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Home My WebLink AboutX2019-0832 - Permits00® mm •, • IIIIIII IIIIIIIIII ILII IIIIIIIIII VIII IIIIIIIIII III II �� by City of Ne®;ivpgrt Bea�hm-�wii�ding Division COMB Permit :X2019-0832 a 100 Civic Cenjgr,Driae:Naw64 I36uctu;°CA?2 60 X 2 0 1 9 0 8 3 2 H Permit Counter Phone (949)644-32138: •, •,� Project No :0561-2019 x�. Inspection; Requests Phone (949)644-3255 • ® - "1rrx�'��. CombinalionType -MFP m. Issued Date: 0312212019 f1SpeCilOn Area : 4 • s • , :,, , PERRITS EXPIRE 180: DAYS AFTER ISSUANCE OR LAST VALID INSPECTION: Construction Hours: Monday ° fi dbV 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: 22 COVENTRY NB - Description: MFR FOOTING, JOISTS AND BEAM REPLACEMENT AT DECK AREA 330 SF Legal Desc.i TR 9588 LOT 2 UNIT 27 OF PROJECT LOCATED ON AP 461-081.08 TOGETHER - Owner: TRAVASSAROS GEORGIA Contractor: PATSCHECK CONSTRUCTION LLC Architect Address:. 22 COVENTRY Address: 656 OTERO COURT Address: NEWPORT BEACH, CA CAMARILLO, CA 93010 Phone:. 9492190578. Phone: 805402-9130 - Phone: State Lie: Applicant: PATSCHECK STAN Con State Lie: 1011514 Engineer: HELFRICH STEVEN Address:. 556 OTERO CT Lie Expire: 0212912020 Address: 30640 KRISTIN CT - CAMARILLO, CA 93010 Bus Lie: BT30061601. REDLANDS CA 92373 Phone. 805.402-9130 - Lie Exp Date: 1213112019 Phone: 909.389-7316 State Li¢C-040046 Code Edit: 2016 Worker's Compensation Insurance Designer :Type of. Construction: Carrier: EXEMPT Address: Occupancy Group: R21U Policy No: .Added /New sq.ft. Bldg: 0 Expire: Phone: Added /New sq. ft. Garage: 0 No of Stories: 0 Building Setbacks Rear I Special Conditions: 1, 3 No of Units : 4 Front. / Bldg Height: 0 Left: / Bldg Sprinklers: Right: /. e, .Flood Zone: Use Zone. Parking Spaces: 0 Fire Hazard Zone ; N Construction Valuation: $20.000.00 Building Permit Fee: $392.00 Excise Tax:.. $0.00 Planning Department Fire Department Plan Check Fee:. $341.04 Additional Fee [ $0.00 Plan check Fee: - $40.00 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: $8.00 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 %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: -. $0.00 .$0.00 TOTAL FEE : $782.04 Plan Check Fee: $381.04 Fee Due at Permit Issuance : $401.00 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: '1 APPROVAL TO ISSUE: 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 §iecheclQnhrk(e) Phabe Tplpced Rext 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 repairbaystructure, prior ro 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' Stale 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 perrgit subjerol9thp,1applicant 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 (_) portions of the work, and the;ruc4ire is nolintenBed or kmcFfpf sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or alsonal•ejfort, 4wlds ePilnproves 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 OWneIItBUlrdar will have the burden of proving that it was not built or Im roved 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 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 1 must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall 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 peiury that I am licensed under provisions of Chapter 9 (commencing with Section 70 0 of Division 3 the Business and P f 'ons Co�Flc�,yln fullrce and effect. License Class 0 License No 10 (1 � f� Da `�- — ContractorSignatur - WORKERS' COMPENSATION DECLARATION NARNING: 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 ($100,0011), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION ]TOS OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: ❑ 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 performance of the work for which this permit is issued. Policy No. ]I 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' compensation Isurance carrier and policy number are: Policy Number Expiration Date lame Agent Phone # dl Cert! y that, in the performance of 1he N ork r which this perm' is issued, I shall not employ any person in any manner so as to become subject to the worke ' compensation laws of California, and agrer tat, if should beco e s b' t -to the wor r ' com ens tI n or sions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ,Ignature of Applicant p IECLARATION RE DING CONSTRUCTION LENDING AGENCY hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, CI it Code). ender's Name Lender's Address lymy 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 i correct. I agree to comply with all applicable city and county ordina c an state laws r atin t building construction. I authorize representatives of this city or county' r th a v Id inspection purposes. li nature of Property Owner or Authorized Agent Print Property Owners or Authorized A ent's Name L,5 f-PAA-iS C`6(�--r—V Date NCTION DATE BY VECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE EXPIRED I I I U I SUBMITTED ASBESTOS PERMIT EXTENDED UAQMD PERMIT FINAL U ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF 7 yq (°l f� PROPOSED DEMOLITION OCCUPANCYISSUED SIGNATURE: