HomeMy WebLinkAboutS2021-0226 - PermitsCity of Newport Beach - Building Division *S2021-0226*
& 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Job Address: 20 BRIDGEPORT RD Floor: Suite: Bldg: 1
Description of Work:SFR POOL 455 SF W/ YARD DRAINAGE.IY'Wd
Inspector Area: 6
Legal Description
Owner: MCMILLAN JANE
Address: 20 BRIDGEPORT RD
NEWPORT COAST CA 92657
Phone:
Applicant: ELLISON PAUL
Address: 24642 VOA RAZA
LAKE FOREST CA 92630
Phone: 949-683-9861
Building Rear:
Setbacks: Front:
Left:
Right:
,unsu ucoon
Construction Valuation: $30,000.00
Building Permit Fee :
$440.00
Permit Issuing Fee:
$0.00
Investigation Fee:
$0.00
Building Green Fee:
$2.00
Plan Dept Plan Check:
$0.00
Building Dep Plan Check:
$396.00
Building PC Investigation :
$0.00
Plan check Ext. Fee :
$0.00
WQ Compliance Insp Fee:
$0.00
TOTAL FEE:
PROCESSED BY: 5S
ZONING APPROVAL: .M5 1^_
Plan Check No: 2337.2021
Code Edit: 2019
Contractor:
DREAMSCAPES BY M G R INC
Address:
1901 NEWPORT BLVD #350
COSTA MESA CA 92627
Phone:
949-480-3420
Con State Lie:
694588
Lie Expire:
10/3112023
Bus Lie:
BT30052223
Lie Exp Date:
0813112022
Worker's Compensation Insurance
Carrier: STATE FUND
Policy No: 9265436
Expiration: 1212812022
FEES
POOLPermit: S2021-0226
Project No: 2337-2021
Inspection Requests Phone (949)644-3255
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Architect:
Address:
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Phone:
State Lie:
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Engineer:
BIEDENBACH CHRISTOPHER
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Address:
1201 NTUSTIN
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ANAHEIM CA 92807
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Phone:
714-630-6100 State Lic:C-074003
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Special Conditions:
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Issued Date:
Record Management:
$6.00
Water Quality ---
Building Dept Inspection Fee:
$0.00
Drainage Permit Fee :
$237.00
Water Quality Dept Insp Fee:
$0.00
Drainage Plan Check:
$199.00
Building Dept WQ Plan Check:
$0.00
Grading Consultant Fee :
$0.00
Others
$0.00
Additional Fee :
$0.00
$0.00
Plan Check Fee:
$595.00 Fee Due at Permit Issuance
: $685.00
PLAN CHECKED BY:: • ' "<
APPROVALTO
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). 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-Builderwill 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 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 legall,
sell a structure ihai Nave 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
Vgges; ions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Signatere of PTop�ettyOwner or Authorized Agent Date
kICENSED CONTRACTOR'S DECLARATION
I hereny affirm under penalty of perju%that I iam licensed under provisions of Chapter 9 (commencing with Section 70 ) oft 1 iop 3 of the Business and Professi od , nd m c s€ is in full force
and gffect. L(Gense Glass S`p{ vvl i License No Date �� Contractor Signature JC.
VIWERS' Gr( PENSATION DECLARATION
NAMING: FAILURE TOSSCURE 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
COST Of COMPENSAINON!DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
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hereby affirm under penalty of perjury one of the following declarations:
I hive and wROilintain 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
Rance of M2 work for which this permit is issued. Policy No.
0�4;e and J11-m4tain 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' compensatioi
insuranihe carrier and policy number are: .
le of Agent
certify that, in the p,
if I should become
of Applicant
Policy Number
Date
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
Tnpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �
Data (Zly/j,�"
: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, Civil Code).
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 owners behalf.
I have read this application and the information I have p video isV-,defi:ed
I agree to comply with all applicable city and county ordi ces ns relating to building construction. ^ /
I authorize representatives of this city or countyto' e a roperty for inspection purposes.mature of Pronertv Owner or Authorized ADent — Print PrODertv Owner's or Authorized Aaent's Name
ACTION DATE BY I REGULATIONS PA TLARATION OF 061OF IIT E40 AN AQMD RULECE WITH CODE OF �L FOR OFFICE USE ONLY
PERMIT EXPIRED LJISUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED EPA
POOLALARMS 7-ASBESTOSNOTITIJATION IS NOTAPPLICABLE TO
INSTALLED PROPOSED .DE LI 0 . ��
SIGNATURE:
PERMITFINAL
Date