The URL can be used to link to this page

Home My WebLink AboutS2021-0228 - PermitsCity of Newport Beach - Building Division 111111III1111p11111111111111A1p111111111111111111 .� 100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 2 1 0 2 2 8 Permit Counter Phone (0,49)644-3288 Job Address: 20221 ORCHID ST Floor: Suite: Bldg:1 Description of Work:SFR `CHANGE OF CONTRACTOR' POOL & SPA 350 SF W/ CITY STANDARD DRAINAGE Inspector Area: 3 Legal Description: N TR 1500 LOT 13 Owner: ORCHID 20221 LLC Address: 215 E EDGEWATER AVE NEWPORT BEACH, CA 92661 Phone: Applicant: ELLISON PAUL Address: 24642 VIA RAZA LAKE FOREST CA 92630 Phone: 949-683-9861 Building Rear: Setbacks: Front: Left: Right: Construction Type : U Plan Check No: Code Edit: Contractor: POOL MAX SERVICES Address: 10925 KALAMA RIVER AVE #G FOUNTAIN VALLEY CA 92708 Phone: 714-656-6769 Con State Lie: 945308 Lie Expire: 04130/2022 Bus Lie: BT30065673 Lie Exp Date: 01/31/2022 Worker's Compensation Insurance Carrier: WELLFLEET NEW YORK INS Policy No: N9WC231017 Expiration: 03/25/2022 Construction Valuation: $0.00 Building Permit Fee : $0.00 Record Management: Permit Issuing Fee: $0.00 Investigation Fee: $0.00 Drainage Permit Fee: Building Green Fee: $0.00 Drainage Plan Check: Plan Dept Plan Check: $0.00 Grading Consultant Fee Building Dep Plan Check: $0.00 Building PC Investigation : $0.00 Additional Fee, Plan check Ext. Fee: $0.00 WQ Compliance Insp Fee: $0.00 TOTAL FEE : $38.00 PROCESSED BY: ZONING FEES $0.00 $0.00 $0.00 $0.00 $38.00 Plan Check Fee REPLACE S2020-016 1312-2020 2019 POOLPermit : S2021-0228 Project No : 1312-2020 Inspection Requests Phone (949)644-3255 Architect: Address: Phone: State Lie: Engineer: BIEDENBACH CHRISTOPHER Address: 1201 N TUSTIN ANAHEIM CA 92807 Phone: 714-630-6100 State Lic:C-074003 Special Conditions: Issued Date: 10106/2021 Water Quality- -- Building Dept Inspection Fee: Water Quality Dept Insp Fee: Building Dept WQ Plan Check: Others : $0.00 o`o ae-PL-AC» CHECKED BY:: c°ijo oROVAL TO ISSUE: PERMIT EXPIRES 180 bWS AV3Et3'95SUANCv`tiR SST VALID INSPECTION B J $0.00 $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $38.00 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indict 'd 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, derh, or repair any structure, prior to ifs 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 Licen, Chapter 9 (commencing with Section 700Cy) 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 c �031.5 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). I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section �044, 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 Cont clot pursuant to the Contractors' State License Law). I am exempt from licensure under the Contractors' State License Law for the following reason: y 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 legalll 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. ignatum 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 000 f Di isio �qf the Business and Professions C and my license is in full force nd effect. License Class License No Date 'V V +�9 Contractor Signature XS"�.�_ PORKERS' 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 THOUSAND 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: 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 erf0mance of the work for which this permit is issued. Policy No. have and will p�iaRtain workers' rance carrier and poicy numbeA as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' 14her Expiration Date ame of Agent M ]I certify that, in the performance of the work forwhich this p rmit 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 lat, if I should become subj t t w rkers' co ti'eR�e on provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. L� �f ignature of Applicant I i p a ECL.ARATION REGf DI TIft LENDING AGENCY hereby affirm under penalty of perjury that them is a construction lending agency for the performance of the work forwhich this permit is issued (Section 3097, Civil Code). Ender's Name Lender's Address y 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 d state laws relating to building construction.U\Li��\ I authorize representatives of this city or cou to nteFt ve-Identified property for inspection purposes. lionature of Property Owner or Authorized Agent _ Print Property Owner's or Authorized Agent's Narr Date 1 ACTION DATE BY 'CFEMRF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY " Ali required alarms,latches REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE gates & fences which serve 1403 aL ° PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIMCATIORTO barrier, shall be in place • �• prior to approval to fill pool/spa & shall remain in PERMITCANCELLED LIEPA L •. •• • PERMIT EXTENDED QMD place - ail 'ned for POOL ALARMS ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO th INSTALLED PROPOSED DEMOLITION. the X < ♦ s a • • • ••• SIGNATURE: ••• • o 0 PERMITFINAL Boa oco 0 0 00� cow coo