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HomeMy WebLinkAboutS2021-0257 - Permitsn,W, i,;r City of Newport Beach - Building Division II II I I IIII III IIII �I I II I III II POOLPermit : S2021-0257 L. 100 Civic Center Drive, Newport Beach, CA 92660 S 2 0 2 1 0 2 5 7 p Project No: 2691-2021 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Job Address: 219 EVENING STAR LN Floor: Suite: Bldg: 1 Description of Work:NEW POOL AND SPA 750 SF p, i Inspector Area: 3 Plan Check No: 2691-2021 L'—'� Code Edit: 2019 Legal Description: N TR 1116 LOT 126 Owner: JONES CLIFTON Contractor: AQUA SCAPES POOLS & SPAS Architect: Address: 219 EVENING CANYON RD Address: 321 CALLE FELICIDAD Address: CORONA DEL MAR, CA 92625 SAN CLEMENTE CA 92672 Phone: Phone: 949-448-7665 Phone: State Lie: Applicant: AQUA SCAPES POOLS & SPAS Con State Lie: 754729 Engineer: LACHER TODD Address: 321 CALLE FELICIDAD Lie Expire: 11130/2022 Address: 1201 N TUSTIN AVE SAN CLEMENTE CA 92672 Bus Lie: BT30069893 ANAHEIM CA 92807 Phone: 949-448-7665 Lie Exp Date: 06/3012022 Phone: 714-630-6100 State Lic:C-067656 Building Rear: Worker's Compensation Insurance Special Conditions: Setbacks: Front: Carrier: WC EXEMPT Left: Policy No: (NO EMPLOYEES) Right: Expiration: Issued Date: 11/16/2021 Construction Type 11 FEES Construction Valuation: $52,875.00 Building Permit Fee: $440.00 Record Management: $14.00 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: $152.00 Building Green Fee: $3.00 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: $396.00 $0.00 Building PC Investigation : $0.00 Additional Fee : $0.00 $0.00 Plan check Ext. Fee: $0.00 WO Compliance Insp Fee: $0.00 11 TOTAL FEE : $1,005.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $1 005 00 PROCESSED BY: PLAN CHECKED BY:: ZONING APPROVAL: APPROVAL TO ISSUE: ti 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, prior to 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 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 Tot more than five hundred dollars ($500). 1201 N TUSTIN AVE ❑ 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 '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 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). ❑ 1 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.htm]. 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) f f i i ion of the Business- usiness rof i s Did , and Icen is in full force and effect. License Class License No to Contractor Sig ura WORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO 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 COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm undE. penalty of perjury one of the following declarations: ❑ 1 hi�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 th Net;5-1 5ance 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' carrier and policy number are: Policy Number of Agent Date JI certify Mat, it to ZR o w k forwhich this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compen Iat, if I sh Id bec c o e ers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignature of ,;ca ate_�� IECLA C. R� CONSTRUCTION LENDING AGENCY hcreby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sectio 097, Civil Code). _ender's Naive _ 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 mvided is correct I agree to comply with all applicable city and co -nty or 1 ads a law relating to building construction. I authorize representatives of this city or t to e t ab a-i enti property for inspection purposes. Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized A ACTION DATE BY bfCrARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMIT EXPIRED I I I LJ I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT EXTENDED LIAQMD POOLALARMS ASBESTOS NOTIFICATION IS NOT APPLICABLE TO INSTALLED PROPOSED DEMOLITION. SIGNATURE: ion laws of California, and diy- V Date IC zi ~ ) ! # )\ 2 ){ ! !k , 4. 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