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Home My WebLink Abouts2016-0169 - Permits�shr,Q City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 ss: et a �tuaurr'�'. Job Address: 1201 DOLPHIN TER Floor: Suite: Bldg: 1 Description of Work:SHOTCRETE POOL & SPA (450 SF) W/ (8) CAISSONS Inspector Area: 2 Legal Description: N TR 1700 LOT 5 O IIU�S 2 0 1 6��►��0 1 6 9�� II Plan Check No: 2624.2016 Code Edit: 2013 wner. DLI PROPERTIES LLC Contractor: DE VORE POOLS & SPAS Address: 27489 AGOURA RD Address: 32908 AVE DEL ROSAL AGOURA HILLS CA 91301 SAN JUAN CAPSTRNO CA 92693 Phone: Phone: 949-493-4374 Applicant: DEVORE POOLS & SPA Con State Lic: 401649 Address: PO BOX 828 Lic Expire: 04/3012018 SAN JUAN CAP CA 92693 Bus Lic: BT97026761 Phone: 949-647-1366 Lic Exp Date: 11/30/2016 Building Rear: Setbacks: Front: Left: Right: Construction Type : V-B Construction Valuation: $100,000.00 Building Permit Fee : $380.00 Permit Issuing Fee: $0.00 Investigation Fee: $0.00 Building Green Fee: $4.00 Plan Dept Plan Check: $37.50 Building Dep Plan Check: $338.00 Building PC Investigation : $399.00 Plan check Ext. Fee: $0.00 WQ Compliance Insp Fee: $0.00 I� TOTAL FEE: $1,344.65 r PROCESSED BY: ZONINGAPPROVAL: Worker's Compensation Insurance Carrier: STATE COMP INS Policy No: 1222520 Expiration: 11 /01/2017 FEES Architect Address: POOLPermit : S2016-0169 Project No: 2524-2016 Inspection Requests Phone (949)644-3255 Phone: State Lic Engineer: BIEDENBACH CHRISTOPHER Address: 1201 N TUSTIN ANAHEIM CA 92807 Phone: 714-630-6100 State Lic:C-074003 Special Conditions Issued Date: 11/2212016 Record Management: $18.00 Water Quality--- Drainage Permit Fee : $0.00 Building Dept Inspection Fee: Water Quality Dept Insp Fee: $0.00 Drainage Plan Check: $0.00 Building Dept WQ Plan Check: $0.00 $0.00 Grading Consultant Fee : $168.15 Others Additional Fee : $0.00 $0.00 $0.00 Plan Check Fee : $1 185.40 Fee Due at Permit Issuance : $1! v ®ea PLAN CHECKED BY::= a a Be _ a APPROVAL TO ISSUE:_ ® a < PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION a a ew e a ue v ®ea as Asa o e „tee „� C 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 items) (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 I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U 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 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 improved 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 Iicensure 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 legall} 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.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 700 Y. D ion 3 f the Business and Profession nd y license is in full force and effect. License Class License No Date Contractor Signature MIORKERS' 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 (S100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I 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 p rformance of the work for Which this permit is issued. Policy No. I have and will tarn 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 nsurance carrier a1N p licy number re: ^ \ Ctc:(. .,l_�_. Expiration Date ie of Agent — certify that, in the performance . if I should become sublegt to' of Applicant 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' Xers' compensa i ' .art0f Section 3700 of the Labor Code, I shall forthwith comply with those provisions CTION LENDING AGENCY hereby affirm under perloryy of 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 per ry Lender's Address 3y 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 ordinances and state laws relating to building construction. I authorize representatives of this city or county to enter above= ntified property for inspection purposes. signature of Property Owner or Authorized Agent Print Pr ner's or Authorized Agent's Name ACTION DATE BV -' DECLARA ON OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGU IONS PART 61 OF TITLE 40 AND AQMD RULE 14 PERMITEXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO ••• •�• �+� ��• : •� PERMIT CANCELLED EPA • • • `„ • a PERMIT EXTENED ! QM D POOLALARMS ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO INSTALLED !1 �n PROPOSED DEMOLITION. • • �•• ":� V (/ SIGNATURE: ••s s�• • s s PERMITFINAL c e•—o 0 • e• e•• •' e• eo• All required alarms,latches a pool / spa 111 be in place 1proval to fill Mall remain in aintained for the poouspa