HomeMy WebLinkAboutS2021-0117 - Permitsy,+aI'f:,� City of Newport Beach - Building Division II�IIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIII II POOLPermit : S2021-0117
100 Civic Center Drive, Newport Beach, CA 92660
p Project No : 1071-2021
w,.. „ hh � '- v Permit Counter Phone (949)644-3288
'�"aq�.x,A+��T Inspection Requests Phone (949)644-3255
Job Address: 1224 DEVON LN Floor: Suite:
Bldg: 1
Description of Work:SWIMMING POOL & SPA 426 SF
Inspector Area: 3
Plan Check No:
1071-2021
Code Edit:
2019
Legal Description: N TR 3000 LOT 33
Owner: HOROWITZ ERIC & TRACY
Contractor:
SCHWARZ POOLS
Architect:
Address: 1224 DEVON LN
Address:
PO BOX 28437
Address:
NEWPORT BEACH, CA 92660
SANTA ANA CA 92799
Phone:
Phone:
714-241-7665
Phone:
State Lic:
Applicant: SCHWARZ POOLS/TOM
Con State Lic:
967325
Engineer:
BIEDENBACH CHRISTOPHER
Address: PO BOX 28437 -
Lic Expire:
09/30/2022
Address:
1201 N TUSTIN
SANTA ANA CA 92799
Bus Lic:
BT30038738
ANAHEIM CA 92807
Phone: 949-872-0450
Lic Exp Date:
03/31/2022
Phone:
714-630-6100 State Lic:C-074003
Building Rear: 6
Worker's Compensation Insurance
Special Conditions:
Setbacks: Front: 20
Carrier:
NO EMPLOYEES
Left: 6
Policy No:
o `^p
I SPEC
Right: 6
Expiration:
Issued Date:
ITV
08/06/2021
Construction Valuation: $75,000.00
Building Permit Fee :
$440:00
Permit Issuing Fee:
$0.00
Investigation Fee:
$0.00
Building Green Fee:
$3.00
Plan Dept Plan Check:
$0.00
Building Dep Plan Check:
$396.00
Building PC Investigation :
$0.00
Plan check Ext. Fee :
$0.00
WQ Compliance Insp Fee:
$0.00
TOTAL FEE : $1,855.00
FEES
Record Management:
$6.00
Water Quality --
Building Dept Inspection Fee:
$0.00
Drainage Permit Fee :
$0.00
Water Quality Dept Insp Fee:
$0.00
Drainage Plan Check:
$0.00
Building Dept WO Plan Check:
$0.00
Grading Consultant Fee :
$672.00
Others
$0.00
Additional Fee :
$338.00
$0.00
Plan Check Fee : $723.00 Fee Due at Permit Issuance : $1,132.00
PROCESSED BY: - ,P6AI4 CWECKED BY::
ZONING APPROVAL:°APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DKr`S AFIVEP, PS31.':At2<CE OR LF iT VALID INSPECTION
oPo
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, priorto its issuance, also requires the applicant for
ie 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). 1201 N TUSTIN ❑
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
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).
7 I am exempt from licensure under the Contractors' State License Law for the following reason:
ly 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,
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.htmi.
signature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 00 jpr� 3 of the Business and Professio ad my license is in full force
nd effect. License Class License No t L Contractor Signature
VORKERS' COMPENSATION DECLARATION
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED OUS DOLLARS ($100,000), 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:
7 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
erformance of the work for which this permit is issued. Policy No.
have 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'
rance carrier and policy number are:
Policy Number
of Agent
Date
rtify that, in the performance of the worli(f rwhich 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
t, ' I should become subject to the s' ompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. p
lignature of Applicant -�`�� Dated/ O ZV
IECLARATION REGARDING TRU ION LENDING AGENCY �'
hereby affirm under penalty o erjury t there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil ode).
ander's Name Lender's Address
ty 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. / 04A oet�,S ✓/O r✓
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 ent r the above-' ntified property for inspection purposes. r
Sionatum of Property Owner or Authorized Agentr / _G/JYe yf �Print Property Owner's or Authorized Agent's Nam '�' '�" Date
ACTION DATE BY v DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY V I `/
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE All required alarms,latches
1403 • gates & fences which serve.
PERMIT EXPIRED LJ I SUBMITTED ASBESTOS NOTMFI6ARON TQ • ; as part of a pool 1 spa
PERMIT CANCELLED EPA • • • + •' ' • barrier, shall be in place
PERMIT EXTENDED QM D • • • •' • • * prior to approval to fill
POOL ALARMS ASBESTOS NOTIFICATION IS NOT APPLICABLE TO pool/spa & shall remain in
INSTALLED PROPOSED DEMOLITION. •'• • • • ••• •� place & be maintained for
SIGNATURE: a the life of the poollspa
X—
PERMIT FINAL