HomeMy WebLinkAboutX2019-1511 - Permitsrtr City of Newport Beach - Building Division
y.< 100 Civic Center Drive, Newport Beach, CA 92660
. Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - BLDG
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Construction Hours: Monday -Friday 7:00 EXPIRE m. to 6 30
Job Address: 220 VIA ITHACA
NB
Description:.. SFR BLOCK WALL 6' X 37 LF (INSIDE
Plan Check Fee: $365.00
p.m. and Saturday i om
8:00 a.m to 6$
Legal Desc.: N TR 907 LOT 731
P/L)
Record Management:
$4.00
Owner: LIGHTNER CINDY
$0.00
CA Seismic Safety:
$0.00
Address: 220 VIA ITHACA
Contractor:
GREYSON CONSTRUCTION
$0.00
NEWPORT BEACH, CA 92663
Address:
22858 HUNWUT DR
Architect:
Phone: 949.300.4443
$0.00
WILDOMAR CA 92595 -
Address:
Applicant: GREYSON JEFF
Phone:
951-541.8312
Phone:
Address: 22858 HUNWUT DR
Con State Lie:
329260
WILDOMAR CA 92595
Lie Expire;
09/30/2020 '
Engineer:
Phone: 951-641-8312
Bus Lie:
BT30067164
.Address:
" -
Code Edit : 2016
Lie Exp Date:
05/31/2020
Phone:
Type of Construction:
Worker's Compensation Insurance
Occupancy Group: U
Carrier:
NORGUARD
Designer:
Added /New sq.ft. Bldg: 0
Policy No:
GR1682
Address:
Added /New sq. ft. Garage 0
Expire:
02/WCO2n
No of Stories: 0
No of Units : 0
Bldg Height: 0
Bldg Sprinklers:
Building Permit Fee:
$412.00
Plan Check Fee: $365.00
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$4.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $822.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Building Setbacks Rear: 4'
Front: 10'
Left: 3'
Right: 3'
Excise Tax:
Additional Fee:
Grading Bonds Fee:
Grading PC Consultant:
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee r
Electrical %:
Mechanical %:
Plumbing %:
Phone:
COMB Permit: X2019-1511
Project No: 1067-2019
Issued Date: 05/13/2019
Inspection Area : 1
p.m. No work on Sundays01/gts a
`d"Y�E 1
41 Jill#
State Lie:
State Lie:
Special Conditions: LIQUEFACTION AREA
$0.00
Planning Department
-
$0.00
Plan check Fee'.
$0.00
$0.00
Fair Share:
$0.00
$0.00
SJH Trans
d
$0.00
In -lieu Housing Fee
$0.00
$0.00
Public Works Department -
$0.00
Park Dedication :
$0.00
$0.00
P1W Plan Check:
$0.00
$0.00
San Dist :
$0.00
$0.00.
NMUSD Fee:
$0.00
$0.00 .
Plan Check Fee:
neo
$0.00 Fee Due at Permit Issuance
$822,00
PUBLIC WORKS APPROVAL:
a < P,11414 CHECK BY:
< APPROVAL TO ISSUE:
42.0
Fire Department
$40.00
Fire Inspection:
$0.00
$0.00
$0.00
Fire Plan Rev
$0.00
Demolition Fee
d
$0.00
Building Dept Adm
$0.00
General Service
$0.00
Refund Deposit
$0.00
Grading Bond:
$0.00
$0.00
$0.00
$0.00 Fee Due at Permit Issuance
$822,00
PUBLIC WORKS APPROVAL:
a < P,11414 CHECK BY:
< APPROVAL TO ISSUE:
42.0
d
icable Items)
OWNER -BUILDER DECLARATION prior to its issuance, also requires the applicant for
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License nstruct Law for t he
State License) Law (Chapter 9t(commenc ng (with Section a7000) of Division ced next to the P3lof the Business and
applicant for a permit subjects the applicant to a civil penalty of
tionpermit03 file a Business
sand
Professions
that he o�sheAls licensed pursuant to the Iprovis prres a ovisions ofmit tthe Contraco GO tolter, improve, demolish, or repair any ppli structure,
Ifessi t Coda) or that he or she i5 exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any app provided that the
more than five hundred dollars ($500). all of or ortions of the work, and the structure is not intended or offered for sale (Section d the
I to , owner of property who, through employees' or personal effort, builds or improves the property, p
1, as owner of the property, or my employees with wages as their sole compensation, will do (_) U P
siness and Professions Code: The Contractors' State License Law does not apply
provements 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 builtor
roved for the purpose of sale).
PI, 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 no
,ply a 0 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). y I cannot legsll
1 I am exempt from licensure under the Contractors' State License Law for the following reason:
I my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior trstand o completion of the im able la nts coverDate ed b this permit,
:II a structure that
h tis available uponI have built as nrow requbuilder if it est this a as Inot
tibees submitted in its
the followinglWeb seta contractors
ntr c/www.legin oeca.govlcalaw.html.of the applicable law, Section 7044 of the Business and
rofesslon
ignature of Property Owner or Authorized Agent and mY license is in fu force
Division 3 of the Business and Profgssions;/Cpda„
ICENSED CONTRACTOR'S DECLARATION DateDl6�ntractor Signet
hereby affirm under penalty of perjury that I am licensed and censeisons of Chapter 9 (commencing with Section 00 )
O THE
nd sfoct. License Class
IIORKERS' COMPENSATION DECLARATION
AWFUL AND SHALL SUBJECT AN EMPLOYER TO !OSTIOF CO FAILURE
TTOION DAMAGES AS S' OOEO FOR IN SECTIOMPENSATION N AGE IS
THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
RIMINAL PENALTIES AND CIVIL FINES OP TO ONE HUNDRED THOUSAND DOLLARS (E�0a,0001, IN ADDITION T
SECURE
hereby affirm under penalty of Perjury one of the following declarations: issued b the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th
I have and will maintain a certificate of consent to self -insure for workers' compensation, Y
910
eyfiprin ce of the work for which this permit is issued. Policy No.
Code, for the performance 1 work for have and maintain workers' compensation insurance, as required by Section 3700 of the Labor nce Expiration Dat which this permit is issued. My workers' compensatlo
9
nsurance carr r a policy nun� ; '01JGy))Umber _Phone S
7arrier 7 yi
Name of Agent
01 certify that, in the performance of the work for which this permit Is Issued, I shall not employ any person m any manner so c as comply
become subject to the woDrker compensation laws California, and agree
that, if I should becomes bject to t w rkers' compensate provisions of Section 3700 of the Labor Cade, I shall forthwith comply with those provisions. —
Signature of Applicant_AA UCTION LENDING AGENCY rformance
DECLARATION REGA DING CONSTRUCTION
I hereby affirm under penalty of perjury that there is a construction lending agency forLthe ender's Address of the work for which this permit is issued (Sectioa Aln__ 1A11 en n 3097. Civil Code).
Lender's Name
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.
1 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. Dat
.int Pro erty Owner's or Authorized Agent's Nam
I authorize representatives of this city or co my o ent th above-identifi property for inspection purposes.
Si nature of Propert Owner or Authorized Agen
DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
ACTION REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
1 SUBMITTED ASBESTOS NOTIFICATION TO
IERMI7 EXPIRED • +
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�ERMITCANCELLED • + ! • , +
QMD • ° • •air
PERMITEXTENDED++•
ASBESTOS NOTIFICATION IS NOT APp }ICABL+.TO •.+!
PERMIT FINAL PROPOSED DEMOLITION
CERTIFICATE OF SIGNATURE:
OCCUPANCYISSUED s • • •••
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