HomeMy WebLinkAboutX2019-3829 - PermitsCity of Newport Beach - Building Division
o y 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
5 n . Inspection Requests Phone (949)644-3255
Combination Type - SFP ELEC PLUM
IIpIIIIIII�IIIIIII�lllllllllllllllllllllll� II COMB Permit: X2019-3829
Project No: 2306-2019
Issued Date: 12103/2019
Inspection Area : 8
PERMITS EXPIRE 180 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: 29 EGRET CT NB
Description: SFR - ADD'L SCOPE -BATH REM 45 SF WISKYLIGHT & CONVERT SPACE UNDER STAIRS TO STORAGE 18 SF (DELTA 2)
Legal Desc.: N TR 12530 LOT 31
Owner: 29 UNOEGRET
STEPHEN Contractor: DYE 1 CAMBJONATHAN
ID D Architect: ' �� ����
Address: 29 EGRET CT Address: 23411 CAMBRIDGE ROAD Address:
NEWPORT BEACH, CA 92660 YORBA LINDA CA 92686
Phone: Phone: 714-334-4775 Phone: State Lic:
Applicant: DYE JON
Con State Lic:
375529
Address: 23411 CANBRIDGE RD
Lic Expire:
05/3112021
YORBA LINDA CA 92887
Bus Lic:
BT30065083
Phone: 714-336-4775
Lic Exp Date:
11/3012020
Code Edit, - 2016
Worker's Compensation Insurance
Type of Construction: VB
Carrier:
WC EXEMPT
Occupancy Group: R31U
Policy No:
(NO EMPLOYEES)
Added /New sq.ft. Bldg: 0
Expire:
Added /New sq. ft. Garage: 0
No of Stories: 2
Building Setbacks
Rear: /
No of Units : 1
Front: /
Bldg Height: 0
Left: /
Bldg Sprinklers:
Right: /
Flood Zone:
Use Zone: Parkins Spaces: 0
Building Permit Fee: $472.00
Plan Check Fee: $410.64
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$10.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
- $1.00
: $1
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Engineer:
Address:
Phone:
State Lic:
Designer: DYE JON
Address: 23411 CANBRIDGE RD
YORBA LINDA CA 92887
Phone:
Special Conditions
Excise Tax:
$0.00
Planning Department -
Additional Fee :
$0.00
Plan check Fee,
Grading Bonds Fee:
$0.00
Fair Share:
Grading PC Consultant:
$0.00
SJH Trans:
Grading Permit Fee:
$0.00
In -lieu Housing Fee:
Grading PC Fee:
$0.00
Public Works Department -
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
PM Plan Check :
$0.00
Electrical %:
$33.04
San Dist:
$0.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
Plumbing %:
$42.48
Fire Department
$40.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
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0$9.90.
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tea••'
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee: $0.00 Fee Due at Permit Issuance : $1,009.16
PUBLIC WORKS APP VAL:
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 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).
I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
usiness 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
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).
1 am exempt from licensure under the Contractors' State License Law for the following reason:
y my signature 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 legalll
ell 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
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
'ignature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of,lyIrjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 00 f Div io 3 of the Business and Pro f�sp' s C de and y icense is in full force
nd effect. License Class) License No 3? `� 529 Date 7 3 / Contractor Signaturei�J
WORKERS' COMPENSATION DECLARATION
'ARNING: FAILUR5 IQ §F�CJIRE 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
DST OF COMPENSATION, "MAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
karsh4affirm urxler penalty of perjury one of the following declarations:
] I hPve and wilt 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 th
eriormence of thework for which this permit is issued. Policy No.
have and wIR irfalydain 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'
rapCe carrierVhdpolicy number are:
Vc ' • Policy Number Expiration Date
r Agent•' '" Phone#
that, in the p� rformance f 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 agree
If I.should kJecGrGasubject tot a woIke ompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Matu:e of App__ " Date ! o�
C'u'aRATIO14 DING CONSTRUCTION LENDING AGENCY
weby affirm under enalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil 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 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 ordirvnces a state laws relating to building construction.
I authorize representatives of this city or county ov - unty �to enter t e abi ntified property for inspection purposes. ,,,,
nature of Prooertv Owner or Authorized Aoent, - Print Prooertv Owner's or Authorized ADent's Nam` J6t4 N G Dates */'
ACTION I DECLARATION OF DATE BY REGULATIONS PART 61 OF IITLE 40 AND OMD RULECE WITH CODE OF
IFOR OFFICE USE ONLY
PERMIT EXPIRED
U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITC4NCELLED
OEPA
PERMIT EXTENDED
QMD
PERMITFINAL
ASBESTOS NO ICATIO NOTAPPLICABLE TO
CERTIFIC4TEOF
"'L
PROPOSED DEMOLI ION
�1 ��
OCCUPANCY ISSUED
SIGNATURE: