HomeMy WebLinkAboutS2018-0210 - Permits",'tv City of Newport Beach - Building Division IIpIIIIIIIII�II��IIIIII�IIIIIIIII
:`t 100 Civic Center Drive, Newport Beach, CA 92660
F ,' ' " Permit Counter Phone (949)644-3288
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POOLPermit : S2018-0210
Project No : 2747-2018
Inspection Requests Phone (949)644-3255
Job Address: 215 EVENING CANYON RD Floor:
Suite: Bldg: 1
Description of Work:POOL REMODEL 430 SF (REVISE SHAPE, CHANGE EQUIPMENT
Inspector Area: 5
Plan Check No:
2747-2018'
Code Edit:
2016
Legal Description: N TR 1116 LOT 125
Owner: ARGYROS
Contractor: CONTEMPORARY POOLS & SPAS
Architect:
Address: 215 EVENING CANYON
Address: 8 CALLE AMEND
Address:
NEWPORT BEACH, CA 92660
SAN CLEMENTE CA 92672
Phone: 714-814-4117
Phone: 949.463-0569
Phone:
State Lic:
Applicant: CONTEMPORARY POOLS
Con State Lie: 456476
Engineer:
LACHER TODD
Address: 8 CALLE AMEND
Lie Expire: 0212812019
Address:
1201 N TUSTIN AVE
SAN CLEMENTE CA 92672
Bus Lie: BT96011220
ANAHEIM CA 92807
Phone: 949-463-0569
Lie Exp Date: 09/30/2019
Phone:
714-630-6100 State Lic:C-067656
Building Rear:
Worker's Compensation Insurance
Special Conditions:
Setbacks: Front:
Carrier: STATE FUND
Left:
Policy No: 1016832
Right:
Expiration: 0410112019
Issued Date:
11/2112018
Construction Type
Construction Valuation: $40,000.00
Building Permit Fee :
$592.00
Permit Issuing Fee:
$0.00
Investigation Fee:
$0.00
Building Green Fee:
$2.00
Plan Dept Plan Check:
$40.00
Building Dep Plan Check:
$515.04
Building PC Investigation :
$0.00
Plan check Ext. Fee :
$0.00
WQ Compliance Insp Fee:
$0.00
TOTAL FEE: $1,161.04
PROCESSED BY:
ZONING APPROVAL: Q A
Record Management
Drainage Permit Fee:
Drainage Plan Check:
Grading Consultant Fee
Additional Fee :
FEES
$12.00
$0.00
$0.00
$aoo
$0.00
Plan Check Fee:
Water Quality- --
Building Dept Inspection Fee:
Water Quality Dept Insp Fee:
Building Dept WQ Plan Check:
Others :
PLAN CHECKED BY::
APPROVAL TO ISSUI
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
$0.00
$0 00 '
M63
$0.00
$0.00
Fee Due at Permit Issuance : $1,161.04
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
he 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
Irofessions 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
iot 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 (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
3usiness 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
Tlprovements 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
n 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
Ipply 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:
3y 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)
;ell 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
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
Signature of Property Owner or Authorized Agent Date
_ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing wit ection 7000) qf�T i�io3 of the Bus' ess and Profs Ion d�, an my lic s� is in full force
Ind effect. License Class License No Date 1 \ / 'z I Con nature
NORKERS' COMPENSATION DECLARATION
DARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL ES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
:DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
1 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
�.�e rmnnce of the vmr� 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' compensatiol
IsLUA.ce carrier and policy number are:
)arrie, _ Policy Number Expiration Date
Jame of Agent _ _ Phone #
'I certify that, in th o once of t ork f which this permit is issued, I shall not employ any person in any manner so as to become subject to thew 'compensation laws of California, and ogre
net, If I should beS a subj t worke ' ompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pr
Sigliatu!e fApo)ba /Z
IECLARA RN RELiAS CTION LENDING AGENCY
hereby affirm urde•pe alty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued n 3097, Civil Code).
.tinder's Name Lender's Address
3y my signature below, Fcerrtifoo 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 informati I have provided " t.
1 agree to comply with all applicable city a d coun sand st laws relating to building construction.
1 authorize represe atives'l7f this city or c my to r t above-' n ' property for inspection purposes.,¢.,
Si nature of Property er Zn-, razed Ag Print Property Owners or Authorized
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE O Y
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED UEPA
PERMIT EMENDED QMI)
POOLALARMS y� /i/ _ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
INSTALLED ! 1'�_ PROPOSED DEMOLITION.
/ r .. SIGNATURE: