HomeMy WebLinkAboutS2019-0132 - PermitsCity of Newport Beach - Building Division 11111111111111111111111111111111111111111111111111111 111�
100 Civic Center Drive, Newport Beach, CA 92660 8 2 0 1 9 0 1 3 2
Permit Counter Phone (949)644-3288
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,lob Address: 2401 BAY FARM PL Floor: Suite: Bldg: 1
Description of Work:NEW POOL AND SPA WI DRAINAGE (476 SF)
Inspector Area: 8 Plan Check No: 1736-2019
Code Edit: 2016
Legal Description: N TR 6407 LOT 24
Owner:
AARON THE CREAMER
Contractor:
BACKBAY CUSTOM POOLS
Address:
2401 BAY FARM PL
Address:
2153-B SAN MICHEL
Address:
NEWPORT BEACH, CA 92660
Building Dept Inspection Fee:
COSTA MESA CA 92627
Phone:
714-630-6100 State Lic:C-074003
Phone:
949-412-0447
Applicant: GLOSSEN CHARLES
Con State Lic:
813938
Address:
2153 B SAN MICHEL
Lic Expire:
10131/2020
$0.00
COSTA MESA, CA 92627
Bus Lia
BT30055011
Phone:
Others
Lic Exp Date:
1 013112 01 9
Building Rear:
25'
Setbacks: Front:
20'
Left:
5'
Right:
S.
Construction Valuation: $45,000.00
Worker's Compensation Insurance
Carrier: WC EXEMPT
Policy No: (NO EMPLOYEES)
Expiration:
FEES
POOLPermit : S2019-0132
Project No: 1736-2019
Inspection Requests Phone (949)644-3255
Architect:
$405.00
Address:
$4.00
Phone:
State Lic:
Engineer:
BIEDENBACH CHRISTOPHER
Address:
1201 N TUSTIN
Building Dept Inspection Fee:
ANAHEIM CA 92807
Phone:
714-630-6100 State Lic:C-074003
Special Conditions:
Issued Date:
Building Permit Fee :
$405.00
Record Management:
$4.00
- Water Quality ---
Permit Issuing Fee:
$0.00
Building Dept Inspection Fee:
$0.00
Investigation Fee:
$0.00
Drainage Permit Fee :
$312.00
Water Quality Dept Insp Fee:.
$0.00
Building Green Fee:
$2.00
Drainage Plan Check:
$312.00
Building Dept WQ Plan Check:
$0.00
Plan Dept Plan Check:
$0.00
Grading Consultant Fee :
$0.00
Others
Building Dep Plan Check:
$361.00
$0.00
Building PC investigation :
$0.00
Additional Fee :
$294.00
$0.00
Plan check .Ext. Fee :
$0.00
WQ Compliance Insp Fee:
$0.00
TOTAL FEE : $1,690.00
Plan Check Fee :
$967.00 Fee Due at Permit Issuance
: $723.00
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APPROVAL TO ISSUE:
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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 ❑
1, 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 -Builder will have the burden of proving that it was not built or
improved for the purpose of sale).
1, 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 legal)
sell 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
Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 0)8f r' rI of the Business and P o as! s Co , and m license is in full force
and effect. License Class License No Dat t Contractor Signal r
WORKERS' COMPENSATION DECLARATION
WARNING: 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
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I 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
performance of the work for which this permit is issued. Policy No.
❑I 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' compensatio
insurance carrier and policy number are:
Carrier Policy Num r Expiration Date
e of Agent - '"`' Phone #
ertify that, in the performance of the w rk for which this permit' issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agreif
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I should become subject to the work s' compensation pr sions o action 37 Labor Code, I shall forthwith comply with those provisions.y�g1��/�ture
6/1 —
of Applicant [pAk�—�/
DECLARATION REGARD G ONSTRUCTI G AGENCY VVI
I hereby 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).
Lender's Name Lender's Address
By my signature below, I certify to each of the following:
I am the property owner or authorized to act on the propertyJcoe
I have read this application and the information I have provi
I agree to comply with all applicable city and county ordinans relating to building construction.I
authorize representatives of this city or county enter thep perty for inspection purposes.
Signature of PropertyOwner or Authorized A ant 'nl PropertyOwner's or Authorized Agent's Name Date
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED
I SUBMITTED ASBESTOS NOTIFICATION TO
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