HomeMy WebLinkAboutX2019-2977 - Permitsto City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
COMB Permit: X2019-2977
o 100 Civic Center Drive, Newport Beach, CA 92660
X 2 0 1 9 2 9 7 7
Project No
t- Permit Phone
- Inspection Requests Phonnter
spect e (949)644-3255
"±ax,�uw*' Combination Type.- GRAD ELEC PLUM
Issued Date: 09118/2019.
Inspection Area : 3
.PERMITS. EXPIRE 180DAYSAFTER ISSUANCE OR LAST VALIDINSPECTION.
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: 1129 PEMBROKE LN NB
Description: SFR DRAINAGE (CITY STANDARD). GAS LINE, HOSE BIBBS,
EXTERIOR ELECTRICAL
Legal Desc.: N TR 3607 LOT 30
-
Owner: SCOTT RICHARD WARREN. Contractor:.
SEA BREEZE LANDSCAPING Architect
'Address: 1129 PEMBROKE LN Address:
625 W KATELLA AVENUE #24 Address:
NEWPORT BEACH, CA 92660
ORANGE, CA 92867 .
-
Phone: Phone:
714.997-7700. Phone:
- State Lic:
Applicant: SEA BREEZE LANDSCAPING Con State Lica 424207 Engineer.
Address: 625 W KATELLA AVENUE#24 Lic Expire:.
05/31/2020 Address:
ORANGE, CA 92867 Bus Lic:
BT30056565
Phone: 714-997-7700 Lic Exp Date:
09/30/2020 _....Phone:
State Lic:
Code Edit: 2016 - Worker's Compensation Insurance Designer.
Type of Construction: V -B Carrier:
OAK RIVER INSURANCE : Address:
Occupancy Group: U Policy No:.
SEWC031706
Added /New sq.ft. Bldg: 0 Expire.
03/26/2020
Added /New sq. ft. Garage: 0
No of Stories: 0 Building Setbacks
No of Units : 1
Rear: /
P��J�OR al Conditions:
Front: /,�
_
_
Bldg Height:. 0
Left: /
Bldg Sprinklers: °oo°
..Right:
Use Zone:
Parking Spaces: 0 Fire Hazard Zone
:N
Co°n Fruc4ion Valuation: ° $2.000.00
Bu Idiao 2°ermit Fee: °$104.00. : Excise Tax:
$0.00 - Planning Department -
Fire Department
PI�k.n,C,beck Fee: $0.00 Additional Fee :
$312.00 Plan check Fee [ $0.00
Fire Inspection:
$0.00
Ov°edtjime Plan Ck. c, ° 0, $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.
Re64d'45magement :. , $0.00 Grading Permit Fee:
$0.00 In -lieu Housing Fee : $0.00
Building Dept Adm
$0.00
Enefgy L°ompliante, ° ` °' $0.00 Grading PC Fee:.
$0.00 Public Works Department -
General Service
$0.00 -
Of$ SOi9fSitc Safety: ° $0.00 WQ Insp. Fee:
$0.00 Park Dedication : $0.00
Refund Deposit
$0.00
Disabla IAccess `. ° $0.00
P/W Plan Check : $0.00
Grading Bond:
$0.00
Hazard®uo Mat < ` $0.00 Electrical %:
$0.00 San Dist: $0.00
° °
Buclraing &een Fee:' $1.00 Mechanical %:
$0.00. NMUSD. Fee: $0.00
$0.00
o°OAG+ Plumbing% :
$0.00
$0.00
TOTAL FEE: $417.00
Plan Check Fee: $0.00 Fee Due at
Permit Issuance ; $417.00
i
PROCESSED BY:
x e
9 P i P O
�o ° gesUB��C WtOvR1SAPO�ROVAL:
ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
APFEtOVk1_ 1`d rSSUE:
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 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).
❑ I, 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
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).
❑ 1 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 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.htmi.
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 7 00) of Divjsion 3 of the Business and Professions Code, land my license is in full force
and effect. License Class License No t 9 %\J t I Contractor Signature
WORKERS' COMPENSATION DECLARATION
WARNING: 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 ($700,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
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 IN
erf r ance of the work forwhich this permit is issued. Policy No.
ve 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' compensatio
insu nce carrier and policy number are:
rier Policy Number Expiration Date
Name of Agent Phone #
I certify that, in the performance 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 I4ws dfCEliforniJ,.*ai dW ire
that, if I should become subject to the w�orkeetri compensation provisions of Section 3700 of the Labor Code I shall forthwith comply with those provisions.. ` ; .....
Signature of ApplicantI�p ��`�°t • • '••'OO
DECLARATION REGA IN ONST CTION LENDING AGENCY /�" • • • ti o
I 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 30 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. • • • e
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 to enter the bove-identified property. for inspection purposes... : • . :. •.. o
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized. Agent's Na .... ate '
ACTION DATE By DECLARA OF COMPLIANCE WITH CODE OF FEDERAL. FOR OFFICE USE ONLY •'" °I �4
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED (SUBMITTED ASBEST�15 NprIFICATIpN •� ��.jkr—�/�S 1pf A �i /�r' i.00�I/f �
PA .PERMIT CANCELLED . ••.� '„' $�O9' 's'OV Ps' IjJS�NLL(<1. 7/6
PERMITEXTENDED
QMD
PERMITFINAL 0/ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATEOF PROPOSED DEMOLITION ••• . . .•.
OCCUPANCY ISSUED SIGNATURE: • : '•: : '
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