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Home My WebLink AboutS2021-0193 - Permits,�wnr City of Newport Beach - Building Division *S2021-0193* POOLPermit : S2021-0193 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 1402-2021 Permit Counter Phone (949)644-3788 �'�ztrnixH4a I 1 P ET Inspection Requests Phone (949)644-3255 Job Address: 423 REDLANDS AVE Floor: Suite: Bldg: 1 Description of Work:SFR POOL REPLASTER 300 SF Inspector Area: 3 Plan Check No: 1402-2021 Code Edit: 2019 Legal Description: FIRST ADD TO NEWPORT HEIGHTS LOT 18 BLK 14 AND LOT19 BLK 14 Owner: DAHL JEFFREY Contractor: LONGMAN JEFF Architect: °°.. Address: 423 REDLANDS AV Address: PO BOX 15372 Address: ° ° ° ° • ° NEWPORT BEACH, CA 92663 NEWPORT BEACH CA 92659 • ° Phone: 310-926-3522 Phone: 949-202-6029 Phone: ° ° State Lic: °°•°°• +6Q°6p Applicant: LONGMAN JEFF Con State Lic: 885301 Engineer: ° •' , °® Address: PO BOX 15372 Lic Expire: 1013112022 Address: ° • ° ° ° NEWPORT BEACH CA 92659 Bus Lic: BT30019621 : °°°° °• Phone: 949-202-6029 Lic Exp Date: 05/31/2022 Phone: State Lic: °•° Building Rear: Worker's Compensation Insurance Special Conditions: Setbacks: Front: Carrier: STATE COMP SUB CONTRACTOR AGREEMENTATTACHED Left: Policy No: 9247121 ° • .. ° Right: Expiration: 03/09/2022 Issued Date: ° ° 08/2612021 ® Construction Type: ;°°J�° ° °°°.• FEES Construction Valuation: $20,000.00 Building Permit Fee : $419.00 Record Management: $2.00 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: $1.00 Drainage Plan Check: $0.00 Building Dept WQ Plan Check: $0.00 Plan Dept Plan Check: $0.00 Grading Consultant Fee : $0.00 Others: Building Dep Plan Check: $364.53 $0.00 Building PC Investigation : $0.00 Additional Fee : $0.00 $0.00 Plan check Ext. Fee : $0.00 WQ Compliance Insp Fee: $0.00 TOTAL FEE: $786.53 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $786.53 PROCESSED BY: PLAN CHECKED BY:: 1 ZONINGAPPROVAL: APPROVAL TO ISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 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 structurr,prior to its issuance, also requires thP-eoplicant 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 31of the Ainess 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). I, 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 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). I 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 legal]) 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:/Aw .leginfo.ca.gov/calaw.html. Signature of ProparWowner or Authorized Agent Date L1QI�NSED CpNZRACTOR'S DECLARATION �) I hereby affire UAdXX enalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0 0 igri' of ttre Business and o ssi n6 s C fie n wny Ilcens is in full force and affect. License Class License No Dat L'J LMontractor Signatui AFGRKERS' C`OMP�NSATION DECLARATION MARRING: FAILURWF,�.�'jd`,SF�URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED T OUSAND DOLLARS ($100,000), IN ADDITION TO THE COS18F COMPENS`A`fION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. IP ejepy affirm ter penalty of perjury one of the following declarations: ..6 pave and wll 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 p�g/Qprryence of the work for which this permit is issued. Policy No. �]cLha�E � and illaigtain 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 I Mreeee carrier and policy number are: �Qii .:. a Policy Number Expiration Date Jame of Agent Phone a I certify that, in the performance of k for which t it is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre hat, if I should become subject to work s' nsatian pro isions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant Cat )ECLARATION REGA�(�,hi%MU&IO'k LENDING AGENCY / \JJJ hereby affirm under penalty of p jCiury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. it 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 provis correct. I agree to comply with all applicable city and county ord' nce lays-f8lating to b ilding construction. - I authorize representatives of this city or county to er the -i mi d p or inspection purposes. py/—/y�� Signature of Property Owner or Authorized Agen Print Property Owner's or Authorized Agent's Nam —' L D ZZ ACTION DATE BY RATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED EPA PERMIT EXTENDED AQMD POOLALARMS �; 7 a Q ASBESTOS NOTIF T APP ICABLE INSTALLED y PROPOSED`AEWt TI04