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Home My WebLink AboutS2017-0070 - PermitsaN~�+'tvf�, . City of Newport Beach - Building Division 5 100 Civic Center Drive, Newport Beach, CA 92660 nPermit Counter Phone (949)644-3288 i- 47 n > '+t�roti4� Job Address: 914 CITRUS PL Floor: Suite: Bldg: 1 Description of Work:SFR - NEW POOL 448 SF WI DRAINAGE Inspector Area: 8 Legal Description: N TR 4892 LOT 14 Owner: CERCIELLO KRISTIN Contractor: Address: 914 CITRUS PL Address: NEWPORT BEACH, CA 92660 Plan Check No: 0909-2017 Code Edit: 2016 1ST CHOICE POOL SERVICE INC Architect: P O BOX 80430 Address: RANCHO SANTA MARGARITA CA 92688 POOLPermit : S2017-0070 arojc-ct;No: 0909-2017 Inspection Requests Phone (949)644-3255 Phone: Phone: Phone: Applicant: PERCY JOHN Con State Lic: 868331 Engineer: LACHER RONALD Address: PO BOX 12529 Lic Expire: 1113012017 Address: 1201 N TUSTIN AVE NEWPORT BEACEH CA 92660 Bus Lic: BT30059108 ANAHEIM CA 92807 Phone: Lic Exp Date: 0513112018 Phone: 714-630-6100 State Lic: State Lic:C-020949 Building Rear: Setbacks: Front: Left: Right: Construction Type Worker's Compensation Insurance Carrier: EXEMPT Policy No: (NO EMPLOYEES) Expiration: Special Conditions: Issued Date: 0511112017 _ FEES Construction Valuation: $70,000.00 i Building Permit Fee : $380.00 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: $0.00 Building Green Fee: $3.00 Drainage Plan Check: $0.00 Building Dept WQ Plan Check: $0.00 Plan Dept Plan Check: $37.50 Grading Consultant Fee: $0.00 Others Building Dep Plan heck: $338.00 $0.00 Building PC Investi ation : $0.00 Additional Fee : $0.00 $0.00 Plan check Ext. F $0.00 WQ Compliance In p Fee: $0.00 TOTAL FE : $766.50 Plan Check Fee : $375.50 Fee Que at Permit Issuance : $391.00 PROCESSED BY: ZONING APPRO'� PLAN CHECKED BY:: APPROVAL TO ISSUI PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION OWNER -BUILDER DECLARATION - I hereby affirm under penalty of perjury that I am oxenSµt from thA 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 Coder ALy city 3r o4unty that requires z 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 Business 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 of more than five hundred dollars ($500). - 1201 N TUSTIN AVE I, as owner of the property, or my employees with wSges as their sc'e cc mpeaaaCon, will do U all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness and Professions Code: The Contractors' State license i-aw dues not aptly .o cn 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. I', hT,v3ver, :habu.lui,ig 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). 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 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). I 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 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 available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. signature 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 Sectio 70 0 of Divlsio of the Business and Pr T 'Go�lr , nd m r e is in full force nd effect. License Class License No Date ( Contractor Signature VORKERS' COMPENSATION DECLARATION IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED D DOLLARS ($100,000), IN ADDITION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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 the erformance of the work for which this permit is issued. Policy`No. 11 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' compensation Isurance carrier and policy number are: Policy Number Agent Date ce fy 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 became subject to the workers' compensation laws of California, and agree t, if I houId becomes 1e o th ork com nsation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. _ net a of Applicant ARATION REG IN ONS RUCTION LENDING A NCY �reby affirm uncle enalty perju that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civl ode). Ider's Name Lender's Address 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 co Ina s laws relating to building construction. I authorize representatives of this city or cou o enter e a -ide operty for inspection purposes. �) �(' nature of Prooertv Owner or Authorized ADentt- Print Prooertv Owner's or Authorized Aoent's Nar Y V .r J)1^r't ACTION DATE BY DECLA TION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY EG TIONS PART 61 OF TITLE 40 AND AQMD RULE 1409 PERMITEXPIRED I L1 I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED PERMIT EXTENED UAQM D POOLALARMS LJ ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO INSTALLED PROPOSED DEMOLITION. SIGNATURE: u SS. w CL cm J u.i uj L) z 0 u R w o F� Uj LU d lu w W ac � 0 w u it a 0m.€ V) k% L) 00 WOW 0} I— 6LI � 489 � ILl 0 W CL lu L w do Hid v r M W � od L 3 C) GD _ � r~ 7 W J w M1 4 L7 J 6L � U 0 z wuj6w rrzi 50 �y a0oc0tiC 0� l� l 1 Y rI 4• 8u i i FR 4 cc IL LO 10 J�3 U� r j ti 9C 9 Iff ..e��t Ea a K a p ry{^� yy�� 04 Lf1 RV iL z u LL Wj �i irk Li r ... J. W i•- EL IIJ LLJF W 0 i4 d 0* 5 8 I i Lll m U LN 0 L J z 0 w x ttAA W �a zc 0 3t LW CL >V) LU w W� Ili