HomeMy WebLinkAboutS2021-0102 - PermitsCity of Newport Beach - Building Division I11111111111111p11111p11111111111p11111111p11111111
"1 100 Civic Center Drive, Newport Beach, CA 92660 5 2 0 2 1 0 1 0 2
Permit Counter Phone (949)644-3288
,lob Address: 1978 PORT TRINITY CIR Floor: Suite: Bldg: 1
Description of Work:SFR POOL/SPA 392 SF, W/ YARD DRAINAGE
Inspector Area: 4
Plan Check No:
0904-2021
$0.00
Code Edit:
2019
Legal Description: N TR 7031 LOT 11
$2.00
Plan Dept Plan Check:
Owner: BINDER MARK N
Contractor: DE VORE POOLS & SPAS
Architect:
Address: 1978 PORT TRINITY CIR
Address: PO BOX 828
Address:
NEWPORT BEACH, CA 92660
SAN JUAN CAPSTRNO CA 92693
$0.00
Phone:
Phone: 949-547-1366
Phone:
Applicant: DEVORE POOLS
Address: PO BOX 828
SAN JUAN CAP CA 92693
Phone: 949-547-1366
Building Rear:
Setbacks: Front:
Left:
Right:
Construction Tvne : VB
Construction Valuation: $50,000.00
Building Permit Fee :
$430.00
Permit Issuing Fee:
$0.00
Investigation Fee:
$430.00
Building Green Fee:
$2.00
Plan Dept Plan Check:
$0.00
Building Dep Plan Check:
$387.00
Building PC Investigation :
$0.00
Plan check Ext. Fee :
$0.00
WQ Compliance Insp Fee:
$0.00
TOTAL FEE : $1,692.00
PROCESSED BY:
ZONING
Con State Lie:
401549
Lie Expire:
04/30/2022
Bus Lie:
BT97026761
Lie Exp Date:
11/3012021
Worker's Compensation Insurance
Carrier: STATE COMP INS
Policy No: 1222520
Expiration: 11101/2021
Record Management:
DrainagePermitFee :
Drainage Plan Check:
Grading Consultant Fee
Additional Fee :
FEES
$16.00
$232.00
$195.00
$0.00
$0.00
POOLPermit: S2021-0102
Project No: 0904-2021
Inspection Requests Phone (949)644-3255
State Lie:
Engineer: PETROV PLAMEN
Address: 28161 CASITAS CT
LAGUNA NIGUEL CA 92677
Phone: 714-717-7542 State Lic:C-066947
Special Conditions:
Issued Date: 05/11/2021
Water Quality- --
Building Dept Inspection Fee:
$0.00
Water Quality Dept Insp Fee:
$0.00
Building Dept WQ Plan Check:
$0.00
Others
$0.00
$0.00
Plan Check Fee: $1
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PERMIT EXPIRES 180 DAYS AFTER Pt§1JA4(E t*, LAST VHkLfU WPECTION
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Fee Due at Permit Issuance :
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
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
Irofessions 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). 28161 CASITAS CT
1 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,
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
nproved 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
pply 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 I 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 Iega111
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 99f Division f the Business and Professi!! � an y lice '9 n full force
nd effect. License Class License No Date' % —' 'N Contractor Signature(
VORKERS' COMPENSATION DECLARATION
DARNING: 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
OST 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:
] 1 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
@rf�irmance of the work for which this permit is issued. Policy No.
and will�intain wort' rs ompensation 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 add licv n ber e: I, _ /)
Ieof Agent
certify that, in the performance of the work for which this permit is
if I should become,subiect to tho workers' compensation gLpWaic
of
Date
I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
ction 3700 of the Labor Code, I shall forthwith comply with those provisions.
CLARATION RE CONSTRUCTION LENDING AGENCY
:reby affirm underipeDafy of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097
Ider's Name I ' Lender's 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.
I authorize representatives of this city or countygt enterrtheq a§ove-igntifie(�property for inspection purposes.
Civil Code).
�CTION DATE BY DECLARATION dF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OFTITLE 40ANDAQMD RULE ,.,(; reGyjred alarms.latcMes
PERMITEXPIRED
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as part of a pool! Spa
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