HomeMy WebLinkAboutS2022-0069 - Permitsx t'r/kT City of Newport Beach - Building Division 11111111111111111111p111111111111p111p1111111111111 POOLPermit : S2022-0069
100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 2 2 0 0 6 9 Project No : 0727-2022
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
6 a ek,f �'•`,J C
Job Address: 1843 COMMODORE RD
Floor: Suite: Bldg: 1
Description of Work:SFR POOL REMODEL AND ADD BAJA SHELF
Inspector Area: 3
Plan Check No: 0727-2022
Code Edit:
2019
-
Legal Description: N TR 3763 LOT 5
- - -
Owner: WELCH
Contractor:
BRIAN'S POOL PLASTERING
Architect:
,
Address: 1843 COMMODORE RD
Address:
701 S ESPLANADE
Address:
NEWPORT BEACH, CA 92660
ORANGE, CA 92869.
Phone:
Phone:
714-497-8675
Phone: State Lic:
- - -
Applicant: ELLISON PAUL
Con State Lie:
821323
Engineer: LACHER TODD
-
Address: 24642 VIA RAZA
Lie Expire:
07/31/2023
Address: 1201 N TUSTIN AVE
- -
LAKE FOREST, CA 92630
Bus Lie :
BT30068753
ANAHEIM CA 92807
.. ,...
Phone: 949-683-9981
Lie Exp Date:
09/30/2022
Phone: 714-630-6100 State Lic:C-067656
-
Building Rear:
Worker's Compensation Insurance
Special Conditions:
Setbacks: Front:
Carrier:
ACE AMERICA
Left:
Policy No:
C6865239A
Right:
Expiration:
02/01/2023
Issued Date: 03/18/2022
Construction Type
FEES
Construction Valuation: $20,000.00
Building Permit Fee : $419.00
Record Management:
$10.00
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 : $794.53
Plan Check Fee :
$0.00 Fee Due at Permit Issuance
: $794.53
PROCESSED BY:
ZONING APPRO\
PLAN CHECKED BY::
APPROVAL TO ISSUI
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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, priordo its issuance, also requires the applicant for
he 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
3rofessions 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
lot more than five hundred dollars ($500). 1201 N TUSTIN AVE
1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
3usiness 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
mprovements 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
mproved 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
Ipply to an owr.E, o; 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 horn licensure under the Contractors' State License Law for the following reason:
31, 7y signatLre 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
;ell a structurA'ha" 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 CodP, is available upon request when this application is submitted or at the following Web site:hftp://www.leginfo.ca.gov/calaw. html.
3igicture of Property Owner or Authorized Agent
.ICENSED COXTFACTOR'S DECLARATION
henPby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0Bj Divi yin If the Business and Pr s 5ions,7,i, nd lic is in full force
01d effect. Linense Class License No Date ` C) / / _Contractor Siqnatur
rKERS' COMPENSATION DECLARATION
NI: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEN TIES AND CIVIL FINES UP TO ONE HUNDRED T USAND DOLLARS ($100,000), IN ADDITION TO
Or COMPENLATIO,1, 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:
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
:e of tau work for which this permit is issued. Policy No.
e nd will maintain workers' compensation insurance, as wired by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatio
a carrier and policy number are:
ri r
PDI' y Nr Expiration Date
um
Name of Agent
Phone #
I certify that, in the performa e o ork for wh'
h th' ermit' 'sued,
shall not employ any person in any manner so as to become subject to the worker compen anon ws of California, and ogre
that, if I should becomes "act a ers' come ion pr Isio
s of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant
Date
DECLARATION REGyy ING C TR N LE
ING AGENCY
I hereby affirm under p nalty of perj that there is a
construction lending ency for the performance of the work for which this permit is issued (Section 30974it Code .
Lender's Name
Lender's Address
By my signature below, 1 certify to each of the following:
I am the property owner or authorized to act on th
arty wn rs be If.
I have read this application and the information I
ave p
ed corr Cit.
I agree to comply with all applicable city and co
ty D nances and
late ws relating to building construction.
G /
I authorize representatives of this city or cou
an
the ab v -iden
' I d property for inspection purposes.
Signature of Property Owner or Authorized Agent
Print Property Owner's or Authorized Agent's Na e
[[[ l Dat a6l�j
ACTION
DATE
BY V
A TIO IOCOMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY All requl ecl slarms,latches
EGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
gates & fences which serve
1403
PERMIT EXPIRED
I SUBMITTED ASBESTOS NOTIFICATION TO
as Peft of a Pool i spa
barrier, shall be in place
PERMITCANCELLED
EPA
prior to approval to fill
PERMIT EXTENDED
AQMD
pool/spa & shall remain in
POOLALARMS
BESTOS NO IFICAT ON IS NOT APPLICABLE TO
place & ntain for
INSTALLED
PROPO El
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