HomeMy WebLinkAboutX2021-1505 - Permits�,�w x� City of Newport Beach - Building Division *X2021-1505* COMB Permit: X2021-1505
L� 100 Civic Center Drive, Newport Beach, CA 92660 ZU �I I S r, PfOJBCt NO
OPermit Counter Phone (949)644-3288 V
Ou. tf Inspection Requests Phone (949)644-3255
2 Issued Date: 06/11/2021
Combination Type -BLDG GRAD INSPECTOR Inspection Area : 3
\� V -
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0611112024 OR PERMIT WILL BE INVALID
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 a"' '
Job Address: 20331 KLINE DR NB
e•ee
Description: SFR DRAINAGE - • "• • m m o o c
Legal Desc.:
Owner:
LEE HOWARD
Address:
4541 OCEANRIDGE DR
Phone:
HUNTINGTON BEACH, CA 92649
Phone:
951-316-6540
Applicant:
LEE HOWARD
Address:
4541 OCEANRIDGE DR
Lic Exp Date:
HUNTINGTON BEACH, CA 92649
Phone:
951-316-6540
Code Edit : 2019
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:
Contractor: OWNER/BLDR
Architect:
Address:
Address:
Phone:
Phone: State Lic:
Con State Lic: 0/B
Engineer:
Lic Expire:
Address:
Bus Lic:
General Service
Lic Exp Date:
Phone: State Lic:
Worker's Compensation Insurance
Carrier:
Policy No:
Expire:
Building Setbacks Rear: I
Front: /
Left: /
Right: /
Designer:
Address:
Phone:
Special Conditions: O/B FORM ATTACHED
Building Permit Fee:
$0.00
Excise Tax:
$0.00
Planning Department -
Fire Plan Rev
Plan Check Fee: $0.00
Demolition Fee
Additional Fee :
$0.00
Plan check Fee
General Service
Overtime Plan Ck:
$0.00
Grading Bonds Fee:
$0.00
Fair Share
Investigation Fee:
$0.00
Grading PC Consultant:
$0.00
SJH Trans
Record Management:
$2.00
Grading Permit Fee:
$232.00
In -lieu Housing Fee:
Energy Compliance:
$0.00
Grading PC Fee:
$195.00
Public Works Department -
CA Seismic Safety:
$0.00
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Disabled Access :
$0.00
P/W Plan Check:
$0.00
Hazardous Mat
$0.00
Electrical %:
$0.00
San Dist:
$0.00
Building Green Fee :
$0.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
Plumbing %:
$0.00
TOTAL FEE: $429.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
N
Plan Check Fee : $0.00 Fee Due at Permit Issuance
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
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$429.00
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Fire Department
$0.00
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:
APPROVAL TO ISSUE:
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$0.00
$0.00
$0.00
$429.00
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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 repair any structure, prior to its issuance, also requires the applicant for
is 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 pgnalty of
of more than five hundred dollars ($500). J
1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or `) 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
nprovemests aye Rot 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
nryved for Qit?'Ifurpose of sale).
as owoerofihe property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Usiness and Professions Code: The Contractors' State License Law does not
ly 6wndr'of property who builds or improves thereon, and who contracts for the projects with a licensed Contract u Lent to the Contractors' State License Law).
„Pam exempt from licensure under the Contractors' State ense Law for the following reason:
ly my sistrgnattjr� Pgow I acknowledge that, except for my per' nal residence in which I must have resided for at least one year prior to completion of the improvements covered by is ermit, I cannot legal
eliaucture that t have built as an owner -buil r if has n een !ted in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 0 e Business and
I"essions Code, is available upon request wh s applic Is submior at the following Web site:http://www.leginfo.ca.gov/ca[aw.html.
iigna�ture oPP4Q(fe1QI Owner or Authorized Age' Dat
.IOENSED CQNTRACTOR'S DECLARATI N
�hefaby affirm �undgpenalty of perjurythat 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
hd $ffect. 61censesClass License No Date Contractor Signature
.• .
(WORKERS' COMeENSATION DECLARATION
ARMING: FAILVR09VSECURE 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 TH:
OST OF COMPENSATIOIA, 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:
I 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 tl
erformance of the work for which this permit is issued. Policy No.
I have 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'
urance carrier and policy number are:
Policy Number
Date
me of Agent Phone #
I certify that,in the pe mance of the for which this permit is issued, I shall not employ any person in any manner so as to become subject to the wor ers compensation laws of California, and agre
I. if I should become Iect to the wo s' pensation provisions of Section 3700 of the Labor Code, shall forthwith comply with those provisions.
(nature of Applicant Da
CLARATION REGA DING CONST ION LENDING AGENCY
�reby 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, C A 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 ower's behalf.
I have read this application and the information I have provided i correct.
I agree to comply with all applicable city and county Inances d state laws relating to building construction. _
I authorize representatives of this city or county t,T(�ydo'tJeOI the a-identi arty for inspection purposes.
mature of Pro❑ertv Owner or Authorized Aoent NIS
Print Propertv Owner's or Authorized Agent's Name / \ Date ,
ACTION DATE BY DEC✓� REGUTATIO1COMPLIANSgART 610E TNT E40 AND AOMD RULECE WITH CODE OF RAL FOR OFFICE USE ONLY
PERMITEXPIRED (SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED EPA h
PERMIT FINAL q f7
CERTIFICATE OF
OCCUPANCY ISSUED
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