HomeMy WebLinkAboutX2019-1018 - PermitsCity of Newport Beach - Building Division��IIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIII
COMB Permit: X2019-1018
100 Civic Center Drive, Newport Beach, CA 92660
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X 2 0 1 9 1 0 1 8
Project NO.; 0613-2019
F Permit Counter, Phone (949)644-3288
9
'�"= Inspection Requests Phone (949)644-3255
"4,, u'g Combination Type- BLDG ELEC
Issued Date : 04/01/2019
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 288 SF (OPEN LATTICE)
Legal Desc.: N TR 1896 LOT 55
Owner. BRIGGS BRYAN Contractor:.
ROMAN CONSTRUCTION
Architect:
Address: 1358 SUSSEX LN Address:
P O BOX 1146
Address:
e,
NEWPORT BEACH, CA 92660
WALNUT, CA 91788
Phone: Phone:
909-229-2099
Phone:
- State Lie:
Applicant: GOLVANEPHRAIM Con State Lica. 971274
Engineer: DAVIS GLEN •°•BO•
Address: PO BOX 9089 Lie Expire:
10/31/2019
Address: 27336 VISTA AZUL o o e •
• °
LAGUNA BEACH CA 92651 Bus Lie:
BT30066707
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- CAPISTRANO BEACH CA 92624
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Phone: 949-412-7281 Lie Exp Date:
`. 04/30/2020
Phone:'. 949-493-2341 State Lic:C-050803 • • O •
m o
Code Edit 2016 Worker's Compensation Insurance
- Designer.
.Type of Construction V-B Carrier..
- EVEREST
Address:
emoo
° o
o °
• e
Occupancy Group: U Policy No:
7600019437181
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Added /New sq.ft. Bldg:. 0 Expire:
09/16/2019
Phone:
Added /New sq. ft. Garage: 0.
- °
•comp•
No of Stories: 0 Building Setbacks
Rear: 10
Special Conditions:
°.
Oee•„°.
No of Units : 1
Front: 20
° °
• ° °
Bldg Height: 0..
Left. 4
0
Bldg Sprinklers:
Right:. 4
ov°oo
Flood Zone: Use Zone:
Parking 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: $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: $0.50 WQ Insp. Fee :.
$0.00
Park Dedication: $0.00
Refund Deposit $0.00.
Disabled Access [ $0.00 :
-
PM 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 Feer $0.00
- $0.00
.Plumbing %:
$0.00
-
$0.00
TOTAL FEE: $385.63
Plan Check Fee:
$0.00 Fee Due at Permit Issuance : $385.63
PROCESSED BY: - tt)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
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 U all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
3usiness 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
mprovements 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
m 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
Ipply 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 am exempt from licensure under the Contractors' State License Law for the following reason:
3y 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 legall)
yell 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
'rofessions Cade, 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
_ICENSED CON711 VICTOR'S DECLARATION $
hereby affirm uAderpenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 00 o i ' ion 3 of the Business and/DRED
essio Code d my tic II force
IAA@ffect. Lioees,Class License No Date t Contractor Sign4& %-_—
YORJ(ERS' COMPENSATION DECLARATION
iAAylyG: FAILURE TU SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI AL PENALTIES AND CIVIL FINES UP TO ONE HU THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
:OST OF COMPENSkIlptti, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
tarety affirm LpQ,r d2nalty of perjury one of the following declarations:
;L••
�bave 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
rforrnance oitiiVV:c:rk for which this permit is issued. Policy No.
• • e 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
1Sural=ce carrier and policy number are:
••.•••
;ary'Par, • Policy Number Expiration Date
)WV% Af Agenj • 0 0 Phone #
:1I certify that, in the pe orman of the rk for which this permit is issued, I shall not employ any person in any manner so as to become subject to the worktavil
mpensation laws of California, and agre
tat, if I should become ubjec o the ers' co sat' rovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
tignature of Applicant Da2•p/
)ECLARATION REG DING CONSTRUCTION LENDING AGENCY
hereby affirm under enalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097,ode).
.ender's Name Lender's Address
fy 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 county 0 man s and ate laws relating o building construction.
I authorize representatives of this city or county toe er man
entifie - e or inspection purposes. ttII
ti nature of Property Owner or Authorized Agent P t Prop rty Owner's or Authorized Agent's Na e?#e_dAj6Q
4CTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REOLATIONS PART 61 OF TITLE 40 AND AQMD RULE
SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT EMENDED I I-
PERMITFINAL Q /r/ q //.f 7-
CERTIFICATEOF
OCCUPANCY ISSUED