HomeMy WebLinkAboutS2021-0264 - PermitsCity of Newport Beach - Building Division 111111111111111111111111111111111111111111111111111111111
100 Civic Center Drive, Newp6icID�,.01h, CA 92660 S 2 0 2 1 0 2 6 4
'- �- Permit Counter Phone (949)644-3288
Job Address: 45 ROYAL SAINT GEORGE RD Floor: Suite: Bldg: 1
Description of Work:SFR RE -PLASTER (E) POOL
Inspector Area: 4 Plan Check No: 2821.2021
Code Edit: 2021
Legal Description: N TR 7223 LOT 73
Owner: ALTON
Address: 45 ROYAL SAINT GEORGE RD
NEWPORT BEACH CA 92660
Phone:
Applicant: MICHAEL/J L G C
Address: 28885 WOODSPRING CIR
TRABUCO CYN CA 92679
Phone: 714-305.2861
Building Rear:
Setbacks: Front:
Left:
Right:
Construction Tvoe: VB
Construction Valuation: $10,000.00
Contractor: J L G C
Address:
28885 WOODSPRING CIR
TRABUCO CANYON CA 92679
Phone:
714-305-2861
Con State Lie:
903819
Lie Expire:
0913012023
Bus Lie:
BT30021002
Lie Exp Date:
10/3112022
Worker's Compensation Insurance
Carrier: STATE FUND
Policy No: 9031570
Expiration: 11101 /2022
FEES
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
POOLPermit : S2021-0264
Project No: 2821-2021
Inspection Requests Phone (949)644-3255
Special Conditions:
Issued Date: 12/02/2022
State Lie:
State Lie:
Building Permit Fee :
$249.00
Record Management:
$2.00
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:
$1.00
Drainage Plan Check:
$0.00
Building Dept WO Plan Check:
$0.00
Plan Dept Plan Check:
$0.00
Grading Consultant Fee :
$0.00
Others
Building Dep Plan Check:
$0.00
$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 : $252.00
Plan Check Fee :
$0.00 Fee Due at Permit Issuance
: $21
PROCESSED BY: I-AXT'o „`„ a PY ,N CHECKED BY::
0 0
ZONING APPROVAL ''' ° ^ % c o e " o •E. APPROVAL TO ISSUE:
t
PERMIT EXPIRES 180-DAY�l AFTER oSaU mANCE`UFt LAST VALID INSPECTION
iD OCq 4 410 POq OAO
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
is 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).
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
nd 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
nprovements 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
nproved for the purpose of sale).
1 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).
1 am exempt from licensure under the Contractors' State License Law for the following reason:
Iy 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.html.
signature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION ��1���
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectior; 7 of Divi ion 3 of the Business and Pr a signy Cgb an-d I cense is in full force
nd effect. License Class License No Da(_ �- Contractor Signatuf r I \ ) —
VORKERS' 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 (E100,000), 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 thl
erfdrmance of the work for which this permit is issued. Policy No.
have and will m Int 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'
rance carrier ancVIDolidv number ara.) _ 1 �\ /\ it
is of Agent —E
certify that, in the pl
. if I should become
re of
Date
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
he workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
CLARATION REGARDING CONSTRUCTION`CENDING AGENCY
:reby 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
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 county or Inances and state laws relating to building construction.
I authorize representatives of this city or county, toB�thg above " e "ad property for inspection purposes. A �.,� �,
nature of Prooertv Owner or Authorized Aaent ((�� (((((( nn Print Property Owner's or Authorized Agent's NamrA— 1
ACTION. DATE BY S ECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY I
REGULATIONS PART 61 OF TITLE 40 AND AQM D RULE
1403 ••• • +• ..• •••
PERMITEXPIRED (SUBMITTED ASBESTOS NOTIF�ATIbN TO . +
PERMIT CANCELLED EPA +. + • • • • • '+' ••
POOL ALARMS LJ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
INSTALLED PROPOSED DEMOLITION. +•• • • ••• •+
+••
SIGNATURE: • • • •',
Civil Code).
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