HomeMy WebLinkAbouts2022-0073 - Permits1v, City of Newport Beach - Building Division *S2022-0073*
100 Civic Center Drive, Newport Beach, CA 92660
..+ Permit Counter Phone (949)644-3288
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POOLPermit : S2022-0073
Project No : 0782-2022
Inspection Requests Phone (949)644-3255
.lob Address: 17 SAN MATEO WAY Floor: Suite: Bldg: 1
Description of Work:SFR POOL ALTERATION. PLMB/ELEC, TILE & COPING. RESURFACE
Inspector Area: 6 Plan Check No: 0782-2022
Code Edit: 2019
Legal Description: N TR 7844 LOT 24
Owner:
TOCCI BOB
Contractor:
GARDNER POOL PLASTERING
Address:
17 SAN MATEO WAY
Address:
600 W FREEDOM AVE
CORONA DEL MAR, CA 92625
ORANGE CA 92865
Phone:
Phone:
174-630-6300
Applicant: FOSTER MIKE
Con State Lie:
896061
Address:
600 W FREEDOM AV
Lie Expire:
05/31/2023
ORANGE CA 92865
Bus Lie:
BT30018497
Phone:
909-263-6344
Lie Exp Date:
01/31/2023
Building Rear:
Setbacks: Front:
Left:
Right:
Construction
Construction Valuation: $20,000.00
Building Permit Fee :
$419.00
Permit Issuing Fee:
$0.00
Investigation Fee:
$0.00
Building Green Fee:
$1.00
Plan Dept Plan Check:
$52.00
Building Dep Plan Check:
$364.53
Building PC Investigation :
$0.00
Plan check Ext. Fee :
$0.00
WO Compliance Insp Fee:
$0.00
TOTAL FEE:
PROCESSED BY:
ZONING APPRO\
Worker's Compensation Insurance
Carrier: DEPARTMENT OF INDUSTRIAL
Policy No: 4503-118
Expiration:
FEES
Architect
Address:
Phone: State Lie:
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Engineer:
Address:
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Phone: State Lie:
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Special Conditions:
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Issued Date: 03/24/2022
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Record Management:
$4.00
Water Quality ---
Building Dept Inspection Fee:
$0.00
Drainage Permit Fee :
$0.00
Water Quality Dept Insp Fee:
$0.00
Drainage Plan Check:
$0.00
Building Dept WQ Plan Check:
$0.00
Grading Consultant Fee :
$0.00
Others:
$0.00
Additional Fee :
$0,00
$0.00
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Plan Check Fee : $0.00
PLAN CHECKED BY::
APPROVALTOISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Fee Due at Permit Issuance :
OWNER -BUILDER
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
'rofessions 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).
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
nd 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).
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).
3 1 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 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
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.html.
Iignature of Property Owner or Authorized Agent Date
.ICENSED C6NM4CTOR'S DECLARATION
hereb,Aaffirm uddef Qenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 ) of Divislopp 3 of the Business and Profess'Ipa , and my li full force
AamOect. Li/Tnseglass License No Date s'lL�//LL Contractor Signatures
ILORKERS' CONIPENSATION DECLARATION
IAI NIM4C.. FAILURE T8 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
'DST OF COMPENSATIOfy DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
t Rregyaffirm %del penalty of perjury one of the following declarations:
�.I•tyave and"ifl i'naintain 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 , rmnce of the work for which this permit is issued. Policy No.
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'
carrigta%& IIcy number are:
• • • Policy Number Expiration Date
ag3f Agenf,• ••
certify that, in .. the performance of the work for which this
. if I should become subiect tialheidykers' compepsatlo
of
I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
:ctiGrr3700-of the Labor Code, I shall forthwith comply with those provisions.
Date
CLARATION REGARD NG CONSTRUCTION LENDING AGENCY
areby 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
ider's Name Lender's Address
my signature below, I certify to each of the following:
1 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 ord' ces anastate laws relating to building construction. <
I authorize representatives of this city or countyntove-ideytified property for inspection purposes.
PERMIT EXPIRED
DATE BY ` DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
I SUBMITTED
TO
PERMIT EXTENDED L_IAQM D
POOLALARMS U ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
INSTALLED PROPOSED DEMOLITION.
SIGNATURE:
PERMITFINAL 9.2 n
Name
FOR OFFICE USE ONLY
Civil Code).
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as part of a pool / spa
barrier, shall be in place
prior to approval to fill
poolispa & shall remain in
ptace & be maintaln4for
tht- life of the pool/