HomeMy WebLinkAboutS2022-0045 - PermitsCity of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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Job Address: 1854 PORT RENWICK PL Floor: Suite:
Description of Work:SFR POOL & SPA 450 SF W/ DRAINAGE
Inspector Area: 4
Legal Description: N TR 7032 LOT 74
Owner:
CHISOLM JOANNA
Address:
1854 PORT RENWICK PL
NEWPORT BEACH, CA 92660
Phone:
Applicant: ELLISON PAUL
Address:
24642 VIA RAZA
LAKE FOREST CA 92630
Phone:
949-683-9861
Building Rear:
Setbacks: Front:
Left:
Right:
Construction
Construction Valuation: $50,000.00
Building Permit Fee :
$440.00
Permit Issuing Fee:
$0.00
Investigation Fee:
$0.00
Building Green Fee:
$2.00
Plan Dept Plan Check:
$0.00
Building Dep Plan Check:
$396.00
Building PC Investigation :
$0.00
Plan check Ext. Fee :
$0.00
WQ Compliance Insp Fee:
$0.00
TOTAL FEE : $1
PROCESSED BY:
ZONING
"S2022-0045'
POOLPermit : S2022-0045
Project No : 0414-2022
Inspection Requests Phone (949)644-3255
Bldg: 1 F n
Plan Check No: 0414-2022
Code Edit: 2019 �J
Contractor: ORANGE COUNTY POOLS INC
Address:
960 6TH ST 101A-148
NORCO CA 92860
Phone:
714-225.2907
Con State Lic:
839719
Lic Expire:
0613012022
Bus Lic:
BT30072637
Lic Exp Date:
08/31/2022
Worker's Compensation Insurance
Carrier: WIC EXEMPT
Policy No:
Expiration:
FEES
Architect:
Address:
Phone:
State Lic:
Engineer: BIEDENBACH CHRISTOPHER
Address: 1201 N TUSTIN
ANAHEIM CA 92807
Phone: 714-630-6100 State Lic:C-074003
Special Conditions:
Issued Date: 02/16/2022
Record Management:
$8.00
Water Quality ---
$0.00
Building Dept Inspection Fee:
Drainage Permit Fee :
$237.00
Water Quality Dept Insp Fee:
$152.00
Drainage Plan Check:
$199.00
Building Dept WQ Plan Check:
$0.00
Grading Consultant Fee :
$0.00
Others
$0.00
Additional Fee :
$0.00
$0.00
Plan Check Fee :
$0.00 Fee Due at Permit Issuance : $1,4
PLAN CHECKED BY::
APPROVALTOISSUE: J6 A` ---
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) 1 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
ie 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
'rofessions 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
of more than five hundred dollars ($500). 1201 N TUSTIN
as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business
no 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
nprovements 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
nproved 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
pply 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).
I am exempt fmm licensure under the Contractors' State License Law for the following reason:
Iy 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 s'vcture 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
rofess,ons Cede, i4 available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.govlcalaw.html.
'signature of Property Owner or Authorized Agent Date
.ICEN3ED CONTRACTOR'S DECLARATION
hereby affirm u,,der penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0) of71y'� 3 of the Business and ProfPsionff'Q.ed�; gn(f'pny license is in full force
rid etrect. License Cass License No Date //� Z-Z Contractor Signature r� (/ f/.��
CORKERS' CO:LFENSATION DECLARATION
'ARNINC FAILUR= TO 3LCURE 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
LET Cf COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
t.a.Lty affirm under Penalty of perjury one of the following declarations:
I have and wT ma±ntain 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,immrnce of the were for which this permit is issued. Policy No.
r
I have and will loain.ain 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' compensatioi
Isurance carrier and policy number are:
;arrier Policy Number Expiration Date
Vame Agent Phone #
ii'E�tat, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' C mpensation laws of California, and agre
, should become su ' ct h wo er ompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. }�',.j\/T/-
3ignatureofApplicant Da �/16�Z Z
)ECLARATION REGARD ING NSTRUCTION LENDING AGENCY
hereby 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 p " ed is correct.
I agree to comply with all applicable city and cou y ina a to la r ating to building construction.
I authorize representatives of this city or county ter abo a-i ntifie roperty for inspection purposes. Z
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name Dat
ACTION DATE BY ECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMITEXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED EPA
PERMIT EXTENDED AQM D
POOLALARMS /1 BEST% N I ION IS NOT APPLICABLE TO
INSTALLED / .. PRnPn n nKnn�rf Indi� ,
PERMIT FINAL
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