HomeMy WebLinkAboutX2018-1180 - PermitsCOMB Permit: X2018-1180
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIII II
Project No: 0950-2018
Issued Date : 04/2412018
Inspection Area y 2
F PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays
Job Address: 208 TUSTIN AVE NB
Description: SFR - NEW DETACHED SHED 288 SF "AS BUILT"
Legal Desc.: N TR 1133 LOT 22
Owner: CARSON THOMAS & ERIKA
Address: 208 TUSTIN AVE
City of Newport Beach - Building Division
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100 Civic Center Drive, Newport Beach, CA 92660
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Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
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Combination Type - BLDG ELEC
COMB Permit: X2018-1180
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIII II
Project No: 0950-2018
Issued Date : 04/2412018
Inspection Area y 2
F PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays
Job Address: 208 TUSTIN AVE NB
Description: SFR - NEW DETACHED SHED 288 SF "AS BUILT"
Legal Desc.: N TR 1133 LOT 22
Owner: CARSON THOMAS & ERIKA
Address: 208 TUSTIN AVE
Contractor:
Address:
OWNERIBLDR
AUTH AGENT:
Architect:
Address:
�t
NEWPORT BEACH CA 92663
ELLINGSON PAUL
y7r.
Phone: 949-463.6777
Phone:
Phone:
State Lie:
l, - ..) •,°O
Applicant: ELLISON PAUL
Con State Lie:
O/B
Engineer:
TINDALL GEORGE
Address: 24642 VIA RAZA
Lie Expire:
Address:
610 MALABAR OR
LAKE FOREST CA 92630
Bus Lie:
CORONA DEL MAR CA 92625
Phone: 949-683-9861
Lie Exp Date:
Phone:
714-357.2685 State Lie:C-019921"')
Code Edit: 2016
Worker's Compensation Insurance
Designer:a
•a1° • °.
Type of Construction:
Carrier:
Address
Occupancy Group: U
Policy No:
Added /New sq.ft. Bldg: 0
Expire:
Phone:
°
Added /New sq. ft. Garage: 0
-
,Z4,
``�"'
No of Stories: 0
Building Setbacks
Rear: / 10
Special Conditions: OWNER/BLDR ATTACHED op °
No of Units : 0
Front: I 'LII
•
Bldg Height: 0
Left: /
Bldg Sprinklers:
Right: /
Flood Zone:
Use Zone: Parking Spaces.
0
Fire Hazard Zone: N
Construction Valuation: $14.000.00
Building Permit Fee: $277.00
Excise Tax:
$0.00
Planning Department-
Fire Department
Plan Check Fee: $240.99
Additional Fee :
$0.00
Plan check Fee:
$37.50 Fire Inspection:
$0.00
Overtime Plan Ck: $0.00
Grading Bonds Fee:
$0.00
Fair Share:
$0.00 Fire Plan Rev
$0.00
Investigation Fee: $0.00
Grading PC Consultant:
$0.00
SJH Trans :
$0.00 Demolition Fee
Record Management: $18.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee:
$0.00 Building Dept Adm
$0.00
Energy Compliance: $0.00
Grading PC Fee:
$0.00
Public Works Department -
General Service
$0.00
CA Seismic Safety: $0.50
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Refund Deposit
$0.00
Disabled Access : $0.00
PNV Plan Check:
$0.00
Grading Bond:
$0.00
Hazardous Mat $0.00
Electrical %:
$19.39
San Dist:
$0.00
Building Green Fee : $1.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE : $594.38
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Plan Check Fee
$278.49 Fee Due at Permit Issuance : $315.89
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
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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 itecn(s)
ction 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
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
fessions 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 pQnalty of
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 or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
iness 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
rovements 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
tbved for the purpose of sale).
i„ 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
Iy 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'
my signature below I acknowledge that, except f
a structure that I have built as an owner-builde if it
fessions Code, is available upon request when t
nature of PAWtf pwner or Authorized Agent
SENSED CONTRACTOR'S DEC LARAT N
:oaby affirm~mder penalty of perjury that I licene
I effAct. License Class
COMPENSATION DECLARATION
r„g�sl ce In w Ich I ust ve resided for at least one year prior to completion of the improvements coven
en nstruc in it n ' y by licensed contractors. I understand that a copy of the applicable law, Section
is b dor at ollowing Web site:http://www.leginfo.ca.gov/calaw.hlml.
der provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions
License No Date Contractor Signature
and
and my license is in full force
ARISING: FAILURE ro SCOURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$100,0001, IN ADDITION TO THE
OST OFC OMPEMOTIION, DAMAGES AS PROVIDED FOR IN SECTION 5706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
herelsy affirm Sl44el penalty of perjury one of the following declarations:
31 "awe and will met'ntain 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
M"rhance of the,work for which this permit is issued. Policy No.
We and will maga fain 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'
nce carrier and policy number are:
Policy Number
Date
lame of Agent • • • Nnone 7f
:1I certify that, in the pert ance for wh' this m' s issued, I shall not employ any person in any manner so as to become subject to the workers' co nsati R laws f California, and agre
iat, if] should becomes ject to a wo ors' c ensati visions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
lignature of Applicant Da
IECLARATION REG DI C DING AGENCY
hereby affirm under enalty 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 owner's be
I have read this application and the information I hav ed is co Jtfflp,
I agree to comply with all applicable city and count rdinan n srelatin building construction.
I authorize representatives of this city or county to merth bov-ideopert r Inspectionpurposes.
linnnhire of Pmnertv Owner or Authorized Anent Print Prooertv Owner's or Authorized ADent's Na
ACTION DATE BY / ]C3 TIO COMP CE WITH CODE OF FEDERAL FOR OFFICE USE ONLYATIONSPART I OF TITLE 40 AND AQMD RULE
PERMITEXPIRED I LJ I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITEXTENDED QMD
PERMIT FINAL STOSN ICATIONIS NOT APPLICABLE TO
CERTIFICATEOF✓! .� PROPOSED DE OLI
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