HomeMy WebLinkAboutS2019-0160 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIII POOLPermit S2019-0160
100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 1 9 0 a 6 0 Project. No: 2157-2019
Permit Counter Phone (949)644-3288
rvs .uet - NO CO S " A/'a NOISE Inspection Requests Phone (949)644-3255
TION
Job Address: 97 LINDA ISLE Floor: Suite:. Bldg 1
Description of Work:SFR SPA 49 SF WIYARD DRAINAGE ON THEWEE
Inspector Area: 2 - Plan �Q157-2019
Code Edit: 2016
Legal Description: N TR 4003 LOT 97
Owner: ATO INVESTMENTS LLC Contractor: STEELE BRETISTEELE POOLS. Architect:. M
Address: 11032 LAVENDER HILL DR #160-11 Address: 4921 E LEEDS Address: A
LAS VEGAS NV 89135 ORANGE CA 92867 "
Phone' Phone 714-496-1427 Phone: State Lic: �.
Applicant PAULISTEELE POOLS Con State Lic 923975 Engineer: LACHER TODD
Address. 4921 E LEEDS Lic Expire. :10131/2020 .Address:. 1201 N TUSTIN AVE
ORANGE CA 92867 Bus Lia BT30042152 ANAHEIM CA 92807
Phone: 714-496.1427 Lic Exp Date: "0212812020 Phone: .714-630-6100 State Lic:C•067656
Building Rear: - Worker's Compensation Insurance Special Conditions: -
Setbacks: Front: Carrier: WC EXEMPT HIGH DENSITY AREA
Left:. Policy No: NO EMPLOYEES
Right: Expiration: Issued Date: 09/30/2019
Construction Type
FEES -
Construction Valuation: $22,000.00
Building Permit Fee$418.00 Record Management:. $8.00 Water Quality- --
Permit Issuing Fee: $0.00 - Building Dept Inspection Fee:. .$0.00
Investigation Fee $0.00 Drainage Permit Fee : $322.00 Water Quality Dept Insp Fee: $0.00
Building Green Fee:. $1.00 Drainage Plan Check: $322.00 Building Dept WQ--Plan Check: $0.00
Plan Dept Plan Check: $0.00 Grading Consultant Fee : $0,00 Others
Building Dep Plan Check:. $373.00 - $0.00
Building PC Investigation : $0.00 Additional Fee : $294.00 $0.00
Plan check Ext. Fee: $0.(10
WQ Compliance Insp Fee: $0.00
TOTAL FEE i $1,727.00 Plan Check Fee : $0.00 : Fee Due at Permit Issuance : $1,727.00
PROCESSED BY: o® o o PLAN0-IBOKEDBY:: ;!.;)
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PERMIT EXPIRES 180 DAYS AF -TR ISSIJANL'.E QR LA`s r-V#Iflp INSPECTION
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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 tWigion 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 AVE
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) 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).
❑ 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
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 legall)
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.html.
Signature of Property Owner or Authorized Agent *feions
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section io f the Business an , and li nse' infullforce
and effect. License Class License No Date rContractor Sign
NORKERS' COMPENSATION DECLARATION
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THO SAND DOLLARS (1100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
herebyaffirm under penalty of perjury one of the following declarations:
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
e ' mance of the work for which this permit is issued. Policy No.
nave 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' compensatiol
is of Agent iI
certify that, in the pe rma 7he/or&'
or which
if should becomes j tcompem
Iature of Applicant
Date
Sermit is issued, I shall not employ any person in any manner so as to become subject to the workers' corspej' I. &
provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 7713
hereby affirm under penalty �(perjury re is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
-ender'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 owner's behalf.
I have read this application and the information I have provided i corn
1 agree to comply with all applicable city and coun In s an aw to building construction.
I authorize representatives of this city or count an bo ' an or I pection purposes. !,
3i nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Nar.
ACTION DATE BY IIIECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE
PERMITEXPIRED U I SUBMITTED ASBE6TOS NO$IFICATCN•TO• • • .,
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PERMITCANCELLED EPA •
PERMIT EXTENDED qMD • • • • • •
POOLALARMS ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO
INSTALLED PROPOSED DEMOLITION.,
GNATURE:
PERMIT FINAL
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