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HomeMy WebLinkAboutS2020-0119 - PermitsCity of Newport Beach - Building Division 111111111111111111111111111111p11p1111p1111111111 100 Civic Center Drive, Newport Beach, CA 92660 p Permit Counter Phone (949)644-3288 Job Address: 1975 PORT BRISTOL CIR Floor: Suite: Bldg: 4 Description of Woorrk:NEW POOL & SPA 498 SF Inspector Area: 4 Plan Check No: 1443-2020 Code Edit: 2019 Legal Description: N TR 6623 LOT 79 Owner: GRISSINGER JEREMY Address: 1863 PORT RENWICK PL Phone: NEWPORT BEACH, CA 92660 Phone: 949-922-5755 Applicant: SCHWARZ POOLSITOM Address: PO BOX 28437 BT30038738 SANTA ANA CA 92799 Phone: 949-872-0450 Building Rear: Setbacks: Front: Left: Right: Contractor: SCHWARZ POOLS Address: PO BOX 28437 SANTA ANA CA 92799 Phone: 714-241-7665 Con State Lie: 967325 Lie Expire: 09130/2022 Bus Lie: BT30038738 Lie Exp Date: 0313112021 Worker's Compensation Insurance Carrier: NO EMRLOYEES Policy No: Expiration: Architect: Address: Phone: Engineer: Address: Phone: P001 -Permit: S2020-0119 Project No: 1443-2020 Inspection Requests Phone (949)644-3255 THOMPSON MATTHEW 12021 N TUSTIN AVE ANAHEIM CA 92807 714.630-6100 Special Conditions: Issued Date: 1010612020 4�� State Lie: me eeoe� m o ••°• oeeemo • m o 0 eemm e o State Lic:C-066051 ° ° • ° em°. • m n ommm em o 0 0 om000 eo o m om000 e 3onstruction Type:"° m • ° FEES°°°•°° m°mm m p Construction Valuation: $50,000.00 oomm ...... Building Permit Fee: $430.00 Record Management: $12.00 Water Quality --- Permit Issuing Fee: $0.00 Building Dept Inspection Fee: $0.00 Investigation Fee: $0.00 Drainage Permit Fee: $0.00 Water Quality Dept Insp Fee: $0.00 Building Green Fee: $2.00 Drainage Plan Check: $0.00 Building Dept WQ Plan Check: $0.00 Plan Dept Plan Check: $0.00 Grading Consultant Fee : $266.00 Others Building Dep Plan Check: $387.00 $0.00 Building PC Investigation : $0.00 Additional Fee : $0.00 $0.00 .Plan. check Ext. Fee: $0.00 WQ Compliance Ihsp Fee: $0.00 TOTAL FEE: $1,097.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $1,097.00 PROCESSED BY: :,e PLAN CHECKED BY:: ZONING APPROVALAPPROVAL TO ISSUE:Y) PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION OWNER -BUILDER DECLARATION I hereby affirm under penally 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) lection 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 is 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 - ot more than five hundred dollars ($500). 12021 N TUSTIN AVE I, 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, usiness and Professions Code: The Contractors' Stale 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). 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 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). I am exempt from licensure under the Contractors' State License Law for the following reason: y 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 professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. ignature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION-'I ECLARATIONi hereby affirm y1c1PfyP,nalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0) of ivisidn 3 of the Business and Pr as Q a- Od�, 11—my license is in full force nd effect. License Class License No 2 © Contractor Signature- 0ORK[RS' C$OMPE,NSATION DECLARATION ARNING: FAILURE TC SMURE 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 OS•r of FOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3703 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. herLn)f affirm urLle;penalty of perjury one of the following declarations: i have and MTI•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 thi erfoHance of the work for which this permit is issued. Policy No. 11 •. aYe and will m9fitain 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' compensalior Isurance carrier aIM policy number are: 'co•rn'e•r ' Policy Number Expiration ration Date . e ..r Anon! • • • A Phone # i cerBiy that, iD t'e performance of the rk for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' c mpensation laws of California, and agre t� If I should be5drfi su ct ,t9.the I ra' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /9 \ L,.,i' J'._..�.m.... Dat nature of Applicant /- c.. � CLARATION REGA I ONSTROCTION LENDING AGENCY �reby affirm under penalty of perjury Jhat there is a construction lending agency for the performance of the work for which this permit is issued (Section 309 , Civil Code). Ider's Name / 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 I have read this application and the information I have provjr I agree to comply with all applicable city and count cord [.is , I authorize representatives of this city or courltk to en�ej the of Prooertv Owner or Authorized ACTION PERMIT EXPIRED PERMIT CANCELLED PERMIT EXTENDED INSTALLED I DATE I sr's behalf. correct. Ind state laws relating to building construction Fe -identified property for inspection purposes. y Print Property Owner's or Authorized Agent's Name✓ OFC MPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY PART 61 OF TITLE 40 AND AQMD RULE A9 re uir DASBESTOS NOTIFICATION TO gates & fences which serve as part of a pool / spa barrier, shall be in place prior to approval to fill VO IFICA710N IS NOT APPLICABLE TO pool/spa & Shall remain In LITTON. place & be maintained for the life Of the Doclisoa/