HomeMy WebLinkAboutX2019-1305 - Permitsa,
City of Newport Beach -/Building Division IIIIIIIIIIIIIIIIIII�illllllllllllllllllllllllllll COMB Permit: X2019-1305
100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 1 3 6 5 Project No
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Issued Date :0412412019
Combination Type - SFP
Inspection Area : 3
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 6:00 a.m. to 6:00 p.m. No work on Sundays or Holidays
Job Address: 4124 ESTELLE LN NB
Description: SFR TIO (E) 26 SQ, INSTALL COMP. SHINGLE, CLASS WMIN.
Legal Desc.: N TR 5184 LOT 7
Owner: BRALEY-LUND ELIZABETH
Contractor:
OWNERIBLOR
Architect:
Address: 1124 ESTELLE LN
Address:
BRALEY-LUND ELIZABETH Address:
NEWPORT BEACH, CA 92660
r
Phone:
Phone:
Phone:
State Lie:
Applicant: BRALEY-LUND ELIZABETH
Con State Lie: OIB
Engineer
Address: 1124 ESTELLE LN
Lie Expire:
Address:
NEWPORT BEACH, CA 92660
Bus Lie:
"r
Phone: 949-861-1100
Lie Exp Date:.
Phone:
State Lie:
.
Code Edit: 2016
Worker's Compensation
Insurance
Designer:
Type of Construction: VB
Carrier:
Address:
Occupancy Group: R3/U
Policy No:
Added /New sq.ft. Bldg: 0
Expire:
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 1
Building Setbacks
Rear: /
Special Conditions:
No of Units: 1
Front: I
Bldg Height: 0
Left: /
Bldg Sprinklers:
Right: /
Flood Zone: X
Use Zone:
Parking Spaces;
0 Fire Hazard Zone : N
Construction Valuation: $20.000.00
Building Permit Fee: $324.00
Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee: $0.00
Additional Fee :
$0.00
Plan check Fee: $0.00
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: $0.00
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: $0.00
WQ Insp. Fee:
$0.00
Park Dedication : $0.00
Refund Deposit
$0.00
Disabled Access : $0.00
PAN Plan Check: $0.00
Grading Bond:
$0.00
Hazardous Mat $0.00
Electrical %:
$0.00
San Dist: $0.00
Building Green Fee : $1.00
Mechanical %m:
$0.00
NMUSD Fee: $0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE : $325;00
Plan Check Fee :
$0.00 Fee Due at Permit Issuance :
$325.00
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ZONING APPROVAL:
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GRADING APPROVAL:
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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
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
lot more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do J all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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
Frdants 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
for the purpose of sale).
wner 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
n owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractorpursuant to the Contractors' State License Law).
xempt from licensure under the Contractors' State License Law for the following reason:
ly 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 legally
ell a structure that I have built as an owner-builder 'if he not been con tructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the BusinPss and
'rofessions Code, is available upon request when h' a ication' .,�¢) h ,f ing Weh,htlp://www.leginfo.ca.gov/calaw.html.
signature of Property Owner or Authorized Agent f�y� C�LJ
.ICENSED CONTRACTOR'S DECLARATIO T—
hereby affirm under penalty of perjury that I am licensed er provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
nd effect. License Class License No Date Contractor Signature
I/ORKERS' COMPENSATION DECLARATION
'ARNING: 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
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES,
hereby affirm under penalty of perjury one of the following declarations:
7 I 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 th
ertormance of the work for which this permit is issued. Policy No.
have 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'
rance carrier and policy number are:
Policy Number Expiration Date
of Agent
I certify that, in the performance of the work for which this ermit is issued, I shall not employy person in any manner so as to become subject to the workers' compensation laws of California, and ogre
:ha , I should become subject to the w k M' c inpa - ti r vi s of Se n 3700 of they/abor Code, I shall forthwith comply with those provisions.
signature of Applicant a
i
DECLARATION REG D G CONS Rl1T ON LENDING AGENCY
hereby affirm under nalty of perjury th - ere 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
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 have provided is correct.
I agree to comply with all applicable city and cou ty ordinances nd state laws relating to build ng
construction.
I authorize representatives of this city or cou 0 art I I d prop yf i ction purposes.
3i nature of Property Owner or Authorized Agent int Propert Owner's or Authorized Agent's Na
ACTION DATE BY E RATION OF compbANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
ULATIONS PART 61 OF TITLE 40 AND AQMD RULE
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