HomeMy WebLinkAboutS2019-0135 - PermitsAwa p City of Newport Beach - Building Division
_ t :I Ob Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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sJob Address: 1215 BERKSHIRE LN Floor: Suite: Bldg: 1
Description of Work:SFR NEW POOL & SPA (432 SF), YARD DRAINAGE
Inspector Area: 3
Legal Description: N. TR 3031 LOT 17.
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Plan Check No: 1747-2019
Code Edit: 2016
Owner:
CLOSE DAVID & STEPHANIE
Contractor:
OWNERIBLDR
Address:
1215 BERKSHIRE LN
Address:
DAVID CLOSE
Plan Dept Plan Check:
NEWPORT BEACH, CA 92660
Building Dep Plan Check:
$361.00
Phone:
949-246-3313
Phone:
949-246-3313
Applicant:
INSTANT POOLSCAPES
Con State Lic:
OIB
Address:
28562 OSO PKWY #13243
Lic Expire:
$0.00
Additional Fee:
RSM CA 92675
Bus Lia
$0.00
Phone:
949-795-0648
Lic Exp Date:
Building
Rear:
Workers Compensation
Insurance
Setbacks:
Front:
Carrier:
Left:
Policy No:
Right:
Expiration:
Construction Valuation: $45,000.00
Building Permit Fee :
$405.00 -
Permit Issuing Fee:
$0.00
Investigation Fee:
$0.00
Building Green Fee:
$2.00
Plan Dept Plan Check:
$0.00
Building Dep Plan Check:
$361.00
Building PC Investigation :
$0.00
Plan check Ext. Fee :
$0.00
WQ Compliance Insp Fee:
$0.00
TOTAL FEE : $1.692.00
PROCESSED
ZONING APPS
POOLPermit : S2019-0135
Project No: 1747-2019
Inspection Requests Phone (949)644-3255
Architect:
$6.00
.Address:
Phone:
Engineer:
LACHER TODD
Address:
1201 N TUSTIN AVE
Water Quality Dept Insp Fee:
ANAHEIM CA 92807
Phone:
714-630-6100
Special Conditions:
$0.00
FEES
Issued Date: 0810812019
State Lic:
State Lic:C-067656
Record Management:
$6.00
Water Quality- --
Building Dept Inspection Fee:
$0.00
Drainage Permit Fee :
$312.00
Water Quality Dept Insp Fee:
$0.00
Drainage Plan Check:
$312.00
Building Dept WQ Plan Check:
$0.00
Grading Consultant Fee :
$0.00
Others
$0.00
Additional Fee:
$294.00
$0.00
Plan Check Fee: $294.00
PLAN CHECKED BY:: —
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PROVAL TG,SSUE:
PERMIT EXPIRES 180 DAYS AFTEP, ISSUANCE OR LAST VALID INSPECTION
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Fee Due at Permit Issuance : $1,398.00
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). 1201 N TUSTIN AVE
❑ I, 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 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
ements 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
I 0 for the purpose of sale).
El 1, s 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 legalh
sell a structure that I have built as an owner -builder if it has not been st ted 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 th' 'cationed or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. ,
Signature of:Property Owner or Authorized Agent De
LICENSED CONTRACTOR'S DECLARATI N
I hereby affirm under penalty 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. License Class License No Date' Contractor Signature
NORKERS' COMPENSATION DECLARATION
NARNING: 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 ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 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 th
Jerformance 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' compensatioi
rance carrier and policy number are:
ler Policy Number Expiration Date
ie of Agent Phone #
certify that, in the performance of the w 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
if I should become bje the wo r mpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
eture of Applicant
`I AOATInM RFP Rni C NSTRI Olrt6m 1 Pmn[NP APPNCV
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 ordinance s to laws relating to building construction.
I authorize representatives of this city or coun�ty,�"� the o ntified property for inspection purposes. J
InnahlrR of PrnnRrtv Owner or Authorized ADent 75H7A/ Print Property Owner's or Authorized Agent's Named
ACTION DATE BY DECLARATIOA't5F COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403 All re wired alarms latches
PERMITEXPIRED 0 1SUBMITTED ASBFSTO$NOTIFICAiIONTO gates & fences which serve
PERMITCANCELLED EPA •• • • - e as part of a pool I spa
PERMIT EXTENDED QMD • s e• *• • • • . : barrier, shall be in place
POOLALARMS Q f ASBESTOS NOTIFICATION IS NOT APPLICABLE TO prior to approval to fill
INSTALLED PROPOSED DEMOLITION. pool/spa & Shall remain in
SIGNATURE: •• ••• • • • ••• place & be maintained for
PERMITFINAL •• the po I p