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Home My WebLink AboutS2021-0079 - PermitsCity of Newport Beach - Building Division 111111III 111111111111p1111111111111111111111111111111 o' G 100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 2 1 0 0 7 9 Permit Counter Phone (949)644-3288 V r�� IT�iYN'a$ ,lob Address: 119 SHORECLIFF RD Floor: Description of Work:SFR POOL/SPA 240 SF Inspector Area: 5 Legal Description: N TR 1116 LOT 116 Owner: BENTLEY GREG & DONELLE Address: 119 SHORECLIFF RD CDM CA 92625 Phone Applicant: GALLO SALVADOR Address: 15660 YOUNGWOOD DR WHITTIER, CA 90603 Phone: 562-756-3841 Building Rear: Setbacks: Front: Left: Right: Construction Type : VB 11 Construction Valuation: $64,000.00 Building Permit Fee : $430.00 Permit Issuing Fee: $0.00 Investigation Fee: $0.00 Building Green Fee: $3.00 Plan Dept Plan Check: $0.00 Building Dep Plan Check: $387.00 Building PC Investigation : $0.00 Plan check Ext. Fee : $0.00 WQ Compliance Insp Fee: $0.00 TOTAL FEE : $869.00 PROCESSED BY: ZONING APPRO'v Suite: Bldg:1 Plan Check No: 0630-2021 Code Edit: 2019 Contractor: SAL GALLO MSN POOL SERVICES CORP Address: 15660 YOUNGWOOD DR Address: WHITTER CA 90603 Phone: 562-756-3841 Phone: Con State Lic: 1046791 Engineer: Lic Expire: 11/30/2022 Address: Bus Lic: BT30073299 Lic Exp Date: 10/31/2021 Phone: Architect: POOL.Permit: S2021-0079 Project No : 0630-2021 Inspection Requests Phone (949)644-3255 State Lic: THOMPSON MATTHEW 12021 N TUSTIN AVE ANAHEIM CA 92807 714-630-6100 State Lic:C-086051 Worker's Compensation Insurance Special Conditions: Carrier: NO EMPLOYEES DRAINAGE ON PERMIT X2019-2821 Policy No: Expiration: Issued Date: 04/01/2021 FEES Record Management: $6.00 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 WQ Plan Check: $0.00 Grading Consultant Fee : $0.00 Others $0.00 Additional Fee : $43.00 $0.00 Plan Check Fee : $387.00 Fee Due at Permit Issuance : $482.00 PLAN CHECKED BY:: A"DROVAL TO ISSUI 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) (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). 12021 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, 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 legally 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 D to LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 000) o `i isi n of the Business and Pro ass and my license is in full force and effect. License Class License No Date Contractor Signatur 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 J$100,000), IN ADDITION 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: 111 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 performance of the work for which this permit is issued. Policy No. have 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 rance carrier and policy number are: pier Policy Number Expiration Date 1e of Agent Phone # certify that, in the performance f e 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 agre if I should becorr�]�a bje t workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. IatureofApplicant ate Ireby affirm underpenalty 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) ider's Name Lender's Address 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 ordinanc nd state laws relating to building construction. I authorize representatives of this city or counr th e-identified roperty for inspection purposes. �I'J/� �IX/ry nature of Prooertv Owner or Authorized ADent INCX� Print Property Owner's o Autho zed d en s Name ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY L REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED UEPA _ PERMIT EXTENDED QMD POOLALAINSTALLED RMS C I (ICJ I� ` ASBESTOS I; NJT aPPLICA4LE TJ 0 `�rJ {/ PROPOSED DEMOLITION.0 „l•� SIGNATURE: