HomeMy WebLinkAboutS2023-0088 - Permitsa��WPoaT City of Newport Beach
Community Development Department - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
u Z Permit Counter Phone: (949) 718-1888
.�.newportbeachca.gov/civic
cg4ror+��P Combination Type - SFP
Work Class - Alteration
1111111111111111111111111111111111111111111111111111 jj Pool Permit : S2023-0088
Plan Check No : PC2023-1030
Issued Date : 05/0812023
Inspection Area : 8
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE
NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS
Job Address : 1107 MARIAN LN Legal Desc : N TR 3800 BLK LOT 34
Description: SFR POOL REMODEL: (N) BAJA SHELF AND MINI PEPPLE PLASTER; IN) BOND WIRE; RE -PLUMBING, SPLIT DRAINS
Owner: 2022 DLMA TRUST
Address : 1107 MARIAN LN
NEWPORT BEACH, CA 92660
Phone
Applicant: SANTOS RICO NAVA
Address: 21060 PACIFIC CITY CIRCLE
HUNTINGTON BEACH,. CA 92648
Phone: (626)251-7581
Owner/Builder : 2022 DLMA TRUST
Address : 1107 MARIAN LN
NEWPORT BEACH, CA 92660
Phone :
Contractor
Address :
Phone:
Con State Lic
Lic Expire
Bus Lic:
Bus Lic Expire
Workers' Compensation Insurance
Carrier :
Policy No:
W. C. Expire:
Code Edition : 2022 Fire Sprinklers : NO
Type of Construction : Fire Hazard Zone : NO
Occupancy Groups : R3/U No of Units : 1
Bldg Height : No of Stories :
Building Setbacks : Front: 20, Side: 6, Side: 6, Rear: 6
Flood Zone : X
Use Zone : R-1-6000 - Single -Unit Residential (6000 indicates minimum lot area)
PROCESSED BY: 8 �
SPECIAL CONDITIONS: OWNER/BUILDER ATTACHED
Architect
Address
Phone:
State Lic
Engineer: CHRISTOPHER JAMES BIEDENBACH
Address : 1201 N TUSTIN AVE
ANAHEIM, CA 92807
Phone: (714)630-6100
Designer:
Address
Phone :
Construction Valuation : $40,000.00
Added/New/TI sq. ft. Bldg : 0
Alteration sq. ft. Bldg :
Added/New sq. ft. Garage : 0
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s
i
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s)
often 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
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
fessions 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 pen? @y of
fnare than five hundred dollars ($500)..
1, as owner of the property, or my employees with wages as their sole compensation, Will do U all of c odions of the work; and the structure is not Intended or offered for sale (Section 7044,
ilease and Professions Code, The Contractors' State License Law does not apply to an owner of propert wh , hrough employees' or personal effort, builds or improves the property, provided that the
rovemenls 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
roved for the purpose of sale).
4_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
ly 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).
J I am exempt from licensors under the Contractors' State License Law for the following reason:
3y 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-oufidar iqhbonstruDt din its entirety by licensed contractors. I untlerstand that a Dopy of theapplicabla law, Section 7 44 0€ the Bus;noes and
7rofessions Code, is available upon request when hm. or at the following +A'eb sits:http:Vfwww.leginfo.ca.gov/calaw.html.
iignature of Property Owner or Authorized Agent Date-ICENSED CONTRACTOR'S DECLARATI
hereby affirm under penalty of perjury [hat I am liceons of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, an my licnseis In full force
Ind effect. License Class o Date Contractor Signature
NORKERS' COMPENSATION DECLARATION
YARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES OP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001, 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 penally of perjuryone of the following declarations:
I 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
lerformanee of the work for which this permit is issued. Policy No.
-1I 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' compensation
isurance carrier and policy number are:
:amler Policy Number Expiration Date
Jame of Agent Phone q
-11 certify that, inthe performance ark for ich this permit Is Issued, I shall not employ any person in any manner so as to become subject to the workers' compensatio aws of California, and agre
hat, if I should become s jec he 4h,,G
pensatien provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
3lgnalure of Applicant Dat
)ECLARATIGN REG iN N L ING AGENCY 1�hereby affirm under penalty of p ry thais a construction lending agency for the performance of the work for which this permit is issued (Section 3097, IV I C
.enders Name Lenders 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. (CXD o, F ,4
1 have read this application and the Information I have provided is correct.
I agree to comply with all applicable city and county ordi as and to laws relating to building construction.
I authorize representatives of this city or county t art e b v -' mifie roperty for inspection purposes.
3i nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name 'I ate
ACTION DATE C BY V E TID O O IANCE WITS CODE OF FEDERAL FOR OFFICE USE ONLY
Ik i REGULATIONS PART 51 OF TITLE 40 AND ACME) RULE
I PERMrIT EXPIREC, 11
PERMiTEXTENDED
PERMITFINAL I_23
CERTIFICATE OF
OCCUPANCY ISSUED
5U9MITTED ASBESTOS NOTIFICATION TO
7'} GAQVID
0,,SBESTOS NOTIFOGITION 15 NOT APPLICABLE
PROPOSED DEMOLITION
TO
All required alarms, latches gates and fences which serve as part of a pool/spa barrier, shall
be in place prior to approval to fill pool/spa & shall remain In place & be maintained for the
life of the pool. J „ „ n
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