HomeMy WebLinkAboutS2021-0224 - PermitsL ity of Newport Beach -Building Division J J1111111 111111111111111111111111111111111 ill 111111111POOLPermit : S2021-0224
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100 Civic Center Drive, Newport Beach, CA 92660 5 2 0 2 1 0 2 2 4 Project No : 2321-2021
Permit Counter Phone(949)644-3288
Inspection Requests Phone (949)644-3255
.lob Address: 1969 PORT BRISTOL CIR
Floor: Suite: Bldg: 1
Description of Work:SFR NEW POOL & SPA 442 SF
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6 S DT C R
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Inspector Area: 4
Plan Check
No: 2321-2021
Code Edit:
2019
Legal Description: N TR 6623 LOT 80
Owner: QUICK RICHARD KEVIN
Contractor:
SHEAR CONSTRUCTION
Architect:
Address: 2618 SAN MIGUEL DR #265
Address:
31 BLAKEMORE DR
Address:
NEWPORT BEACH, CA 92660
LADERA RANCH CA 92694
Phone:
Phone:
714-615-6108
Phone:
State Lic:
Applicant: SHEAR CONSTRUCTION
Con State Lic:
760853
Engineer: LACHER TODD
Address: 31 BLAKEMORE DR
Lic Expire:
07/31/2022
Address: 1201 N TUSTIN AVE
LADERA RANCH CA 92694
Bus Lic:
BT30049686
ANAHEIM CA 92807
Phone: 949-636-0195
Lic Exp Date:
01/31/2022
Phone: 714-630-6100
State Lic:C-067656
Building Rear:
Worker's Compensation
Insurance
Special Conditions:
Setbacks: Front:
Carrier.
OHIO SECURITY
°
Left:
Policy No:
XWS61231341
Right:
Expiration:
04/11/2022
Issued Date: 11/0912021
Construction Type
FEES
Construction Valuation: $30,000.00
Building Permit Fee: $440.00
Record Management:
$30.00
Water Quality---
° "
Permit Issuing Fee: $0.00
Building Dept Inspection Fee:
$0.08°
Investigation Fee: $0.00
Drainage Permit Fee :
$0.00
Water Quality Dept Insp Fee:
$0.00
Building Green Fee: $2.00
Drainage Plan Check:
$0.00
Building Dept WO 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
WQ Compliance Insp Fee: $0.00
TOTAL FEE: $868.00
Plan Check Fee :
$396.00 Fee Due at Permit Issuance : $472.00
PROCESSED BY:
ZONING APPRO%
PLAN CHECKED BY::
APPROVAL TO ISSUE
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
OWNER -BUILDER DECLARATION
1 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
'rofessions 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
-ot 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 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
'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).
❑ I am exempt from Iicensure 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://www.leginfo.ca.gov/calaw.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 Se ion 7000) of Division 3 of the Business an Professi�q^�y C and my license is in full force
and effect. License Class License No 1/-9— 2f Contractor S ture
NORKERS' COMPENSATION DECLARATION
NARNING: FAILURE 70 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 COMPENSAT,Od{ LAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
herebyaffirrn under penalty of perjury one of the following declarations:
3 1 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 the
reAorm,nnce of the work for which this permit is issued. Policy No.
have and wii; .T a.ntain 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'
rance carrier and,?olicy number are:
Policy Number
d
Date
cer"fy 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
if I'should, bacon p s nsation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
'9ct to h w kers' compe
narure of Applic i/ — 9 — Z
CLARATION C DING CONSTRUCTION LENDING AGENCY
:reby affirm under pe Ity 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).
ider's Name Lender's Address
By 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 o na eel�'��ff ate laws relating to building construction.
I authorize representatives of this city or county to to tt tijlvgA entified grope r inspection purposes.01t�.� �5 �
Signature of Property Owner or Authorized A ir' Print Property Owner's or Authorized is Name at
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ON
REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE
1403
PERMITEXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED UEPA
PERMIT EXTENDED 0AQMD
POOLALARMS U ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
INSTALLED PROPOSED DEMOLITION.
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