HomeMy WebLinkAboutS2022-0010 - Permitsyw,r� City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
w Permit Counter Phone (949)644-3288
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Job Address: 1318 DOVER DR Floor: Suite: Bldg: 1
Description of Work:SFR NEW SPA 90 SF W/YARD DRAINAGE
Inspector Area: 3 Plan Check No: 0077.2022
Code Edit: 2019
Legal Description: N TR 3000 LOT 76
Owner: NEW DEREK/KALEE
Address: 829 HARBOR ISLAND DR
NEWPORT BEACH, CA 92660
Phone:
Applicant: WRIGHT JC
Address: 833 DOVER DR #7
NEWPORT BEACH CA 92663
Phone: 949-795-0648
Building Rear:
Setbacks: Front:
Left:
Right:
Construction Type : VB
Construction Valuation: $45,000.00
Building Permit Fee :
$440.00
Permit Issuing Fee:
$0.00
Investigation Fee:
$0.00
Building Green Fee:
$2.00
Plan Dept Plan Check:
$0.00
Building Dep Plan Check:
$396.00
Building PC Investigation :
$0.00
Plan check Ext. Fee :
$0.00
WQ Compliance Insp Fee:
$0.00
TOTAL FEE : $1,282.00
PROCESSED BY:
ZONING
Contractor:
INSTANT POOLS LLC
Address:
116 SENCILLO PL
RANCHO MISSION VIEJO CA 92694
Phone:
949-795-0648
Con State Lic:
1009644
Lic Expire:
07/31/2023
Bus Lic:
BT30063469
Lic Exp Date:
12131/2022
Worker's Compensation Insurance
Carrier: WC EXEMPT
Policy No: (NO EMPLOYEES)
Expiration:
FEES
Architect:
Address:
Phone:
POOLPermit : S2022-0010
Project No : 0077-2022
Inspection Requests Phone (949)644-3255
State Lic:
Engineer: THOMPSON MATTHEW
Address: 12021 N TUSTIN AVE
ANAHEIM CA 92807
Phone: 714-630-6100 State Lic:C-086051
Special Conditions:
Issued Date: 01/24/2022
Record Management:
$8.00
Water Quality- --
Building Dept Inspection Fee:
Drainage Permit Fee :
$237.00
Water Quality Dept Insp Fee:
Drainage Plan Check:
$199.00
Building Dept WQ Plan Check:
Grading Consultant Fee :
$0.00
Others
Additional Fee :
$0.00
Plan Check Fee :
$695.00 Fee Due at Permit Issuance
PLAN CHECKED BY:: W
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID 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 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). 12021 N TUSTIN AVE
❑ 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,
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-Builderwill 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).
J I am exempt from licensure under the Contractors' State License Law for the following reason:
Iy 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
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 al
'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
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 Di i�ioQthe Business a
nd effect. License Class License No Date 1- "1 G LContractor Sig
Tents covered by this permit, I cannot
law, Section 7044 of the Business and
)RKERS' COMPENSATION DECLARATION
:NING: FAILURE TS SEJURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001, IN ADDITION TO THE
T ORCOMPENSP.719Y, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
IN affirm•rmder penalty of perjury one of the following declarations:
1'Vve 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
'ormance of tRe work for which this permit is issued. Policy No.
ireve andwill•malntain 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
IFance carrier and'policy number are:
!:..- °'•• Pnlir_nlilumher Expiration Date
•rtify that. -in jfle performance oft ork for which this ermit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and ogre
plt"ef I shoUjfi bEceme s fact to tfje workers' compere on provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
at .
Da
)ECLARATFOI`I ReGAt381N'G CONSTRU N LENDING AGENCY
hereby affirm under(-bnalty of pt there is a construction lending agency for the perform of the work for which this permit is issued (Section 3097, Civil Code).
.ender's Name er" aLender's Address
3y my signature belo certify to each of the following:
I am the property owner or authorized to act on the property owne
I have read this application and the information I have providedis correct. I � z �
I agree to comply with all applicable city and count ord' antes and st laws relating to building construction. ` /
I authorize representatives of this city or county t ante he abov entified property for inspection purposes.
Signature of Property Owner or Authorized Agent Owner's or Authorized Agent's Na l� V�J 3"l V"3 ( f6fate
ACTION DATE BY DEC A OMPUANCE WITH ODE OF FEDERAL _,FP1 OFFICE USE ONLY REGULATIONS PART 61 OFTI�All required alarms latches
REGULATIONS PART 61 OFTITLE AND AOMD RUL
1403 gates & fences which serve
PERMITEXPIRED I SUBMITTED ASBESTO TION TO as pa O a p00 Spa
barrier, shall be in place
PERMITCANCELLED EPA prior to approval to fill
PERMIT EXTENDED OVID pool/spa & shall remain in
TOOL -ALARMS OASBESTOS NOTIFICATION IS NOTAPPLICABLE TO place & maintained for
INSTALLED I 1 y /�Q /%J OSED DEMOLITION. the Jy OfiFh8P0005J0
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