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Home My WebLink AboutXR2022-2968 - PermitsCity of Newport Beach ��EWPORr C Community Development Department- Building Division s 100 Civic Center Drive, Newport Beach, CA 92660 u x Permit Counter Phone: (949) 644-3288 Inspection Requests Phone: (949) 644-3255 CqG/FORN�P newportbeachce.gov/inspections Combination Type - SFP Work Class - Other iiiiiiiiiiii II COMB Permit : XR2022-2968 Plan Check No : 2305-2021 Issued Date: 11/09/2022 Inspection Area : 5 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS 'Job Address: 4533 PERHAM RD Legal Desc : N TR 3357 BILK LOT 116 Description: DEMO SWIMMING POOL USING CITY STANDARD WETHOD A' Owner: KEVIN RUBIN Contractor: DUGALLY OBERFELD INC Address: 4533 PERHAM RD Address : 484 S SAN VICENTE BLVD CORONA DEL MAR, CA 92625 LOS ANGELES, CA 90048 Phone: Phone: (310)441-5001 Applicant : Brandt LOUCKS Address : 484 S SAN VICENTE BLVD LA, CA 90048 Phone : (714) 925-6B1 B Owner/Builder: Address : Phone Code Edition : Type of Construction Occupancy Groups: Bldg Height: Building Setbacks Flood Zone Use Zone : PROCESSED BY: Con State Lic : 862641 Lic Expire : 08/31/2023 Bus Lic : BT30012281 Bus Lic Expire : 11/30/2022 Workers' Compensation Insurance Carrier: STATE FUND Policy No: 9091853 W. C. Expire: 3/12/2023 Architect Address Phone: State Lic Engineer: Address : Phone Designer: Brandt LOUCKS Address : 484 S SAN VICENTE BLVD LA, CA 90048 Phone: (714)925-6818 2019 Fire Sprinklers : NO Construction Valuation : $5,000.00 V-B Fire Hazard Zone : NO Added/New/Ti sq. ft. Bldg : 0 U No of Units : 0 Alteration sq. ft. Bldg : No of Stories : 0 Added/New sq. ft. Garage : 0 OTAL sq. ft. : 0 Front: 6, Front: 30, Side: 6, Side: 6 1 °� X R-1-6000 - Single' --Unit Residential (6000 indicates minimum lot area) SPECIAL CONDITIONS: 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 checkrnark(s) I have plaoe l next to the applicable item(s) 'Section 7031.5, Business and Professions Code: Any city or county that requires a permit 10 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 lie 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 licensors and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of iot more than five hundred dollars ($500).. I, as owner of the property, or my employees with wages as their sole Compensation, will do (_) all of of L) pardons 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-Builderwill 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 Improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors State License Law). 13 1 am exempt from licensure under the Contractors' State License Law for the following reason y 9 9 y y s y p completion of the improvements covered by this permit, I cannot Iegalt B my signature 6alovr I acknowledge that, except form personal residence in which I must have resided for at toast one year prior to corn I sell a structure that I have built as an owner -builder if it has not been constructed in its enhrero b 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:liwww.leginfo.ca,govlcalow.html. 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 Secli 7000 of Division 3 of the Business and Pr�fessfans C nTi.rr1 icenseis In full force and effect. License Class License No D t D L2 Contractor Signature WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FREE UP TO ONE HUNDRED THOUSAND DOLLARS t5100,0001, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 370E OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will meintam 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 54ner`mance of the work for which this permit is issued. Policy No. and will maintain workars' 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 Date me of Agent Pnone 9 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 agre t, if I should become subject to the workers' c pensay visions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ,, II nature of Applicant__�,„.�� —_ Dad! I/-o9'BOLL CLARATION REGARDIEiG'- .RUCTION LENDING AGENCY 1//�� nreby 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 Cede). ldor's Name Lenders Address 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 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 colt to enter th - �a+id property for inspection purposes. � j // /7 mature of Prooertv Owner or Authorized AosI Print Property Owner's or Authorized Agent's Nam ,�( i'li Date ACTION PERMIT EXPIRED PERILIIT C4NCEUEO PERyRT EX'TENOED PERMIT FINAL CERTIFICATE OF OCCUPANCYISSUEO 1-z3 DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY REGULATIONS PART 51 OF TITLE 40 AND AQMD RULE I SUBMITTED ASBI TO ..............____.--- _ _ __....-..___ _ __. taMa_ __ _ _ _ { S L iASFESTOSNLfIHCA IIONISNOT APPLICABLE PROPOSED DEMOLITION To