HomeMy WebLinkAboutX2019-3717 - Permits11ea'o� City of Newport Beach - Building Division
..o , 100 Civic Cent6,'Jrive, Newport Beach, CA 92660
C Permit Counter Phone (949)B44-3288
v Inspection Requests Phone 1949)644-3255
"'xar„u •` Combination Type - GRAID
911 COMB Permit: X2019-3717
x 2 0 1 9 3 7 1 7 Project No:
Issued Date :1112012019
Inspection Area : 3
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
Construction (lours: 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: 1915 HOLIDAY RD NBDescription: SFR rig
Legal Desc.: N TR 3765 LOT 59GE (CITY STd PLAN) 119-3136'STOP WORK AS BUILT PERMIT
Owner:
KINSTLER LYNDSAY
Address:
1915 HOLIDAY RD
NEWPORT BEACH, CA 92660
Phone:
562505-5504
Applicant:
KINSTLER LYNDSAY
Address:
Phone
Code Edit: 2016
Type of Construction: VB
Occupancy Group: U
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 0
No of Units : 0
Bldg Height: 0
Bldg Sprinklers:
Flood Zone: X
Contractor
Address:
Phone
Con State Lic:
Lic Expire:
Bus Lic:
Lic Exp Date:
OWNER/BLDR
KINSTLER LYNDSAY
O/B
Worker's Compensation Insurance
Carrier:
Policy No:
Expire:
Building Setbacks Rear: /
Front: I
Left: /
Right: /
ArchitPOSE ALL STRUCTURAL,
AftTCTRICAL, PLUMBING, AM
P o Sate Lie:
CHANICAL COMP ONEM
Engineer.
Address:?
Phone: State Lic: �tt
Designer: KINSTLER LYNDSAY
Address: 1915 HOLIDAY RD
NEWPORT BEACH CA 92660
Phone: 562-506-5504
Special Conditions:
Building Permit Fee:
$0.00
Excise Tax:
$0.00
Planning Department -
Plan Check Fee: $0.00
Additional Fee :
$0.00
Plan check Fee:
Overtime Plan Ck:
$0.00
Grading Bonds Fee:
$0.00
Fair Share :
Investigation Fee:
$0.00
Grading PC Consultant :
$0.00
SJH Trans:
Record Management:
$2.00
Grading Permit Fee:
$624.00 -
In -lieu Housing Fee:
Energy Compliance:
$0.00
Grading PC Fee:
$312.00
Public Works Department -
CA Seismic Safety:
$0.00 -
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Disabled Access :
$0.00
PAN Plan Check,
$38.00
Hazardous Mat
$0.00
Electrical %:
$0.00
San Dist:
$0.00
Building Green Fee :
$0.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
Plumbing %:
$0.00
TOTAL FEE: $976.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Fire Department
$0.00
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
Plan Check Fee : $0.00 Fee Due at Permit Issuance : $976.00
Q - PIJJI&ORAS APPROVAL:
� J d
� t O
PLAN CHECK BY:
APPROVAL704S&WE:
C`� Vtl 'JJ J
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)
Iction 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
ermit 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
�fe ions 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
mole than five hundred dollars ($500).
I, I owner of the property, or my employees with wages as their sole compensation, will d all of 0 portions
si ss and Professions Code: The Contractors' State License Law does not apply to an owner properto, throuc
)rovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of co
)roved for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 70,
)ly to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contrac
I am exempt from licensure under the Contractors: State License Law for the following reason:
my signature below I acknowledge that, except for my personal residence in which I must have resided for at least or
a structure that I have built as an owner builder if it has not been co r di 'ts entirety by licensed contractors. I
ifessions Code, is available upon request whe h' pplication is ub a he followin W site:http://www.le
nature of Property Owner or Authorized Agent
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9
nd effect. License Class License No
COMPENSATION DECLARATION
Section
Date
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
DST 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 Dire
erformance of the work for which this permit is issued. Policy No.
]I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for
Isurance carrier and policy number are:
:arrier Policy Number
lame of Agent
in the performance for which this permit is issued, I shall not employ any person in any
become subjec h ofkerg' �mc, p,Ensation pJoyisions of Section 3700 of the Labor Code, I shall
of
Ireby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for w
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 count or n state laws re p n to building construction.
I authorize representatives of this city or co nt o - inspection purposes.
.nah lra of Prnnerty Owner or Authorized ADe Print ProDertv Owners or
DATE
PERMIT EXPIRED
PERMITFINAL CERTIFICATE OF �
OCCUPANCY ISSUED
OF COMPLIANCE WITH CODE OF FEDERAL I FOR OR
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
aIuyvu un - I ry Iv
LJ ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO
PROPOSED DEMOUTk7N ••• • • • eee
SIGNATURE: e°
the work, and the structure is not intended or offered for sale (Section 7044,
employees' or personal effort, builds or improves the property, provided that the
1letion, the Owner -Builder will have the burden of proving that it was not built or
Business and Professions Code: The Contractors' State License Law does not
pursuant to the Contractors' State License Law).
year prior to completion of the improvements covered by this permit, I cannot legall,
Inderstand that a copy of the applicable law, Section 7044 of the Business and
nfo.ca.gov/calaw.html.
e p>
of Division 3 of the Business and Professions Code, and my license is in full force
Contractor Signature
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO
Industrial Relations as provided for by Section 3700 of the Labor Code, for
of the work for which this permit is issued. My workers'
Date
so as to become subject to the workers' compens tion laws of California, and agrel
1 comply with those provisions.
i this permit is issued (Section 3097, Civil Code).
USE ONLY
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