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Home My WebLink AboutS2022-0078 - Permits� t � -•City of Newport Beach - Building Division 11111111111111111111111111111111111111111111111111111111111 100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 2 2 0 0 7 8 u Permit Counter Phone (949)644-3288 t'r n4 - 'tee L Job Address: 1528 KEEL DR Floor: Suite: Bldg: 1 Description of Work:SFR POOL & SPA REPLASTER AND DRAINAGE Inspector Area: 6 Plan Check No: Code Edit: 2019 Legal Description: N TR 6152 LOT 116 Owner: ANDERSON TIMOTHY Address: 1528 KEEL DR CORONA DEL MAR, CA 92625 Phone: Applicant: QS CONSTRUCTION INC Address: PO BOX 12109 COSTA MESA 92503 Phone: 949-285-8326 Building Rear: Setbacks: Front: Left: Right: Construction Tvoe : Construction Valuation: $40,000.00 Building Permit Fee : $690.00 Permit Issuing Fee: $0.00 Investigation Fee: $0.00 Building Green Fee: $2.00 Plan Dept Plan Check: $0.00 Building Dep Plan Check: $600.30 Building PC Investigation : $0.00 Plan check Ext. Fee: $0.00 WQ Compliance Insp Fee: $0.00 TOTAL FEE : $1,732.30 PROCESSED BY: ZONING Contractor: QS CONSTRUCTION INC Address: PO BOX 12109 COSTA MESA 92503 Phone: 949-285-8326 Con State Lic: 1021012 Lic Expire: 11/30/2022 Bus Lic: BT30069027 Lic Exp Date: 09130/2022 Worker's Compensation Insurance Carrier: STATE FUND Policy No: 9224879 Expiration: 01 /24/2023 FEES Record Management: $4.00 Drainage Permit Fee : $237.00 Drainage Plan Check: $199.00 Grading Consultant Fee : $0.00 Additional Fee : $0.00 Architect: Address: POOLPermit : S2022-0078 Project No : Inspection Requests Phone (949)644-3255 Phone: State Lic: Engineer: Address: Phone: State Lic: Special Conditions: Issued Date: Water Quality- -- Building Dept Inspection Fee: Water Quality Dept Insp Fee: Building Dept WQ Plan Check: Others : caca ° o vca�ca aeo¢ o 3 aaaa 4p ° ° ° o a ° as °p o °am° °aaaa 0 ® aa°aa ° ° a $0.00 $0.00 $0.00 $0.00 $0.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $1,732.30 PLAN CHECKED BY:: APPROVAL TO ISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION 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 ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions ode: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or impr2ved for fht�urpose of sale). • • •I; as owner oithe property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an ownb? Wroperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). • �19m exempi from licensure under the Contractors' State License Law for the following reason: By my signatVFe6e1gw I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally sell UtructureitNaM have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Glide. is available upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.htmi. Signature of Prop$rjl.Owner or Authorized Agent Date LIGENSED CC INTRACTOR'S DECLARATION 17sr¢by affirm undelpenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 7 O) f 'vision 3 of the Business and Pro ions C �, d my license is in full force afteffect. License Glass License No Date Z'L Contractor Signature 1pr13RKERS' COMPJENSATION DECLARATION N/I,ViNG: FAILURE TVSEFURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CNIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS IE100,0001, 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, performance of the work forwhich this permit is issued. Policy No. 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' carrier and policy number are: Policy Number Date me of Agent rnone s I certify that, in the pert ante 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 agree fm It, if I should becom s lect to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. C' Inature of Applicant Date 7Al2, L iCLARATION REG DI TRUCTION LENDING AGENCY ; \!1, ereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this pennit is issued (Section 3097, Ci it Code). rider'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 owners 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 t"�Qniter the ove-identified property for inspection purposes. mature of Prooertv Owner or Authorized Agent / ate. � Print Property Owners or Authorized Agent's Name Fk " z eC • r*Dat ACTION DATE BY ✓ DfCLOMATION OF COMPLIANCE WITH CODE OF FEDERAL REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE FOR OFFICE USE ONLY I/ Alt required alarms,latches 1403 e PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO as part of a pool / spa barrier, shalt be in place prior to approval to fill pool/spa 8 shall remain in place & be maintained for the llfe Of the p00 pa X PERMIT CANCELLED EPA PERMIT EXTENDED AQMD POOLALARMS INSTALLED E TOS NOTIFICATION NOT APPLICABLE TO PROP05 DEMOLITION. 51GNATUR • ( PERMITFINAL .ZZ _