HomeMy WebLinkAboutX2019-3077 - PermitsOwner:
MATTHEWS JOHN & ENGRID
Address:
1712 GALAXY DR
NEWPORT BEACH, CA 92660
Phone:
Applicant:
FERGUSON JAY
Address:
20731 CHAUNCER LN
HUNTINGTON BEACH CA 92646
Phone:
949412-5518
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City of Newport Beach - Building Division "X2019-3077'
COMB Permit: X2019-3077
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100 Civic Center Drive. Newport Beach, CA 92660Permit
nter Phone 644-3288
Project No: 2143-2019
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_ Inspection Requests Phone (949)644-3255
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Combination Type - SFP ELEC
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Issued Date : 01/16/2020
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Inspection Area : 3
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 qr H9tisfatts
Job Address: 1718 GALAXY DR NB
Description: SFR ADD HALLWAY TO CONNECT 1712 & 1718 GALAXY DR 182 SF "AS -BUILT" s
Legal Desc.: N TR 4224 LOT 40�,.,.u=""""'��- if -able.
C USON JAY B Architect: �T PBE�HAMP DANIEL
_ didress: 3 CHAUCER LANE Address: 470V� LD ((''''''�� � f0 i- Ot-
`3 I , CA 92646 ❑IIj Q"28i$
�3 .Phone: 9-4125518- -; ne: 949-7273840 State Lic:C014593
Con State 46 �� E r. ineer: +A
' Expn. ` 07 021 M , --A`lr • 12 CHAPMAN #D , 4...
Lic B�►:83< �y-_ ' ` "'' ORANGE CA 92866 e,° • • °
L xp :°=s0, 1g& �' Phone: 714-997-9120 State LicC-043205
.. ce'Joao o°.•••
Code Edit : 2016 ompensation Insurance aDneType of Constmction: V-BSPR Carrier E modOccupancy Group: R3IU N0N `R a ° Q ° • °
Added /New sq.ft. Bldg: 182 x 1- � °
%one. £ • °
Added /New sq.ft. Garage: 0 -"
No of Stories: 1 uil acksa / (p
No of Units . 1 _ Special Conditions, ag a • ° ° °
Front: I ZO
Bldg Height: 0 Left: I Cp C s sc
Bldg Sprinklers: Y Right, I ° �.`•
Flood Zone: Us e: ,� Parkiag Snce5n re azarrl 7nna,NAt,
Building Permit Fee: $784.00
Plan Check Fee: $607.00
Overtime Plan Ck:
$0.00
Investigation Fee:
$784.00
Record Management:
$28.00
Energy Compliance:
$56.00
CA Seismic Safety:
$6.50
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$2.00
TOTALFEE:
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Exci
Ta
Department-
Addi
.
nal Fee :
{}rtireortstarled:Planning
+, • 0.00 Plan check Fee
Grad,
g Bonds Fee:
$0.00 Fair Share
Gradi
PC Consultant
: $0.00 rans
Gradin
�:
In -lieu Housing Fee
Gradin
P�a-
$0.00 P epartm
WQ In
.Fee:
p
AN Plan Check
MechanidsT%: $0.00
Plumbing %: $0.00
Plan Check Fee:
San Dist:
NMUSD Fee:
Fire
,
Fire Inspectiof�:q,
0 001
$0.00
tardation Fee
.00
apt Adm
$0.00
e
General Service
$0.00
$0.00
Refund Deposit
$0.00
$41.25
Grading Bond:
$0.00
$0.00
$0.00
$0.00
$0.00
$808.25 Fee Due at Permit Issuance : $1,715.38
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' S (elf 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 s (} ` . h, or repair any structure, prior to its issuance, also requires the applicant for
the permit to file a signed statement that he or she is licensed pursuant to the provisions oft r ' a i ense aw (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professions Code) or that he or she is exempt from licensure and the basis for the alleged a `n4 o III Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
not more than five hundred dollars ($500). _ - -
❑ I, as owner of the property, or m emp oyees with wages a tl air a�9 co rn tion, will do (_) all of or U portions of the work, and the structure is not intended or o� eredJor sale (Section 7044,
Business and Professions Code: Th Contractors' State Licens awoe�, 1'iot p to an owner of property who, throughigntglpys'roF�je,I�gRal effort, builds or Improv the property, provided that the
improvements are not intended or o erect E�Nff, however, b I In r " ar of comff�llleffrrBBhh'' I G er- udder, will have the burden f proving that it was not built or
improved for the purpose of sale). I�--I o n / I—� /
❑ I, as owner of the property, am clusivel contracting with ' sect C tract _ to str p e n 7044L9USIrresOsen®'rdlfeksOdtl�:r�Tl�ba rs' State License Law does not
apply to an owner of property who b Ids o e area o c ,>i cts ro s ce sect ontractgr pursuant to the Contractors' State License La ).
❑ I am exempt from licensure and the ntracto Stat 'tense L e r son: '
By my signature below 1 acknowledg that x a fo y pe _ w h s si t e' r ib c 4 ered.by this permit, I Cannot legally
sell a structure that I have built as a own has not n constructa In its entirety by licensed contractors. I understand that a copy of the applicable law, Sec on 7.044 of the Business and
Professions Code, is available upon quest when this application is submitted or at the following Web site:http://www.legi{rfo.ca.gov/calaw.html.
Signature of Property Owner or Auth rized w — D `
LICENSED CONTRACTOR'S D C TI
I hereby affirm ubeler WrIalty of perju the ce dun isi f C g act 70 ) ws' n 3 of the Busl ss and Profess s C e rid my li rise is in full force
and effect. License Class I.fi ontractor Ignature f
WQIR&RS' COlViPgNSATION C e�_
&ARNING FAILURE TO SECURE WORKERS' MPENSATON COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO JE HUOOREDUSAND 4 (!RS ($100,000), IN ADDITION TO THE
COST OF COMPENSAT40N, DAMAGES AS PR IDED R IN TION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 1 CC '.
Ghe�aby affirm urider pWalty of perju. one IIo ' declarations: r d"�y
....
h3ue and will.m.aintain a certifi to nt I i f r I or Is tion, issued Dir I - at a 1. I r Secb 3790 of the Labor Code, for the
oROance of thiyNark for which thi per ed. alit
•' FA 1 D (Q ')%gk stArteddi p u Y p
• fiev6. and wfll maiTtain workers' mpe sation insur7al f0 'ylCr�:j�i'§ouzytS� tion 3700 of the Labor Code, for �e ante o he woo
for which this, eYtmt IsLa ed. M workers' compensator
i 4ante carrier and policy number a `
C�fr�. • : • Policy Number Expiration Date Il
e (Agent •• •• Noe. hone# � I�
ro that, irb • peoformance work for w ' h t permit is issued, I shall not employ any person in any manner so as a atlon laws of California, and agre
if I should subject, he orkers' a Tor"TFiw comply wit those provisions.
gnature Applicant `. Da
DECLARATION REGARD ISRUCT D AGENCY
I hereby affirm under p ally pe ry tha e I construction lending agency for the performance of the work for which this permit is issued (Section 0 , Civil Code).
Lender's Name Lenders Address
By my signature below, I artily to each of a following:
I am the property owner or authorized to act on the property nets b If.
1 have read this application and the information I have p id is c act. `•J
I agree to comply with all applicable city and county dina as -state aws relating to building construction.
I authorize representatives o city or county t, b ve-ide Pied prope ar't If—spection purposes.
Signature of Property Owner or o d A Print Property Owner's or Authorized Agen ' m. ' D t
ACTION DATE BY E RATION F LIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY /
it ULATIO PART6IOFTITLE40ANDAQI RULE
PERMITEXPIRED / I U I SUBMITTED ASBESTOS
PERMITCANCELLED I DEPA
PERMIT EXTENDED I LIAQMD l
TO
CERTIFICATE OF
OCCUPANCYISSUED