HomeMy WebLinkAboutS2019-0039 - PermitsCity of Newport Beach - Building Division `S2019--0039* POOLPermit: S2019-0039
(9)
100 Civic Center Drive, Newport Beach, CA 92660 Project No
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
PL
Bldg: 0
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/
Job Address: 120 KINGS Floor:
Suite:
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Description of Work:RELOCATE POOL EQUIPMENT
& EXTEND GAS LINE TO POOL **STOP WORK*'
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ll
Inspector Area: 2
Plan Check No:
Code Edit:
2016
Legal Description: N TR 1219 BLK E LOT 1
Owner: BROOKS BRIAN E
Contractor:
OWNER/BLDR
Architect:
,
Address: 120 KINGS PL
Address:
Address:
,
NEWPORT BEACH CA 92663
'
Phone: 702-539.2988
Phone:
Phone:
State Lic:
Applicant: BROOKS BRIAN E
Con State Lic:
O/B
Engineer:
Address: 120 KINGS PL
Lic Expire:
Address:
NEWPORT BEACH CA 92663
Bus Lic:
Phone: 702-539-2988
Lic Exp Date:
Phone:
State Lic:
Building Rear:
Worker's Compensation Insurance
Special Conditions:
Setbacks: Front:
Carrier:
Left:
Policy No:
Right:
Expiration:
Issued Date: 03/13/2019
, .
,
Construction Type
FEES
Construction Valuation: $2,500.00
Building Permit Fee : $120.00
Record Management:
$0.00
Water Quality ---
$0.00
Permit Issuing Fee: $0.00
Building Dept Inspection Fee:
Investigation Fee: $120.00
Drainage Permit Fee :
$0.00
Water Quality Dept Insp Fee:
$0.00
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
$0.00
Building Dep Plan Check: $0.00
$0.00
Building PC Investigation'
Additional Fee :
$0.00
Plan check Ext. Fee $0.00
WQ Compliance hXFee: $0.00
TOTAL 4E : $241.00
Plan Check Fee :
$0.00 Fee Due at Permit Issuance
: $241.00
PROCESSED BY:
ZONING APPRO%
APPROVALTO
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID
BY::
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, priorto its issuance, also requires the applicant for
1e 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 licensum 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).
as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business
nd 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
n oved for the purpose of sale).
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).
7 lam 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 least one year prior to completion of the improvements covered by this permit, I cannot legally
ell 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
'rofessions Code,'is cvailable upon request when th''plication is submitt or at he following Web site:http://www.leginfo.ca.gov/calaw.html.
iignatpre of Property Owner or Authorized Agenf�}-� 1 '..._ c ;��- Date ) 3/J 3_1 ZC �! S
.13ENSED CONTRACTOR'S DECLARATI N Z,
hereby affirm, under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 f Divisi n of the Business and Profe, signs Code, and my lie se is in full force
rid effect. License Class License No Dat 3 za yContractor Signature_ of �.r,
VORKERS' CJMPENSATION DECLARATION
'AfNING: FAILURE TO SEi URE 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
OS', uF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
aeaaov affirm anuer penalty of perjury one of the following declarations:
I have and wi:l 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 thl
ertormance 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'
ranee carrier find policy number are:
Policy Number
Agent
Date
that, 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' compensation laws of California, and agrel
ould become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
of
D310�e:31131 Zcy 9
IECLARATION REGARDING CONSTRUCTION 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
'y 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 cougy tt ter the abov Iden'fied property for inspection purposes.
lionature of Prooertv Owner or Authorized Agent l j� �v� Print Prooertv Owner's or Authorized Agent's Nam& r:-a f31110 k,
ACTION
DATE
BY I
DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
FOR OFFICE USE ONLY
PERMITEXPIRED
LJ I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED
EPA
PERMIT EXTENDED
QMD
POOLALARMS
INSTALLED
�ILt7 2`
7
J
ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL