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Home My WebLink AboutX2019-3382 - Permitsw City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIillllllllllllllllllll i COMB Permit: X2019-3382 100 Civic Center Drive, Newport Beach, CA. 92660 X 2 0 1 9 3 3 8 2 Project No :2338-2019. h rt Permit Counter Phone (949)644-3288 - ci •., Inspection Requests Phone (949)644-3255 Issued Date: .1 012312 01 9 +arnr kb Combination Type -SFP Inspection Area : 3 i PERMITS EXPIRE 980 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: 1129 PEMBROKE LN NB Description: SFR ATTACHED ALUMINUM PATIO COVER (13 X 25) Legal Desc.: N TR 3607 LOT 30 T OR Owner: SCOTT ANN MARY Contractor: TSG CONSTRUCTION INC Architect::. yw�� ' 1 tl PEC 1 Address: '15418 W BALTIC AVE Address. 1040 N GROVE ST#A Address: LAKEWOOD IIA 90228 -. ANAHEIM CA 92606 - Phone: ' Phone:: 562-500-2776 Phone: State Lie: Applicant ?SG CONSTRUCTION INC Con State Lie: 1040123 r - Engineer: PUTNAM CARL MATTHEW - Address: 1040 N GROVE ST #A ` Lie Expire: 06/30/2020 Address: 3441 IVYLINK PL - ANAHEIM CA 92806 Bus Lie : BT30069458 LYNCHBURG VA 91926 Phone: 562-500-2776. Lie Exp Date: 10/31/2020 - Phone: 434.384-2514 State Lic:C-068139 - Code Edit: 2016 Worker's Compensation Insurance Designer. t'Type of Construction: VIB Carrier: STATE FUND Address: Occupancy Group: R31U Policy No: 1943629 - Added /New sq.ft. Bldg: 0 Expire: 06/01/2020 Phone: Added /New sq.. ft. Garage: 0 No of Stories:. 1 Building Setbacks ,. Rear: / Special Conditions: .... No of Units : 1 Front P1,0 Bldg Heights 0 Left:. /:'.. Bldg Sprinklers: �( Right: Flood Zone: Use Zone: 1v Parkin S aces: 0 Fire Hazard Zone : N Construction Valuation: $5.000.00 GO Building Permit Feer $359.00 -Excise Tax: - $0.00 Planning Department - Fire Department 'Plan Check Fee: $261.00. Additional Feer.. $0.00 Plan check Fee : " $40.00 Fire Inspection:. - $000.' 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°a o°CO Energy Compliance: - $0.00 Grading PC Fee:. $0.00 Public Works Department - General Service $0.00 CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication ; $0.00 Refund Deposit - so b° Disabled Access: $0.00 PIN Plan Check:. $0.00 Grading Bond: .$0.00: Hazardous Mat $0.00 Electrical %: $0.00 San Dist: $0.00 .Building Green Fee : ,'$1.00 Mechanical %: $0.00 - NMUSDFee: $0.00 $0.00 - - ° Plumbing %: ......$0.00 $0.00,.. i TOTAL FEE: $661.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $661.00 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: GRACING APhROVAL:. 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 ie 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 of more than five hundred dollars ($500)... 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, lusiness 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). 1, 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: ly. my signature below7l 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, all 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 'rofessionsCode, 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 CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Secti rf 7000) f/n f Divi ion th Bu 'n s and Professions owe, and my i6 (Ise is in full force nd effect. License Class License No ate 1 C ntrac r Signature I/ORKERS' COMPENSATION DECLARATION ARMING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER T CRI INAL PENALTIES AND CIVIL FINES UP T ONE HUNDRED THOUSAND DOLLARS ( 100,000), IN ADDITION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: ] 1 have and.will rVintain 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 er ance Q1`111Wwark for which this permit is issued. Policy No. e and wiY 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 urance car?1gr 4W policy number are: 0arrier . Policy Number Expiration Date .• Name of Agent. .. Phone # hserti that,'iTl thL+peRormance of the work for which this arm, t is issued, I shall not employ any person in any manner so as to become subject to theworkers' compensation laws of California, and agre :Fjrit•if I sh b Seco €subject tot rkers' omp a ' provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisio s. 9igrfature of •p }� ate_�O DEQ6ARAT19 REGAR G ONST UCTIO E AGENCY •her&& rgJ gspenalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sects 097, Civil Code). ,Wpr's Nam • Lender's Address .Yjmy signatuca belpw, I certify to each of the following: I am the0proWy owner or authors ed to act on the property owner's behalf. I have read this application an a information I have provided is correct. I agree to comply with all ap Ici le city and county or in es and stat relating to building construction. 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