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Home My WebLink AboutS2020-0022 - PermitsCity of Newport Beata - Building Division I 111�111111111111p11111111p11111111p111p11111111111 11 o 100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 2 0 0 0 2 2 Permit Counter Phone (949)644-3288 Job Address: 503 KINGS RD Floor: Suite: Description of Work:SFR REPLASTER SPA 47 SF Inspector Area: 2 Legal Description: N TR 1219 BILK E LOT 13 Owner: HILL GARY P Address: 503 KINGS RD NEWPORT BEACH, CA 92663 Phone Applicant: FULFER JOSH Address: 227W CARRIER AVE ORANGE, CA 92867 Phone: 714.628-6812 Building Rear: Setbacks: Front: Left: Right: Construction Type : Construction Valuation: $4,000.00 Building Permit Fee Permit Issuing Fee: Investigation Fee: Building Green Fee: Plan Dept Plan Check: Building Dep Plan Check: Building PC Investigatiorrryyyyr Plan check EM. Fee : / WQ Compliance Insp eE TOTALFEE: PROCESSED BY: ZONING APPROb Bldg: 1 Plan Check No: 0275-2020 Code Edit: 2019 Contractor: SMITH ALAN POOL PLASTERING Address: 227 W CARLETON AVE • ORANGE CA 92867 Phone: 714-628-9494 Con State Lic: 571196 Lie Expire: 06/3012021 Bus Lie: BT00012422 Lie Exp Date: 08131/2020 Worker's Compensation Insurance Carrier: ARCH INS. CO. Policy No: ZAWC12545401 Expiration: 0410112020 FEES Architect: Address: Phone: Engineer: Address: Phone: Special Conditions Issued Date: 12001 -Permit: S2020-0022 Project No: 0275-2020 Inspection Requests Phone (949)644-3255 State Lie: "" $4.00 Water Quality- -- • $0.00 moos Building Dept Inspection Fee: $0.00 $0.00 o m $0.00 mm o ccoe $1.00 o • o or Building Dept WQ Plan Check: o eo $0.00 Grading Consultant Fee : $0.00 n e of o e State Lie: $0.00 3$`R0 moom $0.00 m m G(4m ( m mom m ® e U(J9 OC IJC000 02107/2020 am e c o L 9 PO4G CGUGGI mom• $139.00 Record Management: $4.00 Water Quality- -- $0.00 Building Dept Inspection Fee: $0.00 $0.00 Drainage Permit Fee : $0.00 Water Quality Dept Insp Fee: $0.00 $1.00 Drainage Plan Check: $0.00 Building Dept WQ Plan Check: $0.00 $0.00 Grading Consultant Fee : $0.00 .Others $120.93 $0.00 3$`R0 Additional Fee: $0.00 $0.00 Plan Check Fee: PLAN CRECKED BY:: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID Fee Due at Permit Issuance : $144.00 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 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 improvements are not intended orofferedfor 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 im 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 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). ❑ 1 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 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.leginfo.ca.gov/calaw.htm[. Signature of Property Owner or Authorized Agent Date LICENSED COK%RACTOR'S DECLARATION I hereby affirm aprjp� y@natty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Di ' 'on 3 of the Business and Profess' ns�b an m i e 's.ia fyjLLorce 'rlgc�tJJ,t. Licepse lass License No Date�0 Contractor Signature _ --- WORKERS' CQPPP,NSATION DECLARATION APNI fCj FAILURE TQQ 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 COSRGF COMPENSAYION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereli affirm UrSdelbenally of perjury one of the following declarations: o • •.c• I1fave 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 Cade, for IN nonce ottth®workk for which this permit is issued. Policy No. ®rd ve and willmaintain 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' compensatioLe carr.r. rr andtiolicy number are:^�' ITI�GL' • Policy Number L.i� C SLS tl S�'((l'� Expiration Date }fa°mepfAgentPhone# rr��r� Certify r Ell that,o intks• 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 that, if I should become subject he w rkers' o pensa provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ` ^ Signature of Applicant —rf ` `/ Date 0 2--7rZ O�iitn DECLARATION REGA G CONSTRU&ItON LENDING AGENCY TT I hereby affirm under p nalty 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 all applicable city and county ordinan es an �re!VP o building construction.I authorize representatives of this city or county to ent abo - entir inspection purposes. Signature of Property Owner or Authorized A en Print Property Owner's or Authorized Agent's Name D ACTION DATE BY DECLARATI COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMITEXPIRED L1 I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED UEPA PERMIT EXTENDED qMD POOLALARMS ASBESTOS NOTIFICATION IS NOT APPLICABLE TO INSTALLED PROPOSED DEMOLITION.