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HomeMy WebLinkAboutS2020-0112 - Permits�nok� City of Newport Beach - Building Division 't .l I I I 100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 2 0 II IIIIIII I I III II p ;9a 1 Permit Counter Phone (949)644-3288 r Job Address: 1900 PORT BRISTOL CIR Floor: Description of Work:SFR SPA 64 SF Inspector Area: 4 Legal Description: N TR 6623 LOT 45 Owner: SEATON Address: 1900 PORT BRISTOL CIR NEWPORT BEACH, CA 92660 Phone: Applicant: ELLSON PAUL Address: 24642 VIA RAZA LAKE FOREST CA 92630 Phone: 949-683-9881 Building Rear: Setbacks: Front: Left: Right: Construction Type : Construction Valuation: $20,000.00 Building Permit Fee: $430.00 Permit Issuing Fee: $0.00 Investigation Fee: $0.00 Building Green Fee: $1.00 Plan Dept Plan Check: $0.00 Building Dep Plan Check: $387.00 Building PC Investigation : $0.00 Plan check Ext. Fee : $0.00 WQ Compliance Insp Fee: $0.00 TOTAL FEE : $824.00 PROCESSED BY: ZONING APPROVAL: �.J\ Suite: Bldg:1 Plan Check No: 1388-2020 Code Edit: 2019 Contractor: SUN C NTRY Address: 22785 LAMARE LANE LAKE FOREST CA 92630 Phone: 949-859-9636 Con State Lic: 542772 Lic Expire: 12/3112020 Bus Lic: BT30072679 Lic Exp Date: 08131/2021 Worker's Compensation Insurance Carder: STATE FUND Policy No: 9269135 Expiration: 01131/2021 FEES Architect Address: Phone POOLPermit : S2020-0112 Project No: 1388-2020 Inspection Requests Phone (949)644-3255 Engineer: LACHER TODD Address: 1201 N TUSTIN AVE ANAHEIM CA 92807 Phone: 714-630-6100 Special Conditions Issued Date: 08112/2020 State LIC: State Lic:C-067656 � NAN� =CT01R Record Management: $6.00 Water Quality -- Building Dept Inspection Fee: $0.00 Drainage Permit Fee : $0.00 Water Quality Dept Insp Fee: $0.00 Drainage Plan Check: $0.00 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 PV,N CHECKED RY:: APPROVAL TO 13SU' PERMIT EXPIRES 180 DAYS AFTER ISSUANCE CR LAGT VALID INSPECTION Fee Due at Permit Issuance : $824.00 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, 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). ❑ 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). ❑ 1, 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 a ply 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 Iiceniure under the Contractors' State License Law for the following reason: By my signature below I ac:mowledge 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 legal) 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 available upon request when this application is submitted or at the following Web site:http://www.leginfb.ca.gov/calaw.htm]. Signature of Property Owmar or Authorized Agent Date LICENSED CONTRACI OR'S DECLARATION I hereby affirm under penaly of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. \/ 8/11120 g � � // //////// License Class License No Date Contractor Si nature�.PF�'CLL� 0�"LQ6IL WORKERS' 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 THOUSAND DOLLARS IS700,000), IN ADDITION TO THE COST OF COMPENSATION, DAW,OES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. I hereby affirm under penalty of perjury one of the following declarations: ❑ I have 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 rmance of the work for which this permit is issued. Policy No. eve 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 ance carrier and policy number are: Carder Policy Number Expiration Date Name of Agent Phone # I certify 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 agre at, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant la�d&�&Af, Dated/8/11/20 DECLARATION REG R AG CONSTRUCTION LENDING AGENCY I hereby affirm under penally 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 ill[ applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or county to enter the bov ant ad property for inspection purposes. Signature of Property Owner or Authorized Agen Print Property Owners or Authorized Agent's Nam Paul Ellison ate 8111120 ACDON DATE BY DFCL+1P477 ONOFCOMPUANCEWfTNCODEOF yate� & fefi@��FAISCdp6�®let. FEDERAL IiEGULAF10N5PAf27610F77TLE40AND ALpff4D4U'-E7403' iSt£s1UU]TEDASBEST05NOTIFICATIDNTO: El EPA ❑ AQMD , part Of a pgol /spa �rrrief, shall be in place pi irJr to approval to fill poolispa &shall remain in PERM1T17CPtRED _ pERM1FC4NCELLED PER1vi1TEX7ENDED ��8O 710N15NOTAPPLfCA8LET0 ©OF0EDDEMOLITf i Sff;NA•7r}fE: placebe ali ffomaintained ( f thepoollsa k --- pLRMFT3YAL 10/06/20 CE4TiFfCATEOF OCCUPANCYISSDED