HomeMy WebLinkAboutS2020-0052 - PermitsCity of Newport Beach - Building Division 11111111111111111111111111111111111111111111111111111111111POOLPermit : S2020-0062
o 100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 2 0 0 0 5 2 Project No : 0707-2020
4 Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
.a{+Filtin-�
.lob Address: 20112 KLINE DR Floor: Suite: Bldg: 1
Description of Work:SFR NEW POOL 276 SF AND DRAINAGE *CITY STANDARD*
Inspector Area: 8
Plan Check No: 0707-2020
Code Edit: 2019 I NSP
�r 1
��®
Legal Description:
1
„
Owner: MORI DAVID
Contractor:
PREMIER POOLS ORANGE CTY Architect:
Address: 20112 KLINE DR
Address:
22 SAN RAPHAEL
Address:
NEWPORT BEACH CA 92660
DANA POINT CA 92629
State Lie:
°ae°
Phone:
Phone:
62fi-422.5426
Phone:
°� a
Applicant: ELLISON PAUL
Con State Lie:
798298
Engineer: LENEHAN GERRY
....
Address: 22 SAN RAPHAEL
Lie Expire:
03131/2021
Address: 1024 IRON POINT
DANA POINT CA 92629
Bus Lie:
BT30071442
FOLSOM CA 925630
Phone: 949.683-9861
Lie Exp Date:
0313112021
Phone: 916-287-1445
State LlaC-073459
°o°a
a
Building Rear:
Worker's Compensation
Insurance
Special Conditions:
Setbacks: Front:
Carrier:
STATE COMP
a�
Left:
Policy No:
9158204
Right:
Expiration:
0510312020
Issued Date: 0411712020
Construction Type
FEES
Construction Valuation: $30,000.00
Building Permit Fee :
$418.00
Record Management:
$4.00
Water Quality --
Building Dept Inspection Fee:
$0.00
Permit Issuing Fee:
Investigation Fee:
$0.00
$0.00
Drainage Permit Fee :
$322.00
Water Quality Dept Insp Fee:
$0.00
$0.00
Building Green Fee:
$2.00
Drainage Plan Check:
$322.00
Building Dept WQ Plan Check:
Plan Dept Plan Check:
$0.00
Grading Consultant Fee:
$0.00
Others
$0.00
Building Delp Plan Check:
$0.00
$0.00
$0.00
Building PC Investigation :
$0.00
Additional Fee :
Plan check Ext. Fee :
$0.00
WQ Compliance Insp Fee:
$0.00
TOTAL FEE : $1,068.00
Plan Check Fee :
$0.00 Fee Due at Permit Issuance
: $1,068.00
PROCESSED BY:
PLAN CHECKED BY::
TO ISSUE:
ZONING APPROVAL:_APPROVAL
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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 7031.6, Business and Professions Cade: 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
tha 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 Ilcensure 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). 1024IRON POINT C
Iand , as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) portions of the work, and the structure is not Intended or offered forests (Section 7044, Business
mprovementsns Code: The Contractors' State are not Intended or offered for sale, If, however, the builnse Law does not dinglo an owner of or improvement r spsold within honeyea oflcompletioees' or n, the Ow oersonal effort,
guider will haa or ve the burden roves the property,
f proving that thwashnot built or
improved for the purpose of sale).
0 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 Ilcensure 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 leastone year prior to completion of the improvements covered by this permit, I cannot Is all,
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 avallable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
Signature of PropoCp Owner or Authorized Agent
LICENSED 00r I! CcgCTOR'S DECLARATION Date
':'errks affirm L'ri1. penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section ) of Ivi on 3 of the Business and Profs Co
a,id effect. License Clcss License No Date 2.0 Contractor5lgnature ' ce se is in full farce
.IVORK'RS' COVPENSATION DECLARATION
WARNING: FAILURE TO SECLRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SOaJECT AN EMPLOYER TO CRIMIN L NALTIES ANo CIVIL FINES uP TD ONE HUNDR O THOUSAND OOLLAft51f10a,600), IN ADDITION TO THE
7G�T O'.: COMPENSA, ll.', 3 WAGES AS PROVIDED FOR IN SECTION 37e6 OF THE LABOR CODE, INTEREST. AND ATTORNEY'S FEES.
mere.`, affirm under penalty of perjury one of the following declarations:
-+ I nave and 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 thi
,3nce of the work for which this permit is issued. policy No.
'lave and will-nali t::in 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'
;ancc carrier and PC icy number are:
Id of Agent___
certify that, in the
, if I should bacon
Iature of ADolican
Policy Number Expiration Date
this permit Is issued, 1 shall not employ any person in any manner so as to become subject to the workers'
ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
sreby affirm underoanah�•of perjury thet there is a construction lending agency for the
ider's Name
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 cortnty o a c a t e la
I authorize representatives of this city or ceunty% t f b e n1iF1a(
or
INSTALLED
0.-ccer
of the work for which this permit Is issued (Section 3097,A11 Code).
relating to building construction,
property for Inspection purposes.
OF COMPLIANCE WITH CODE OF FEDERAL I FOR
PART 61 OF TITLE 40 AND AQMD RULE
UASBESTOS NOTIFICATION IS NOTAPPLICABLE TO
PROPOSED DEMOLITION.
USE ONLY
1
of California, and