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Home My WebLink AboutS2021-0221 - Permits4 ywl•crfr City of Newport Beach - Building Division 11111111111111p11111p11111111111p111111111111111111 POOLPermit : S2021-0221 !� 100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 2 1 0 2 2 1 Project No : 2295-2021 w I Permit Counter Phone (949)644-3288 tf�Y91µ�a~ Inspection Requests Phone (949)644-3255 NO CONSTRUCTION NOISE ,lob Address: 23 HARBOR ISLAND Floor: Suite: Bldg: 1 Description of Work:SFR NEW SPA 182 SF THE WEEKEND Inspector Area: 2 Plan Check No: 2295-20®N Code Edit: 2019 Legal Description: TR 802 LOT 23 ALL -INC BET SAME & HIGH TIDE LINE- Owner: PICKUP TODD Contractor: FLUID DYNAMICS POOL & SPA Architect: Address: 23 HARBOR ISLAND Address: 620 E WALNUT AVE, #B Address: NEWPORT BEACH, CA 92660 FULLERTON CA 92831 Phone: Phone: 714-213-8047 Phone: State Lie: I u , Applicant: PETERSON DAVID Can State Lie: 809954 Engineer: PETERSON DAVID 0 Address: 140 LOMAS SANTAFE DR STE 202 Lie Expire: 1213112022 Address: 140 LOMAS SANTA FE DR #202 g SOLANDO BEACH, CA 92075 Bus Lie: BT30055899 SOLANA BEACH CA 92075 � Phone: 714-213-8047 Lie Exp Date: 07/31/2022 Phone: 858-720-1001 State Lic:C-05 Building Rear: Worker's Compensation Insurance Special Conditions: Setbacks: Front: Carrier: INS CO OF THE WEST Left: Policy No: WSD5049838 Right: Expiration: 0811212022 Issued Date: 1010112021 Construction Type FEES Construction Valuation: $25,000.00 Building Permit Fee : $440.00 Record Management: $8.00 Water Quality -- Permit Issuing Fee: $0.00 Building Dept Inspection Fee: $0.00 Investigation Fee: $0.00 Drainage Permit Fee : $0.00 Water Quality Dept Insp Fee: $152.00 Building Green Fee: $1.00 Drainage Plan Check: $0.00 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 : $997.00 Plan Check Fee : $396.00 Fee Due at Permit Issuance : $601.00 G PROCESSED BY: V PLAN CHECKED BY:: ZONING APPROVAL: �Q 1 APPROVAL TO ISSUE' 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 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 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). 140 LOMAS SANTA FE DR #202 ❑ 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). ❑ I 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 M=^red contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request vobn this application is submitted or at the following Web site:http://wwvi.1-�i9fo.ca.gov/calaw.html. Signature of Property Owner or Authorized Age - Da} LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 00 o Div' ion 3 of tusiness and Frofe„siO Cod '.pen s in f II ce an effect. License Class License No .,j Dat �? $. Gntractor Signauur Y:OaARS' Cul-IPt;NSAT10 ECL TION V 17ik Ir;G: 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 I$100,0001, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm nude, penalty of perjury one of the following declarations: haje 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 yri#q,mance of tfe �icra for which this permit is issued. Policy No. PlAave 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' compensatio i rance carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # ❑1 certify that, in the perform ce of the work fO 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 that, if I should become S ib ct o the wor -;ce pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ��// Signature of Applicant / Date —,,— DECLARATION REGA CONSTRUCTION LEN AGENCY �� DECLARATION I 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). Lender's Name Lender's Address By 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 ordinances and state laws relating to building construction. I authorize representatives of this city or county t n the abo - ntifle rrty for opeinspection purposes. / �SA-9444 B LA—_7_A/1 �V Signature of Property Owner or Authorized Agent Print Property Owner's Or Authorized Agent's Nan,1� ,1e Date r ACTION DATE BY ECLARATION OF COMPUARff WITH CODE OF FEDERAL FOR OFFICE USE ONLY ��--y0' X REGULATIONS CATIONS PART 61 OF TITLE 40 AND AOMD RULE eds/lood aqi so a;ll ay 0 e d PERMITEXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO Ul Ulewaj Keys V eds/lood lly 01 lenoudde of joud aoeld ul aq Ileys'jelJJBq eds / lood a 10 lied BE PERMIT CANCELLED EPA PERMIT EXTENDED DAQMD UASBESTCS POOLALARMS NOTIFICATION IS NOTAPPLICABLE TO glues yOIgM SeOuej.'$ SejeB INSTALLED PROPOSED DEMOLITION. pajlflbej lld SIGNATURE: Say01e1'SWjele PERMITFINAL 2_Z 4 y r N � V W a 2 0 0 a of d m m s o w v a TS z 0 0 U 0 0 N `f r c a