HomeMy WebLinkAboutX2020-1132 - PermitsCity of Newport Beach - Building DivisionI�COMB
Per Civic Center Drive, Newport Beach, CA 92660 2 0 2 0 1
Permit Counter Phone (949)fi44-3288Inspection Requests Phone (949)644-3255
Combination Type - BLDG PLUM
a
1 3 2
Permit: X2020-1132
Project No: 0853-2020
Issued Date : 05/1212020
Inspection Area : 2
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: 2701 CIRCLE DR NB
Description: DEMO SFR & GARAGE 3250 SF 4 BEDROOMS. SEWER CAP INCLUDED
Legal Desc.: N TR 1102 LOT 27
Owner. LISENBEE GARY - Contractor:
PATTERSON CONSTRUCTION
Architect:5o�®
Address: 2581 CIRCLE DR Address:
15 CORPORATE PLAZA STE.150
Address:
-�9911
NEWPORT BEACH CA 92663
Phone:
NEWPORT BEACH CA 92660
Mate
Phone:
949-723-1800
Phone:.
Lie,
Applicant: ROOT TIM Con State Lie:
Address: 15 CORPORATE PLAZA STE 150 Lie Expire:
3
071
07/3112/2020
Engineer:
NEWPORT BEACH CA 92660 Bus Lie:
BT02110534
Address:
Phone: 949-723-1800 Lie Exp Date:
09/30/2020
Phone:
Lic.
Code Edit: 2019 Worker's Compensation Insurance
Designer:
Type of Construction: V-B Carrier:
STATE COMP
Address:
Occupancy Group: R3/U Policy No:
9066406
Added /New sq.ft. Bldg: 0 Expire:
09/01/2020
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 2 Building Setbacks
No of Units: 1
Rear: /
Special Conditions:
HIGH DENSITY
Bldg Height: 0
Bldg Sprinklers:
Front: /
Left: /
Right:
DEBRISO TO HAUL ��� -
B
/
Flood Zone: Use Zone: Parking Spaces: 0
Fire Hazard Zone :
N
Construction Valuation:_ $10,000.00
Building Permit Fee: $103.00 Excise Tax:
$0.00 Planning Department -
Fire Department
Plan Check Fee: $208.00 Additional Fee:
Overtime Plan Ck: $0.00 Grading Bonds Fee:
$0.00 Plan check Fee:
$0,00
$90.00
Fire Inspection: $0.00
Investigation Fee: $0.00 - Grading PC Consultant:
Fair Share :
$0.00 SJH Trans :
$0.00
Kill)
Fire Plan Rev $0.00
Record Management: $0.00 - Grading Permit Fee:
$0.00 In -lieu Housing Fee:
$0.00
Demolition Fee
Building Dept Adm $26.00
Energy Compliance: $0.00 Grading PC Fee:
CA Seismic Safety: $0.00
$0.00 Public Works Department -
General Service $210.00
WO Insp. Fee:
Disabled Access: $0.00
$0.00 Park Dedication :
$0.00
Refund Deposit $1,692.00
Hazardous Mat $0.00 Electrical %:
PIW Plan Check:
$0.00 San Dist:
$0.00
$0.00
Grading Bond: $0.00
Building Green Fee: $1.00 Mechanical %:
$0.00 NMUSD Fee:
$0.00
$0.00
Plumbing %:
$9.27
$0.00
TOTAL FEE: $2,339.27 o b b Plan Check Fee
b e
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL: e' o b b b o o b o
D oU o0 O
b� OJv U U bU OJ UvU
$0.00 Fee Due at Permit Issuance : $2,339.27
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
I
hereby amrm unclerpenany, of penury mat I am exempt from the Contractors' Stale Ucerrse law for the reasons) Indicated below by the checkmam(s) I have placed next to the apNicable Rem(s)
(Section 7031.6, Business and Prolessions Code: Any city or county that requlfes a permit to construct, alter, Improve, demotim, or repair any structure, prior to its Issuance, also requires me applicant Mr
the permit to me a signed statement that he a she Is licensed pursuam to Me provisions of me Contractors' Stale Ucanse Law (Chapter 9 (canmencingwlth Seclicn 7000) of Division 3 niche Business and
Pmressfons lode) of that he a she is exempt from ticensura and the basis for Me alleged exemption. Any violation of Section 7031.6 by Bug' applicant for a pemtlt subjects me appldard to a clv9 penalty of
not more man rive hundred dollars (5500).
111, as owner of the property, or my employees War wages as their sole compensation, will do U all of or Pomurrs of Due work, and the structure Is not Intended a offered for sale (Section 7044,
Business and Professlnn Code: The Contractors' State License Law does not apply to an owner of properly who, through employees' a personal effort, builds a impro✓es me properly, prwMad that the
imPruvemords are not Intended or offered for sale. If, haweveq me building almpmvament Is Bud within one yam of completion, the Owner-Buildw will have the burden of proving that a was not built of
i ved for the purpose Of sala).
L.1 I, as owner or the properly, am exclusively contracting wlm licensed Contractors to coretruG me project (Section 7044; Business and Professions Code: The Contraclors' State License law does not
apply to an avner of property who builds or improves thereon, and who contacts for the projects with a licensed Contractor pursuant la thB Contramors' State License W.
❑ 1 am exempt from ecansure under the Contractors' State Ucense 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 pnorW completion of the Impmvemems covered by this permit, I cannol legally
_ sell a structure that I have built as an owner under B R has not been contacted M Its entirely by licensed co liactorS. I understand Mal 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 Me following Wall slto:hepyAwvw.lagimo.ca.govimlaw.hlmL
Signature a Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby amrm under penalty, of penury that I am licensed under provisions of Chapter 9 (commencing with Section 70001of Division 3 of the Business and ProfessfOOF CoOe, license Is In full Inrra
and ,IT
tfcense Class Llcmrm No Cal, :S/I2/2e Contractor Signatur f-
_ ORKERS' COMPENSATION DECLARATION 7Ll
aouwr:•lien rmc rnxramcwaaxTns•CONPENRATx1N COVEMGEIS IINLAWNLANa SHALL MMEaANENPLGMTO CRIMM PEIVLTIMANO CNa r OPTOONEMMREDTN0U5MOMLAM(SIOG.MLNA00 7OTHE
I hereby am LNLRE By of perjury are a the following declarations:
I 110 stain a CorMICahe Of WMant to mil -Insure for workers' compensation, Issued by the Director of IndusMal Rotations as provided for by Section 37DO or true labor Code, for
IN
hero workrorwhichthispornilisissued Polky No.
have and will maintain workers' compensation irnsaariw, as required by Section 3700.of the Labor Code, for the performance of the wok for whfcll tills permit Is Issued. sly workers' compensalfo
insurance carder and policy numberam: '
Carder Policy Number Expiation Data
Name of Agent Phones
cerfffy Mat. In Me performanONSTRUCTION
which this permit Is Issued, I shelf not employ any person In any manner so as to become subject to Ure womers' compensation laws a California, and agre
that, It I should become sub tmpensatlon provisions of Section S700 of the Labor Code, I shall fonWlh comply with those prwisions.
StgreNre of Mpicani (j Dal
DECLARATION RE LENDING AGENCY
I hereby amrm underperlaffy o perjury that there Is a conshuctiorl lending agony for the performance of mework for which this permlt Is Issued (Section 309' Chtl Coded.
Lenders Name Lenders Address
By my signature below. ) certify to each of the followdg:
I am the property owner orEadhD fed to act on the properly owners behalf. -
1 haws read this application and fhe Information I have provided Is codecL
I agree to comply WIM all applicable city a' county ordinaniJON
olds to laws relasng to bullNrg construction.
I authorize represerdatNes of this dry or cow t ante e- property for lnspecllon purposes. �T � V S LZ
Signature of Property OwneraALlMorizedA III
Print Property Owner's orAmhodzedA enrs Na e I I�� DaX
ACTION DATE BY OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART61 OF TITLE 40 AND AOMD RULE
1403
PEirmiraPIRED I SUBMITTED ASBESTOS NOTIr101TI0N TO
PERMITC4110EI1EO EPA
PERMITFXTfNDfD 0MD
PERMIT FINAL ASBESTOS NOTIR TION IS NCABLE TO ,
CERTIFIfAT£OF -� '� PROPOSED DEMO ON • • • ... ... • •
OCCLPANcrissuEO SIGNATURE: • • • • • • • • .
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