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HomeMy WebLinkAboutS2021-0273 - PermitsCity of Newport Beach - Building Division 1pilIII ��III�IIII��pI11111111111111111p111p111111 100 Civic Center Drive, Newport Beach, CA 92660 > Permit Counter Phone (949)644-3288 r'r�eriAH't Job Address: 3001 CAROB ST Floor: Description of Work:NEW POOL & SPA 500 SF Inspector Area: 4 Legal Description: N TR 5018 LOT 45 Owner: LOURES MARCO Address: 3001 CAROB ST NEWPORT BEACH, CA 92660 Phone: Applicant:TSAI SPENCER Address: 130 MCCORMICK STE 107 COSTA MESA CA 92626 Phone: 949-838-4310 Building Rear: Setbacks: Front: Left: Right: Construction Tyne : Construction Valuation: $75,000.00 Building Permit Fee : $440.00 Permit Issuing Fee: $0.00 Investigation Fee: $0.00 Building Green Fee: $3.00 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 : $845.00 PROCESSED BY: ZONING APPROVAL: Suite: Bldg:1 Plan Check No: 2923-2021 Code Edit: 2019 Contractor: BURKHART BROTHERS CONSTR Address: 12 BALBOA COVES NEWPORT BEACH CA 92663 Phone: 949-375-6725 Con State Lie: 905510 Lie Expire: 10/31/2023 Bus Lie: BT30026859 Lie Exp Date: 0313112023 Worker's Compensation Insurance Carrier: SECURITY NATIONAL INS Policy No: SWC1373426 Expiration: 02/01/2023 FEES POOLPermit : S2021-0273 Project No : 2923-2021 Inspection Requests Phone (949)644-3255 Architect: Address: Phone: State Lic: Engineer: KOLODZIEJ KENNETH J Address: 400 E ESTHER PLACE PLACENTIA CA 92870 Phone: 714-996-1219 State Lic:C-064768 Special Conditions: subcontractor agreement attached y�y� Issued Date: 04/07@022 A ',� "� T o.J ► Record Management: $6.00 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 Plan Check Fee : $396.00 PLAN CHECKED BY:: APPROVAL TO ISSUI Fee Due at Permit Issuance : $449.00 lLir PERMIT EXPIRES 180 DAYS A- TER ISSUANCE OR I'AST 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, 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 t0 a civil penalty of not more than five hundred dollars ($500). 400 E ESTHER PLACE ❑ I, 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, 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 legall) 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://www.leginfo.ca.gov/calaw.htmi. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 c Div Sion 3 of the Business and Professions Pace,gad my license is in full force and effect. License Class License No Datqs Contractor Signature WORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS I$100,000I, IN ADDITION TO THE COST OF COMPENSATION, 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: D I have 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 th )Vrfgrmance of the work for which this permit is issued. Policy No. have 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' ranee carrier and policy number are: Policy Number of Agent Date 11 certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and iat, if I should become sublec to the rkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. / Iignature of ApplicantA _ Rfe7` Z14 IECLARATION REGARDING CONSTRUCTION LENDING AGENCY hereby 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, Civil Code). Ender's Name Lender's Address ly my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owners behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or county to eftt2r the above -identified property for inspection purposes. T?r / 'kmature of Prooertv Owner or Authorized AGeW v 7.Gs / Print Property Owner's or Authorized Agent's Name U /Gn < CGS Date 4/7/� ACTION DATE BY J ' DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE All required alarms,latches 1403 _ _ _ gates & fences which sefVE PERMIT EXPIRED LJ 1 SUBMITTED ASBESTOS NOTIHCAI,(,N TO LJEPA - as part of a pool / spa barrier, shall be in place prior to approval to fill PERMITCANCELLED PERMIT EXTENDED LlAQMD pool/spa & shall remain in PODLALARMS ASBESTOS NOTIFICATION IS NOT APPLICABLE TO place & be maintained for INSTALLED PROPOSED DEMOLITION. the life Of the pool/spa SIGNATURE: - x PERMITFINAL �• CL \}� _0 oU) co §co $ % uE § / ( ƒ m< u L #2: « 0 3\] Ep IL 0 z k D E © m / D = jcn MR 0 r >1 [�7 o k \// / � � ■ § 2 §ƒ�a7 2 t / a*± c ( $ � � '§& % q w 0 k � � I LL a. U) w / I i � I I (