HomeMy WebLinkAboutX2019-1879 - PermitsCity of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
1 Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
ctv a,a ; Combination Type - SFP
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII� II COMB Permit: X2019-1879
Project No: 1357-2019
Issued Date : 06/13/2019
Inspection Area : 8
Address: 715 CAMPHOR ST
Lie Expire:
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
NEWPORT BEACH, CA 92660
Bus Lie:
$10.00
Phone: 847-722-7709
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 olidays
Code Edit : 2016
Worker's Compensation
Job Address:
715 CAMPHOR ST NB
Carrier:
Building Green Fee :
Occupancy Group: U
Policy No:
Description:
Legal Desc.:
SFR -ATTACHED. OPEN LATTICE PATIO COVER 325 SF
N TR 4892 LOT 36
41fy' r'ry'A
Grading PC Fee:
Added /New sq. ft. Garage: 0
Owner:
GRAVES JAMES A & CAROL A
Contractor: OWNER/BLDR Architect
a
Rear: I (G
No of Units : 0
Address:
715 CAMPHOR ST
Address: GRAVES CAROL Address:
s
Left: 1 (11
San Dist:
NEWPORT BEACH, CA 92660
OIB AUTH ATTACHED
$0.00
NMUSD Fee:
_
Phone:.
$0.00
Phone: Phone: State
Lie:
Applicant:
GRAVES JAMES A & CAROL A
Con State Lie: Die Engineer: HOUSHMAND MOHSEN
Address: 715 CAMPHOR ST
Lie Expire:
Investigation Fee:
NEWPORT BEACH, CA 92660
Bus Lie:
$10.00
Phone: 847-722-7709
Lie Exp Date:
CA Seismic Safety:
Code Edit : 2016
Worker's Compensation
Insurance
Type of Construction:
Carrier:
Building Green Fee :
Occupancy Group: U
Policy No:
$0.00
Added /New sq.ft. Bldg: 0
Expire:
Grading PC Fee:
Added /New sq. ft. Garage: 0
Public Works Department -
WQ Insp. Fee:
No of Stories: 0
Building Setbacks
Rear: I (G
No of Units : 0
Front: 1 /0
Bldg Height: 0
Electrical %:
Left: 1 (11
Bldg Sprinklers: Right: 1 0
Construction Valuation:
Building Permit Fee: $104.00
Plan Check Fee: $90.48
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$10.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access:
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $245.48
PROCESSED BY:
ZONING APPROVAL:
Address:
Phone:
Designer:
Address:
Phone:
4400 CAMPUS DR #A
NEWPORT BEACH CA 92660 + e
949.752-1612 State Lic:C-042283 Oe1e
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Special Conditions:
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
P/W Plan Check:
$0.00
Electrical %:
$0.00
San Dist:
$0.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
Plumbing %m:
$0.00
Plan Check Fee : $0.00 Fee Due at Permit Issuance
PUBLIC WORKS APPROVAL: _
PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
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$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$245.48
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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:
Plan Check Fee : $0.00 Fee Due at Permit Issuance
PUBLIC WORKS APPROVAL: _
PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
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00 00
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$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$245.48
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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 repO.4 any structure, prior to its issuance, also requires the appKant fort
1e 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
0fessions 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
o more than five hundred dollars ($500).
5iI, as owner of the property, or my employees with wages as their sole compensation, will do U all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
ness 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
nprovements 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
n 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
pply 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:
y 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
ell a structure that 1 have built as an owner -builder if it has t been cc EIru d in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
'rofessions Code, is available upon request when this g{fpr at)pn js,�u(Synitt d r at�he/toll it site:http://ww .leginfo.ca.gov/calaw.html. Date /� ,�
ignature of Property Owner or Authorized Agent UJ./t j/f`.i' �(,Vt 3 ao
tq
.ICENSED CONTRACTOR'S DECLARATION— ��
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
nd effect. Lice nse•CVSS License No Date Contractor Signature
✓ORKPRS' Ct%MVENSATION DECLARATION
RRNM? FAILURE 11L�,99CORE 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
OST OF COMPENSATIONPDAMAGES AS PROVIDED FOR IN SECTION STOS OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. -
hl%elay+affirm under penalty of perjury one of the following declarations:
I have and mll,rptilotain 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 IN
arformance of the work for which this permit is issued. Policy No.
rate and w;l waihtain 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
11
00
surance carriePand'i7olicy number are:
Policy Number
Date
in the pejformance 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 workers' compensation laws of California, and
become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant Date_
CLARATION REGARDING CONSTRUCTION LENDING AGENCY
areby 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, Civil Code).
Ider's Name Lender's Address
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 ordinances and state laws relating to building construction.
I authorize representatives of this city or county ft yannte�g aJ)ove- entified prop y or i action purposes.
nature of Prooertv Owner or Authorized ADent t �%,Y (�il� Print Prooertv Owner's or Authorized ADent's Name
ACTION DATE BY/ DECLARATION OF IREGULAT ONS PA T061 OF WIT E 40 AND AQMD RULE CE WITH CODE OF AL FOR OFFICE USE ONLY
PERMIT EXPIRED
U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED
OEPA
PERMIT EXTENDED
0AQMD
PERMITFINALeyd
CERTIFICATEOF
OCCUPANCYISSUED
>hslY
i 1
ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION
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