HomeMy WebLinkAboutX2019-0544 - Permits1r1. City of Newport Beech -_BbNdii-,g Division
III�III�IIIIIIIInIIIUIII�IIIIIIIIIIIIIIIII�
COMB Permit: X2019-0544
100 Civic Center Dri4'1'le4oh Bea eh,2JA„9 � 60 o =
x 2
0
1
9
0
5
4
4
Project
Permit Counter Phone (949)644-3288 • • ®• o e
No: 2187-2018
•
ey .Inspection Requests Phone (949)644-3255
ra uy y>'a' Combination TYP `gkDG L-PUM.
Issued bate: 0212012019
•• a - ®® • a ® o
Inspection Area : 2
'" • PER,*TS E7(P/RE
180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
Construction Hours: Monday - Friday 7;dQPa.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: 333 HOLMWOOD DR NB
Description: DEMO SFR& GARAGE 1870 SF LIVABLE, 3 BEDROOMS. SEWER CAP INCLUDED
Legal Desc.i N TR 1136 LOT 15
Owner. ATKINS JEFFERY SContractor:
CLAYTON BUILDERS INC Architect:
Address: 333 HOLMWOOD DR Address:
- 735FARAD STREET Address:
NEWPORT BEACH, CA92663
COSTA MESA, CA 92627
Phone: - Phone.
.949-279.5910 Phone: State Lie:
Applicant GUIDERO BILL Con State Lie:`
846631 - Engineer: GABRIEL MICHAEL R
Address: 426 30TH ST STE 23 Lie Expire:
09/30/2020 Address: 483 E 20TH STREET
NEWPORT BEACH CA 92663 Bus Lie:
-: BT30043010 COSTA MESA CA 92627
Phone::. 949-675-2626 ` Lie Exp Date:
04/30/2019 Phone:. 949-646-6596 '. State LiaS-002939
Code Edit, 2016 Workers Compensation Insurance Designer.
Type of. Construction: V-B Carrier:
NO EMPLOYEES Address:
Occupancy Group: R3/U Policy No:
Added /New sq.ft, Bldg: 0 Expire:
- Phone:
Added /New sq. ft. Garage: 0'
No of Stories: 1 Building Setbacks
Rear: / Special Conditions: JD DEMO 70 HAUL
No of Units : 1
Front / DEBRIS'
Bldg Height: 0
Left:l
Bldg Sprinklers:
Right /
Flood Zone: Use Zone: Parking Spaces: 0 - Fire Hazard Zone : N ;
Construction Valuation: $7,500.00
y ,
Building Permit Fee: $103.00 Excise Tax:
$0.00 Planning Department - Fire Department
Plan Check Fee:.: $0.00 rAdditional Fee :
- $0.00. Plan check Fee :. $0.00 Fire Inspection: $0.00
Overtime Plan Ck $0.00 Grading Bonds Fee:
$0.00 Fair Sham: $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 $26.00
Energy Compliance: $0.00 Grading PC Fee:
$0.00 Public Works Department - General Service $210.00 -
CA Seismic Safety: _ $0.00 WQ Insp. Fee:
$0.00 Park Dedication : $0.00 Refund Deposit-$1,127.00
Disabled Access : $0.00
P/W 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 %:...
$9.27 $0.00
TOTAL FEE : $1,476.27 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $1,476.27
PROCESSED BY:
- PUBLIC WORKS APPROVAL:
ZONING APPROVAL:
.PLAN CHECK BY:
:GRADING APPROVAL:
APPROVAL TO ISSUE:
e®•
OWNER -BUILDER DECLARATION • : •• . • . ' o
I hereby affirm under penalty of perjury that I am exempt from the Contractors'. State License Law for the reason(s) indicated b elo; by A L'heckmark(s) shave placed next to the applicable items)
(Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, orvapaVany 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 of the Contractors' State License Law (Chapter 9 (commencing with Section MO) of Division 3 of the Business and
Professions 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 apphBent fjR a permit gut;" the applicant to a civil penalty of
not more than five hundred dollars ($500). o �• o . ,� • o •o •.•'
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or (, portions of the wori+ti1ld the structilreds pp%ntend'Lt41•or offered for sale (Section 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employee' or,91monal Ofort, builds or improves the. property, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the 6wner-Builder will have the burden of proving that it was notbuilt or
improved 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
apply 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:
Bymy 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 legalq
sell a structure that I. have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. II understand that 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 the following Web site:http://Ww .lepinfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent D
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 00�) of vision the Business and Profess' s i ens s q iul4fierse
and effect. License Class License No Date Z 2D Contractor Signatu -
WORKERS' COMPENSATION DECLARATION
WARNING: 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
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. -
I hereby affirm under penalty of perjury one of the following declarations:
111 have and will maintain a certificate of consent to self -insure for workers'. compensation,: issued by the Directo[ of Industrial Relations as provided for by Section 3700 of the Labor Code, for th
performance of the work for which this permit is issued. Policy No.
II 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' compensatio
insurance carrier and policy number are:
rrier _ Policy Number Expiration Date
of Agent
t ify that, in the performance t work for which t�hh"II,s, permit is issued, I shall not employ any person in any
h should become subjectito rker�:rcm spat' n provis,46%gf, Section 3700 of the Labor Code, I shall
InatureofApplican tW�""'
ICLARATION REG RD CONSTRUCTION LENDING A CY
areby affirm under penalty ofperjury that there is a construction lending agency for the performance of the work for
rider'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 owners behalf.
I have read this application and the information I have provided is correct.
I agree to comply with all applicable city and county ord' ces and s t aws relating to building construction.
I authorize representatives of this city or co n�I ly a to r a = e if d p cinspection purposes.
mature of Prooertv Owner or Authorized Agenty"print Property Owner's
ACTION
PERMITEXPIRED
PERMIT CANCELLED
PERMITFINAL
CERTIFICATE OF
OCCUPANCYISSUED
BY— /�BECLARATION OF COMPLIVCE WITH CODE OF FEDERAL I FOR
/ REGULAgIONS PART 61 OF TITLE 40 AND AQMD RULE
PROPOSED
OTIFICATION TO
IS NOT APP E TO
Phone #
soas to become subject to the workers' compensation laws of California, and agre
i comply with those provisions.
oat -Z zC)h
I this permit is issued (Section 3097, Civil Code).
ONLY