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Home My WebLink AboutS2019-0179 - Permits£wrrTr City of Newport Beach - Building Division 11111111111111p111111111111111111p111111111p1111111 100 �,� •, ;p ry: C Counter Phone (949)644- Civic Drive, ne Beach, CA 92660 5 2 0 1 9 0 1 7 9 Permit c �trvnK�a4� Job Address: 1831 NEWPORT HILLS DR E Floor: Suite: Bldg: 1 Description of Work:SFR POOL & SPA 512 SF Inspector Area: 4 Legal Description: N TR 7031 LOT 59 Owner: EKEDAL DAVID Address: 1831 NEWPORT HILLS DR E NEWPORT BEACH CA 92660 Phone: Applicant: ELLISON PAUL Address: Phone Building Rear: Setbacks: Front: Left: Right: V-B Construction Valuation: $40,000.00 Building Permit Fee : $418.00 Permit Issuing Fee: $0.00 Investigation Fee: $0.00 Building Green Fee: $2.00 Plan Dept Plan Check: $0.00 Building Dep Plan Check: $373.00 Building PC Investigation : $0.00 Plan check Ext. Fee : $0.00 WQ Compliance Insp Fee: $0.00 TOTALFEE: PROCESSED ZONING Code Edit: 2016 Date: cl o- Z, I POOLPermit : S2019-0179 Project No : 2505-2019 Inspection Requests Phone (949)644-3255 If applicable: Contractor: ELITE CUSTOM POOLS & SPAS Architect: F dress' ."x. 8871;VICAR WAY 'Address: ❑ 80% or ❑ 100% refund KE FOREST CA 92630 one: ,714-606 4007 6 - Phone }� {�� 1y� State Lic: r n State - 529870 Fnglneer: LXCHERQODD Lic Expire' 05/31/2020 Address: 1201 N TUSTIN AVE s Lich----BT30031Q-Y,-_.,, - ANAHEIM CA 92807 `.1c E�xp Date 03/31/262073t Phone 714-630-6100 State Li¢C-067656 ^` J ers Compensation lnsurafti a Era `t..w .:. Special Conditions: Carrier: STATE FUND L Expcy No: 137574 I a �T ► �•/Gj�-Expiration: 06/01/2020 Issued Date: .� � e e�—e, e•m • e • F ES (work started) Record: Management: $4.00 Water Quality (no Work started) Drainage Permit Fee: $0.00 Water Quality Dept Insp Fee: Drainage Plan Check: $0.00 Building Dept WQ l"9fJ1e4h1fialS: Grading Consultant ee 4iu.uu Others: Additional Fee : $294.00 Plan Check Fee : Fee Due at Permit Issuance : PLAN CHECKED BY:: 4PPROVAL TO ISSUE PERMIT EXPIRES 180 DAY3 t` FTER ISSUANCE OR LAST VALID INSPECTION $0.00 OWNER -BUILDER 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 items) 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 AVE 1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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 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 n 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 poly 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 1 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 legally 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. 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) of/ Dyv� ion 3 of the Business and Profes i d a my license is in full force no effect. License Class License No Date �� i3 r Contractor Signatur IIORKERS' 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 ($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 the e ante of the work for 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' carrier and policy number are: Policy Number of Agent Date certify that, in the performance of 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 agree t, if I should become sub' tot o/rkq/`,¢�or/9rfs'ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. / nature of Applicant X/V Dates 1��3�% CLARATION REGA NG CONSTRUCTION LENDING AGENCY r areby 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 3y 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 provided is correct. I agree to comply with all applicable city and county o nc s an K aws r g to building construction. I authorize representatives of this city or county t me a -denti operty for inspection purposes. Signature of Property Owner or Authorized Age Print Property Owner's or Authorized Ag ACTION DATE TTDECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 63 0E TITLE 40 AND AQMD RULE PERMIT EXPIRED —` U I SUBMITTED ASBESTOS NOTIFICATION TO EPA PERMITCANCELLEO PERMIT EXTENDED IJAQMD POOLALARMS INSTALLED ,� �j{7 i L-1l _ ASBESTOS NOTIFICATION IS iNOTAPPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: Name `� Date