESSED BY: \ Vx d� _ _ _ PLAN CHECKED BY::
ZONING APPROVAL: 1 APPROVAL TO ISSUI
PERMIT EXPIRES 180 DAYS Gr'. ER ;SSUANCE 0R LPST 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, 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
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
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).
❑ 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 legall3
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:http://www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION p
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 is 3 of the Business and P fes to s r?e, a icense fifull force
and effect. License Class License No Date Contractor Signatu
WORKERS' COMPENSATION DECLARATION
NARNING: 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
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
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
:e of the work for which this permit is issued. Policy No.
and will mynOA& 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 an olic number are: ,-N _
re of Agent
certify that, in the p
. if I should become
re of Applicant
Date
Ice f the o orw pe is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation la s of California, and agree
to hew rs' co ation ovisI ns of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. G Z Zi
nu of r �i vu nu.ir_ nr_or.iry Date o
hereby affirm under penaty of perjurylhat 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
y my signature below, I certify to each of the following:
I am the property owner or authorized to act on the
I have read this application and the information I ha,
I agree to comply with all applicable city and county
I authorize representatives of this city or county to
Onature of Prooertv Owner or Authorized Aaentl
owner's behalf.
ed is correct. i
g to building construction.
for inspection purposes.
I Print Property Owner's or Authorized
ACTION DATE BY r I
R GULATIONS PAT 61 OF TITTLE 40 AND AQMD RULEf
OLICLARATION OF
FOR OFFICE USE ONLY
Name V hU t
PERMIT EXPIRED
-
❑ I SUBMITTED ASBESTOS NOTIFICAT:ON TO
gates & fences win cn serve
as part of a pool / spa
barrier, Shall be In place
prior to approval to fill
poollspa & shall remain in
place & be maintained for
pool/spa
the life V21
PERMIT CANCELLED
UEPA
QMD
PERMITEXTENDED
POOL ALARMS
INSTALLED
Z
ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE: -
PERMITFINAL