HomeMy WebLinkAboutM2018-0079 - PermitsW ' City of Newport Beach - Building Division I 111�111111111p1p11111111111111111p111p111111p11111
100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 1 6 0 0 8 3
H Permit Counter Phone (949)644-3288
13001 -Permit: S2016-0083
Project No: 1306-2016
Inspection Requests Phone (949)644-3255
Job Address: 4606 ROXBURY RD Floor: Suite: Bldg: 1
Description of Work:POOL & SPA 665 SF
Inspector Area: 5 Plan Check No: 1306-2016
Code Edit: 2013
Legal Description: N TR 3357 LOT 18 INSPEC[o,
Owner: NELLIGAN JOHN& LAUREL J Contractor: CONTEMPORARY POOLS & SPAS Architect:
Address: 4606 ROXBURY RD 92625 Address: 8 CALLE AMEND Address: • ° ° m ° • ° • • • °
CORONA DEL MAR, CA SAN CLEMENTE CA 92672
Phone: 703-307-5527 Phone: 949-463-0569 Phone: State Lic: • . • • m ° °
Applicant: CONTEMPORARY POOLS/PAUL Con State Lic: 456476 Engineer: BIEDENBACH CHRISTOPHER
Address: 8 CALLE AMEND Lic Expire: 02/28/2017 Address: 1201 N TUSTIN m ° °o • ° o
SAN CLEMENTE CA 92672 Bus Lic: BT30052747 ANAHEIM CA 92807
Phone: 949-830.0905 Lic Exp Date: 10/31/2016 Phone: 714.630-6100 State Lic:C-074003
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Building Rear: Worker's Compensation Insurance Special Conditions: o•m•em o m o
Setbacks: Front: Carrier: STATE FUND ......
Left: Policy No: 1016832 °O0.°° 0
Right: Expiration: 04/01/2017 Issued Date: 06/13/2016 °O
Construction Type
FEES
Construction Valuation: $49,000.00
Building Permit Fee : $673.00 Record Management: $6.00 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: $2.00 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 Check: $585.51 $0.00
Building PC Investigation : $0.00 Additional Fee : $0.00 $0.00
Plan check Ext. Fee : $0.00
WQ Compliance Insp Fee: $0.00
TOTAL FEE : $1,304.01 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $1,304.01
PROCESSED BY: PLAN CHECKED BY::
ZONING APPROVAL: APPROVAL TO ISSUE:
"ALL REQUIRED EXIT ALARMS, LATCHES, GATES AND FENCES WHICH SERVE AS PART OF A POOUSPA BARRIER ARE IN PLACE AT
REMAIN IN PLACE AND BE MAINTAINED FOR THE LIFE OF THE POOL/SPA"
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
v
OF APPROVAL TO FILL POOLISPA AND SHALL
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)
action 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
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
efessions 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
more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
siness 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
)rovements 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
)roved 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
fly 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:
my signa4lre 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 legalll
aptructurd'th6fl 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
feesions Cdcr. %available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
nature of I5ropelly Owner or Authorized Agent Date
USED CONTRACTOR'S DECLARATION
!rbby affirm under-penalty of perjury that I am licensed under provisions of Chapter 9 (commence Ith Sec ion 70 ) of Division 3 of the Business and rofes ons Code, y license is in full force
I effect. •."" ,[
irtse Class License No �lL'� Contractor Signal
iRKERS'fwOVMNSATION DECLARATION
MING: 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 (5100,000), IN ADDITION TO THE
19� COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
reby affirmaOsr penalty of perjury one of the following declarations:
l.h d tgjll jgaintain 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 Cade, for the
tFF1la w o Mc for which this permit is issued. Policy No.
Fand *4rylaintain 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' compensatiol
ur carrier and policy number are:
ler P cy um er Expiration Date
me of Agent Phone #
I certify that, in the pe ormance ft e w rk for Ich t Is ermit is issued, I shall not employ any person in any manner so as to become subject to the workers'com ensation laws of California, and agre
t, if I should beco u ject h or rs' pensa ' n provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applica Da v
CLARATION RE AR G COUSIfRUCtIONIENDING AGENCY
:reby affirm under pena y of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 309 ivil Code).
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
I have read this application and the information I h d orr
I agree to comply with all applicable city an c ce an tate laws relating to building construction. /t
I authorize representatives of this city or co rt� toe the ee-ids property for inspection purposes.
AC77ON DATE BY
DECLARATION OFCOMPLIANCEtMTHCODEOF
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