HomeMy WebLinkAboutX2021-0606 - Permitsn City of Newport Beach - Building Division
Lys + 100 Civic Center Drive, Newport Beach, CA 92660
H '= Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - BLDG
COMB Permit: X2021-0606
Project No: 1891-2020
Issued Date : 03/12/2021
Inspection Area: 3
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:
Construction Valuation:
Building Permit Fee: $110.00
Plan Check Fee: $95.70
Overtime Plan Ck:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0311212024 OR PERMIT WILL BE INVALID
Investigation Fee:
$0.00
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
o
Job Address:
1105 DEVON LN NB
Disabled Access:
$0.00
Hazardous Mat
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Description:
DELTA 1 - 6' BLOCK WALL X 9 LF (INSIDE PIL)
NMUSD Fee:
$0.00
Refund Deposit
• • °
1 1
Legal Desc.:
NTR 3000 LOT 16
$0.00
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Pie�Pa�
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Owner:
BRATZ TOM &CHERYL
Contractor:
AQUA SCAPES POOLS & SPAS
Architect:
•97gE
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Address:
1105 DEVON LN
Address:
321 CALLE FELICIDAD
Address:
es
NEWPORT BEACH CA 92660
SAN CLEMENTE CA 92672
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Phone:
949/230-3746
Phone:
949-448-7665
Phone:
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State Lie:
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Applicant:
ELLISON PAUL
Con State Lie:
754729
Engineer:
•• •
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oo•eon
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Address:
24642 VIA RAZA
Lie Expire:
11/3012022
Address:
• • e
LAKE FOREST CA 92630
Bus Lie:
BT30069893
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Phone:
949-683-9861
Lie Exp Date:
0613012021
Phone:
State Lie:
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:
Construction Valuation:
Building Permit Fee: $110.00
Plan Check Fee: $95.70
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: $252.95
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Worker's Compensation Insurance
Carrier: WC EXEMPT
Policy No: (NO EMPLOYEES)
Expire:
Building Setbacks
Excise Tax:
Additional Fee:
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WO Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: / 20
Front: / tp
Left: I lP
Right: I cP
'arkina Soaces:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee
0
Designer:
Address:
Phone:
Special Conditions:
Fire Hazard Zone : N
Planning Department -
Fire Department
Plan check Fee:
$46.25
Fair Share
$0.00
SJH Trans
Fire Plan Rev
In -lieu Housing Fee
$0.00
Public Works Department -
Park Dedication :
$0.00
P/W Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
$0.00 Fee Due at Permit Issuance : $252.95
PUBLIC WORKS APPROVAL: ��y�•
PLAN CHECK BY: • '
APPROVAL TO ISSUE:
Fire Department
$46.25
Fire Inspection:
$0.00
$0.00
Fire Plan Rev
$0.00
$0.00
Demolition Fee
$0.00
Building Dept Adm
$0.00
General Service
$0.00
Refund Deposit
$0.00
Grading Bond:
$0.00
$0.00
$0.00
$0.00 Fee Due at Permit Issuance : $252.95
PUBLIC WORKS APPROVAL: ��y�•
PLAN CHECK BY: • '
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 items)
lection 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 rhe aunt 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 Busiri
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
of more than five hundred dollars ($500).
I, as owner of ttfe lfroperty, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
',usiness and Profeesisns Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
oproltsrrdents arw not Intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
M1 roved'for theN;J%oiSE of sale).
,J' L
as owner of tqe property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
pply t0 an owner�of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
L arhexempfflldM firensure under the Contractors' State License Law for the following reason:
Py mf Signature belowacknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally
eM it -structure that Ihaye built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
Irafassions Code; is avAailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
ygrWgirg of Property Owner or Authorized Agent Date
5CEN$ED CQNTMCTOR'S DECLARATION
hereby affirm under penalty of perjury hat I am licensed under provisions of ClLgptgr 9 (��o encing with Section 0) of Division 3 of the Business d Profess! , a my liL's in full force
ed e�feot. License Class �• Z�� License No /.S yZp� Da 5 -�1�-7 Contrac 'nature
VORKERS' COMARSATION DECLARATION
'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDR HOUSAND 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 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 the
erformance of the work for which this permit is issued. Policy No.
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'
rance carrier and policy number are:
Policy Number
Date
e of Agent Phone #
ertify 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 laws of California, and
if I should beco subject e w rkers;�orApen 'dn provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /
iture OLADol' nt Date_
hereby aff'Hrfiul)der pei j)t of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sectio 3D97, Civil Code).
ender's Name,. v Lender's Address 11
y 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 r g to building construction. ^
I authorize representatives of this city oXounty to �ph5rj�e give-i*ltif% rty for inspection purposes.
of Property Owner
ACTION
PERMIT CANCELLED
PERMIT EMENDED
PERMIT FINAL
CERTIFICATE OF
f .
OCCUPANCY ISSUED
Print Property Owner's or Authorized A
j=fECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE
1403
DI SUBMITTED ASBESTOS NOTIFICATION TO
UASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION
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