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Home My WebLink AboutX2019-2002 - Permits (2)relar�' City of Newport Beach - Building Division a,4 ' 100 Civic Center Drive, Newport Beach, CA 92660 r-: a Permit Counter Phone (949)644-3288 u Inspection Requests Phone (949)644-3255 Combination Type - BLDG ipiiiiiiii II COMB Permit: X2019-2002 Project No: Issued Date : 06/2512019 Inspection Area :,3' //01/- FEHMI FS 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: 515 TUSTIN AVE NS Description: BLOCK WALLS 6'H X 210 LF "INSIDE THE P/L" "CTY STD" Legal Desc.: FIRST ADD TO NEWPORT HEIGHTS BLK 36 LOT 21 Owner: ASHBY CONSTRUCTION Contractor: ASHBY RICHARD KENT Architect F"n 'k Address: 5642 RESEARCH DR #A Address: 5642 RESEARCH DR #A Address: HUNTINGTON BEACH CA 92649 HUNTINGTON BEACH CA 92649 Phone: Phone: (714) 895-5349 ��' �` r 4' Phone Applicant: ASHBY RICHARD KENT Address: 5642 RESEARCH DR #A HUNTINGTON BEACH CA 92649 Phone: (714) 895-5349 Lie Exp Date: Code Edit: 2016 Type of Construction: Occupancy Group: U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 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: $0.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building. Green Fee : $1.00 TOTAL FEE: $818.00 PROCESSED BY: ZONING APPROVAL: 0212812020 Phone: Worker's Compensation Insurance Carrier: WC EXEMPT Policy No: (NO EMPLOYEES) Expire: Building Setbacks Rear: I Front: I Left: I Right: / Engineer Address: State Lie: Designer: Address: Phone: Special Conditions: MARKERS ON SITE Use Zone: Parkinq Spaces: 0 Fire H; Excise Tax: State Lia Con State Lie: 237718 Lie Expire: 1013112020 Bus Lia BT30050028 0212812020 Phone: Worker's Compensation Insurance Carrier: WC EXEMPT Policy No: (NO EMPLOYEES) Expire: Building Setbacks Rear: I Front: I Left: I Right: / Engineer Address: State Lie: Designer: Address: Phone: Special Conditions: MARKERS ON SITE Use Zone: Parkinq Spaces: 0 Fire H; Excise Tax: $0.00 Planning Department - Fire Inspection: Additional Fee : $0.00 Plan check Fee: Demolition Fee Grading Bonds Fee: $0.00 Fair Share : -- General Service Grading PC Consultant: $0.00 SJH Trans Grading Bond: Grading Permit Fee: $0.00 In -lieu Housing Fee: Grading PC Fee: $0.00 Public Works Department - WQ Insp. Fee : $0.00. Park Dedication : $0.00 PAN Plan Check: $0.00 Electrical %: $0.00 San Dist: $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 Plumbing %: $0.00 Check Fee : $0.00 Fee Due at Permit Issuance PUBLIC WORKS APPROVAL: PLAN CHECK BY: gimme • e ooe• eemo e ¢o m m9 m m e e •m emm o m mm• m fl b coommm e $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0 0 meeemo o e 00000 m b0em0 oee¢0c m o 0 c 0 oor oac 0 0 ea•a $0.00 II $0.00 $818.00 Fire Department $40.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: Check Fee : $0.00 Fee Due at Permit Issuance PUBLIC WORKS APPROVAL: PLAN CHECK BY: gimme • e ooe• eemo e ¢o m m9 m m e e •m emm o m mm• m fl b coommm e $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0 0 meeemo o e 00000 m b0em0 oee¢0c m o 0 c 0 oor oac 0 0 ea•a $0.00 II $0.00 $818.00 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License taw 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 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 permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). 11 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) 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 within one year of completion, the Owner -Builder will have the burden of proving that it was not built or improved 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 ncs. ap ly 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). II 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 I must have resided for at least. one year prior to completion of the improvements covered by this permit, I cannot legal) sell a structure than 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:hftp://www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7990) of Division 3 of the mess and Pro ssio Code,/�n nd�y license is in full force and effect. License Class. License No D j�.2S -Ih Cont for Signatu i=/1 `7W WORKERS' COIIQe�ATION DECLARATION AAf�tt@@1N IPILURE TO gggRE 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 DOFiTB UMPENSA71001, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. e Eby affirm un8er penalty of perjury one of the following declarations: Wand will,maipltain 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 Brice of the work for which this permit is issued. Policy No. d'and will,rp7intain 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' compensatiotSparrierind'goJitynumberare: o Policy Number Expiration Date _ Phone # rti ghat, in the ce of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the work rs' compensation laws of California, and agre thai, i{I s u tc the worker om nsation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. .... Signature of Ap�-DE__ RGAIRDfNG 1ATID ONSTRUCTION LENDING AGENCY I hereby affirm under penally of perjury that there is a construction lending agency for the performance of the work for which this permit is Issued (Section 30 7, 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 hparprovided is correct. -- Iagree to comply with all applica I co ty inances and state laws relating to building construction. I authorize representatives oft Is Ity or cou o e ter the ve [ntif. d arty for inspection purposes. Name ✓ (� l,J —12 Signature of Pro ertOwner orA0 orized A t G Print Property Owner's or Auth Ize ent's ACTION DA Y DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE DKFOOY REGULATIONS PART fit OF TITLE 40 AND AQMD RULE 1403 PERM)TEXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO - PERMIT CANCELLED UEPA PERMIT EXTENDED QMD PER MITFINAL ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF e PROPOSED DEMOLITION OCCUPANCYISSUED Z(% l SIGNATURE: V Y - 67 le?