HomeMy WebLinkAboutX2022-1831 - Permits9' City of Newport Beach - Building Division II�IIIIII'IIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2022-1831
100 Civic Center Drive, Newport Beach, CA 92660 X 2 9 2 2 1 8 3 1 Project No : 2996-2021
Permit Counter Phone (949)644-3288
s1.. ,- .@ Inspection Requests Phone (949)644-3255
`' zrr�c�''' Combination Type - BLDG Issued Date : 07/05/2022
- - Inspection Area : 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 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
Job Address: 1227 BERKSHIRE LN NB
Description: DEMO POOL USING CITY STANDARD-$
Legal Desc.: N TR 3031 LOT 19
Owner:
RUCKER LLOYD
Contractor: OWNER/BLDR
Architect:
Address:
260 NEWPORT CENTER DR
Address:
Address:
NEWPORT BEACH, CA 92660
Phone:
Phone:
Phone: State Lie:
Applicant:
RUCKER LLOYD
Con State Lie: O/B
Engineer:
Address:
260 NEWPORT CENTER OR
Lie Expire:
Address:
NEWPORT BEACH, CA 92660
Bus Lie:
Phone:
949-463-4509
Lie Exp Date:
Phone: State Lie:
Code Edit :
2019
Worker's Compensation Insurance
Designer:
Type of Construction:
Carrier:
Address:
Occupancy Group:
U
Policy No:
Added /New sq.ft. Bldg:
0
Expire:
Phone:
Added /New sq. ft. Garage:
0
No of Stories:
0
Building Setbacks
Rear: /
Special Conditions:
No of Units :
0
Front: /
Bldg Height:
0
Left: /
Bldg Sprinklers:
Right: /
OR
Flood Zone:
Use Zone:
Parking Spaces:
0
Fire Hazard Zone : N
Construction Valuation:
$5,000.00
Building Permit Fee:
$161.00
Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee: $140.07
Additional Fee :
$0.00
Plan check Fee :
$0.00
Fire Inspection:
$0.00
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
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
$0.00
Disabled Access :
$0.00
PAN 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
NMUSD Fee:
$0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE : $302.07
Plan Check Fee
: $0.00
Fee Due at Permit
Issuance :
$302.07
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
PglBLIC,WORKS APPI10YA♦': °° a
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PLAN CHECK BY:
APPojc"(9VbL �Oc���tJ Fa�o o°. ea°
0 0 0 0 0 0 0 0
OWNER -BUILDER
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 penalty of
of more than five hundred dollars ($500).
7 I, 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
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
nproved 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
pp 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 a exempt from Iicensure under the Contractors' State License Law for the following reason:
Iy my ignature 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 legall;
ell a ructure that I have built as an owner -builder if it has not been constr ed in entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
sions Code, is available upon request when t is p s or he following Web site:http://www.leginfo.ca.gov/calaw.html. — 7 .Z
ignature of Property Owner or Authorized Agent ate
.ICENS 2 CONTRACTOR'S DECLARATIO
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, nd my license is in full force
nd effect. License Class License No Date Contractor Signature
COMPENSATION DECLARATION
FARNING: 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 ($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:
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 thi
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
of Agent
Date
JI C rtify that, in the performance of the work for which this permi 's issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
hat, if I should become sub'e ork s' c pensation pro Isions of Section 3700 of the Labor Code, shall forthwith comply with those provisions.
Sign ure of Applicant Da e ZZ
DECLARATION REGAR G CON UCTIO LENDING ENCY
hereby affirm under penalty of perjury that there is a constr ction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
-ender's Name Lender's Address
3y 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 coun to. nter th entified oparty for inspection purposes.
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Nam
ACTION DATE BY DECL<RATION &COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERMITEXPIRED LLzI'19JBMITTED ASBESTOS NOTIFICATION TO
•ti �• • • • s
PERMIT CANCELLED _• EpQ,
PERMITFINAL g ` n U ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO
CERTIFICATE OF /'f Y' 4�' PR405EQI5JMfl1IjlOr1• ••• ••
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