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Home My WebLink AboutS2023-0083 - Permits�gWPOR� City of Newport Beach C4 _ Community Development Department- Building Division 100 Civic Center Drive, Newport Beach, CA 92660 G rr s Permit Counter Phone: (949) 718-1888 a.. newportbeachca.gov/civic °gcicoa��p Combination Type - Work Class - Alteration 11111111111111111111111111111111111111111111111111II jj Pool Permit : S2023-0083 Plan Check No: PC2023-0947 Issued Date : 07/11/2023 Final Date: Permit Status: Issued Inspection Area : 4 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 : 1967 PORT PROVENCE PL Legal Desc : N TR 6624 BILK LOT 54 Description: SFR ALT (E) POOL AND SPA TO ADD BAJA SHELF AND BACKFILL (3'X15-). REPLASTER AND NEW TILE Owner: Daniel Hamm Contractor: BETSY CARDINALLY Architect Address : 1967 Port Provence PI. Address : 9999 FOOTHILL BLVD Spc 115, Spc 115 Address Newport Beach, CA 92660 RANCHO CUCAMONGA, CA 91730 Phone: (562)212-3694 Phone: (909)294-5566 Phone: Con State Lic : 997004 State Lic Lic Expire : 09/30/2024 Applicant: BETSY CARDINALLY Bus Lic : BT30052282 Engineer : LACHER TODD Address : 9999 FOOTHILL BLVD Spc 115, Spc 115 Bus Lic Expire : 07/31/2023 Address : 1201 N TUSTIN AVE RANCHO CUCAMONGA, CA 91730 ANAHEIM, CA 92807 Phone: (909)294-5566 Phone: (714)630-6100 Owner/Builder : Address : Phone Code Edition : Type of Construction Occupancy Groups: Bldg Height : Building Setbacks Flood Zone Use Zone: PROCESSED BY Workers' Compensation Insurance Carrier: INSURANCE COMPANY OF THE WEST Policy No: WPL504363004 Designer W. C. Expire : 9/30/2023 Address 2022 Fire Sprinklers : Fire Hazard Zone U No of Units : No of Stories Front: 22, Side: 5, Side: 5, Rear: 10 X PC - Harbor View Hills SPECIAL CONDITIONS: Phone: NO Construction Valuation : NO Added/New/TI sq. ft. Bldg Alteration sq. ft. Bldg : Added/New sq. ft. Garage: INC) $45,000.00 0 Ll OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable items) price 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 Huensure 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 more than five hundred dollars ($500). 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure Is not intended or offered for sale (Section 7044, Ideas 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 rovements 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). 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 iy 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 livansure under the Contractors' State License Law for the following reason _ ........... o-y my signature below i acknowledge that., except for my personal residence in which I must have resided for at least oneyear prior to completion of the. improvements covered by this permit, I cannot ell a structure that I have built as an owner -builder if it has not been constructed in its entirely 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:(fwww.leginfo.ca.govicalow.html, 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 0) o Divi 'on 3 of the Business and Pr f One de, a 1d my lice se Is In full fk nd effect. License Class License No Date �- I t Z Contractor Signature d 2L VORKERS' COMPENSATION DECLARATION ARNING: 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 (S100,0001, IN ADDITION TO THE J_l CF COMPENSL. 710N, J aMAGES AS PROVIDED FOR IN SECTION 3700OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm uI goer penalty of perjury one of the following declarations: I Ihave 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 III, 6rlo3mance of the wnr4Yor which 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' carder Rid pnPcy number are: Policy Number Expiration Date ,)1.Agenl certify that, in the performance Rf 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 agre '.f , ;:;ould become subject to rtc m-.co enapti n provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �y nature of Appt3nt ,�.1,2 Date w Z CLARATiON REGAR t 'G CON Ireby affirm under penalty of perjury that thar s a construction landin ency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Idors Name Lenders Address 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 and state laws relating to building construction. p I authorize representatives of this city or count t r the above -identified property for inspection purposes, 4y LAD" Ll'. mature of Property Owner or Authorized A ant L� L 1 iNrint Property Owner's or Authorized Agent's Name�z Date j TION DATE BY 1. DECLARAT€C)NOFICOMPLIANCEWIT9CODt OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART fit OF TITLE 40 AND AOMD RUlF PERIJ7if EXPIRED ' I I tJ I SURMITTFD A5RFSTOS NOTIFICATION TO PERMIT CANCELLED IEP—A l—'� FEAMIT £YTfNDEb -I.'IL _ LJq(1rMD PERMIT FINAL. II,D r � ASBESTOS NOT IFICATION 15 NOT APPLICABLE TO CERTIFICATE OF //11,�' OCCUPANCVISSUED 9� PROPOSED DEMOLITION i SIGNATURE, 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. 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