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Home My WebLink AboutX2019-0900 - Permitsf9 City of Newport Beach - Building Division COMB Permit: X2019-0900 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII �s i i 100 Civic Center Drive, Newport Beach, CA 92660 a x. 2 0 1 9 0 9 0 0 Project No :0613-2099 t+ Permit Counter Phone (949)644-3288 :Inspection Requests Phone (949)644-3255 Combination Type - BLDG ELEC Issued Date: 04/01/2018 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 8:00 a.m. to 6;00 p.m. No work on Sundays or Holidays Job Address: 1358 SUSSEX LN NB - Description: SFR - DETACHED PATIO COVER 120 $F (SOLID) Legal Desc.: N TR 1896 LOT 55 s r . , Owner BRIGGS BRYAN Contractor ROMAN CONSTRUCTION Architect: ` `�n �p Address: .1358 SUSSEX LN Address P O BOX 114fi : Address: �g i !jell NEWPORT BEACH, CA 92660: WALNUT, CA 91788 Phone: Phone: 909-229-2099 Phone: - State Lic: Applicant: GOLVAN EPHRAIM Con State Lia 971274 - Engineer: DAVIS GLEN T .... - Address: PO BOX 9089 Lic Expire:.. - 10/31/2019 Address: 27336 VISTA AZUL LAGUNA BEACH CA 92651 Bus Lic BT30066707 CAPISTRANO BEACH CA 92624 a Phone. 949412-7281 Lic Exp Date: 04/30/2020 Phone: 949-493-2341 State Lic:C-050803 Code Edit : 2016 Worker's Compensation Insurance: Designer Type of Construction: V-B Carrier: -EVEREST Address: Occupancy Group: U. PolicyNo: - 7600019437161 Added /New aq:ft. Bldg 0 Expire: 09116/2019 .Phone: pO ° Added/New sq. ft. Garage: 0°°om® . °°°° No of Stories: - 0 Building Setbacks Rear: 10 Special Conditions: ' No of Units : 1 Front: 20 .Bldg Height 0.. Left:. 4 Bldg Sprinklers: Right:. 4 o O ° ° ° ° Flood Zone: Use Zone: Parkin Spaces: 0 Fire Hazard Zone : N ...... ° ° °� Construction Valuation: $9,750.00 .... Building Permit Fee: $359.00 Excise Tax: $0.00 Planning Department- Fire Department Plan Check Fee: '$261.00 Additional Fee : $0.00 Plan check Fee: $40.00 Fire Inspection: $0.00 Overtime Plan -0k: $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: $4.00 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 PAN Plan Check: $0:00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $25.13 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 : $690.63 Plan Check Fee : $301.00 Fee Due at Permit Issuance: $389:63 PROCESSED BY: PUBLIC WORKS APPROVAL:' ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: 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 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 theBusiness 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). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) 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 improvements are not intended or offered for sale. If, however, the building or improvement is sold withinone year of completion, the Owner -Builder will have the burden of proving that if was not built or improved for the purpose of sale). ❑ I, asowner 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). ❑ 1 amexempt 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 covered by this permit, I cannot legally 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 availableupon request when this application is submitted or at the following Web site:http://wvvw.leginfo.ca.gov/calaw.htmi. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION o r I hereby affirm wnSer panalty of perjury that I am licensed under provisions of Chapter 9.(commencing with Section 7 ) ision 3 of the Business and Profe ion ode hd my IiQ�€n II force and effect. Liceh?LfClass License No Date Con tractor Signature W05AMERS' C6WENSATION DECLARATION ... NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI AL PENALTIES AND CIVIL FINES UP TO ONE HUND EO THOUSAND DOLLARS (E766,666), IN ADDITION TO THE f;09 %OFCOMPENSA'MON, DAMAGES AS PROVIDED FOR IN SECTION 1766 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. geregyaffirm LRdupenalty of perjury one of the following declarations: ❑h.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 7C pr ance of t0%VQOc for which this permit is issued. Policy No. ave 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' compensatiol wr.o&e carrier And policy number are: Ex ration Date Carrier: .:...: Policy Number P Neme.of Agent • Phone # I�, L'Udertify that,•ipj..lje„pertor once of the workfor which this per 't is issued, I shall not employ any person in any manner so as to become subject to the workers' mpensation laws of California, and ogre that, if I should become su )act the rkers' co nsation p 'sions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant. Da A0, DECLARATION REGA G CONSTRUCTION LENDING AGENCY I hereby affirm under p ally of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Name Lender's Address 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_ - I have read this application and the information I have provided is correct I agree to comply with all applicable city and co ty or ante and state laws ating to building construction.. 1 authorize representatives of this city or count eI}�dr I L ove4dewVyl erty for. inspection purposes. of PrODertv Owner or Au ACTION DATE BY /. DECLARATION OF II REGyLATIONS PA PAMPLIANCE WITH CODE OF RTOF ITLE 40 AND AQMD RULE AL I FOR OFFICE USE ONLY / I SUBMITTED ASBESTOS NOTIFICATION TO PERMITFINAL VIVO �WVT' "A ESTOSN TIF( 10 NOT AP TO CERTIFICATEOF i PROPOS E O �� I OCCUPANCYISSUED SIGNATURE: