HomeMy WebLinkAboutX2019-1162 - Permitssa
City of Newport Beach - Building Division
1 oD Civic Center Drive, Newport Beach, CA 92660
Investigation Fee:
Permit Counter Phone (949)644-3288
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COMB Permit: X2019-1162
Project No:
et Inspection Requests Phone (949)644-3255
r'a r�rp�iv Combination Type - SFP Issued Date : 2019
Inspection Arearea : 4
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: 1233 OUTRIGGER DR NB
.Description: SFR REPLACE WOOD LATTICE PATIO COVER@DETACHED GARAGE "CTYSTD"
Legal Desc.: N TR 6634 LOT 42�
Owner. K.CUMMINS/TRUST B CHRISTOPHER Contractor: OWNER/BLDR Architect:
Address: 5120 CAMPUS DR#100 Address: AUTH AGNT: CHRISTOPHER ANTHONY Address: s o^ ,
NEWPORT BEACH CA 92660
Phone: Phone: Phone: State Lie:
Applicant: K.CUMMINS/TRUST B CHRISTOPHER Con State Lie: O/B Engineer: ....
Address: 5120 CAMPUS DR #100 Lie Expire: Address: e
NEWPORT BEACH CA 92660
Phone: 949-422-7283
Code Edit: 2016
Type of Construction:.
Occupancy Group: U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0 .
No of Stories: 0
No of Units : 1
Bldg Height: 0
.Bldg Sprinklers:
Building permit Fee: $359.00
Plan Check. Fee: $261.00
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management.:
$2.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access ;
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $663.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Bus Lie:
Lie Exp Date:
Worker's Compensation Insurance
Carrier:
Policy No:
Expire:
Building Setbacks
Use Zone:
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Rear: I
Front: I
Left: I
Right: I
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Electrical %: $0.00
Mechanical %: $0.00
Plumbing %: $0.00
Phone: State Lie:
Designer:
Address:
Phone:
Special Conditions: 119.0095
O/B AUTH & POA ATTACHED
0 Fire
Planning Department -
Fire Department
Plan check Fee
Fire Inspection:
Fair Share
Fire Plan Rev
SJH Trans
Demolition Fee
In -lieu Housing Fee
Building Dept Adm
Public Works Department -
Park Dedication :
$0.00
PAN Plan Check:
$0.00
Ban Dist:.
$0.00
NMUSD Fee:
$0.00
Plan Check Fee: $0.00
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$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Fee Due at Permit Issuance : $663.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY: ✓�/�y',
APPROVAL TO ISSUE:
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Fire Department
$40.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00.
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
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$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Fee Due at Permit Issuance : $663.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY: ✓�/�y',
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 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 to a civil penalty of
not more than five hundred dollars ($500).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
I ovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
ved for the purpose of sale).
as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
I am exempt from licensure under the Contractors' State License Law for the following reason:
By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements cover d by this permit, I cannot legally
sell a structure that I have built as an owner Ilder if it not been constru ted 1 irety by licensed contractors. I understand that a copy of the applicable law, Sectio 7044 of the Business and
Professions Code, is available upon requestw n ap li tion is it tt fo owing Web site:http:/lwww.Ieginfo.ca.gov/calaw.htmi. —[(—/
—/ C(�
Signature of Property Owner or Authorized Age a t
LICENSED CONTRACTOR'S DEC TON
I hereby affirm up$erf eualty of perjury that I am licensed undo ovision of Chapter ( mmencing with Section 7000) of Division 3 of the Business and Professions C de, and my license is in full force
apd effecj. License Cf2ss License No Date Contractor Signature
605AMS' COMKENSATION DECLARATION
NABNING6 FAILURE TO SEGrIIAE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($700,000), IN ADDITION TO THE
COSPOF OOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3106 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under Penalty of perjury one of the following declarations:
Q1*to;& and will mairflain 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 thi
agUience of tlH arM or which this permit is issued. Policy No.
11Lgaveand 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' compensatior
'.rWWrapge carrier Bob policy number are:
Policy Number
Date
jtNdfy that, in 14e,Retformance 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
ra , if I should bEG
e e r ns t n provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
signature of 4
IECLARA 14ARD G CON RUCT L I AGENCY
hereby affirm under penalt of jury that t re is e o ruction lending agency for the performance of the work for which this permit is issued (Section 3097 Civil Code).
ender's Name Lender's Address
Iy 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 9nd county ordinances and stn laws lating to building construction.
I authorize representatives of this'NyXcouny ybr kkegDyq'=i�enj dpr rty for inspection purposes. A 0 %t LA
Si nature of Property Owner or Author' d Agent /1(4/" d'i' – Print Property Owner's or Authori:
ACTION DATE,Z BY DE lAR ION OF PLA ITH CODE OF FEDERAL FOR OFFICE USE
REG TIONS PA T 61 OF TITL 40 AND AQMD RULE
PERMIT EXPIRED
U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED
DEPA
PERMIT EXTENDED
13AQMD
PERMITFINAL
CERTIFIC,9TEOF
OCCUPANCY ISSUED
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E3ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO
PROPOSED DEMOLITION
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