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Home My WebLink AboutS2023-0120 - PermitsOk �EWFORT City of Newport Beach 11111111111111111111111111111111111111111111111111111Pool Permit : S2023-01 20 pI Community Development Department- Building Division S 2 0 2 3 0 1 2 0 Plan Check No : PC2023-1444 • 100 Civic Center Drive, Newport Beach, CA 92660 Permif Counter Phone: (949) 718-1888 Issued Date : 07/12/2023 V newportbeachca.gov/civic Final Date: Combination Type - SFP Permit Status: Issued Work Class - New Inspection Area : 3 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS Job Address : 2107 INDIAN SPRING LN Description : SFR NEW POOL AND SPA 664 SF Owner: MATTHEW BOLLER Address : 2107 INDIAN SPRINGS LN NEWPORT BEACH, CA 92660 Phone: (949)929-2586 Applicant: OUTDOOR CONCEPTS Address: 28241 CROWN VALLEY PKWY, F293 LAGUNA NIGUEL, CA 92677 Phone : (949) 295-4417 Owner/Builder : Address : Phone Legal Desc : Contractor: OUTDOOR CONCEPTS Address : 28241 CROWN VALLEY PKWY, F293 LAGUNA NIGUEL, CA 92677 Phone: (949)295-4417 Con State Lic : 831378 Lic Expire : 02/29/2024 Bus Lic: BT30060506 Bus Lic Expire : 09/30/2023 Workers' Compensation Insurance Carrier: BENCHMARK INSURANCE CO Policy No : CST5025614 W. C. Expire: 6/18/2024 Code Edition : 2022 Fire Sprinklers : NO Type of Construction : Fire Hazard Zone : NO Occupancy Groups : R3/U No of Units : 1 Bldg Height : No of Stories Building Setbacks : Front: 20, Side: 6, Side: 6, Rear: 6 Flood Zone : Use Zone: R-1-6000 - Single -Unit Residential (6000 indicates minimum lot area) PROCESSED BY: 4_2� SPECIAL CONDITIONS: Architect Address Phone: State Lic Engineer: LACHER TODD ' Address : 1201 N TUSTIN AVE , , • ANAHEIM, CA 92807 Phone: (714)630-6100 Designer: , Address:' Phone: — 1. Construction Valuation : $65,000.00 Added/New/TI sq. ft. Bldg: 0 Alteration sq. ft. Bldg : Added/New sq. ft. Garage: 0 INSPLECTOR OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Law for the reasan(s) indicated below by the chackmark(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 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 lusiness 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 got more than five hundred dollars (S500). 1, 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, Iusiness 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 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). 1 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 poly 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 _ , __.., _ ly my signature below I acknowledge that, except for my personal residence in which I must have resided for at leas) one year poor to completion of the improvements covered by this permit. I cannot IDgall) ell a structure that I have built as an owner -builder it It has not been constructed in its entirely 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:11wA'w.leginfo.ca.gov/calew,html, tlgnature, 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 with Section 7 ) of ivision 3 \o�f the Business and Pr essl n de, and my license is In full force no effect. License Class License No Date �i fjrc;ontractor Signature VORKERS' COMPENSATION DECLARATION 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THfi SANO DOLLARS ($100,0001, IN ADDITION TO THE DST OF COMPENSAr ION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEE& au, aby affirm wider penalty of perjury one of the following declarations: .I-tirve and will maintain a certificate of consent to sell -insure for workers' compensation. Issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th rI furmanee of the work for which this permit Is issued. Policy No. hh a a CI n.aii,tein 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' compernsatiol an^ carrier and policy number are: Policy Number Expiration Date Nome c" Agent _. Phone H :1I oeruh, that, in the performance of the work for which this permit is issued, I shail not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre hat, If I s.1ouid bacon e'Ubbjjeej/�t to worker pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /� " �} 9&nature of CIN F nl _5/�� Data 4— (/'� �C TEOuutATfON PFG IRD! G TRUCTI LEN NG AGENCY' hereby affirm under penally of rjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). -enders Name Lenders Address 3y my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owners 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 D ter the above -Identified property for inspection purposes. 31nature of Property Owner cr Authorized Agent Print PropertyOwner's or Authorized Agent's Name AMON DATE 0y I DECLARAT€ON. OF COMPLIANCE WIT4 CODE OF FEDERAL FOR OFFICE USE ONLY ((( REGULATIONS PART 51 OF TITIE40 AND AQMD RULE 1403 PERMIT EXPIRED i SURMI7F. D A5RFSTOS NOTIFICATION TO CERTIFICATE of `S �y�Z I ASB SMos o1lFl t NOrA CARLe To fie inn pt iced alarms, latches gates and fences which serve as part e a be main trawler, shall PERMIT CANCFLLED PERMIT EXTENDED 4e In lane prior t0 approval to fill pool/spa &shall remain in place & be maintained for the PERMITFINAL�lq'}/�/r he pool. ROPOSEDEJ4t L / '/� OCCUPANCyf55UED 1 SIGNATURE A ��/