HomeMy WebLinkAboutX2020-2831 - PermitsCity of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination 'i ype - BLDG
*X2020--2831* COMB Permit: X2020-2831
Project No: 0782-2020
Issued Date : 1210412020
Inspection Area : 6
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, PROJECTS MUST BE COMPLETED BY 1210512023 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: 41 MONACO NB
Description: BLOCK WALL 11 LF X 5' H SURROUNDING MECHANICAL EQUIPMENT
Legal Desc.: TR 9858 LOT 3 UNIT 24 OF PROJECT LOCATED ON AP 461-131-39 TOGETHER 7 N I
Owner:
LILLY JOSIAH
Contractor:
G D M LANDSCAPE
Address:
2431 WINDWARD LN
Address:
31878 DEL OBISPO, STE 118 #435
NEWPORT BEACH, CA 92660
SAN JUAN CAP CA 92675
Phone:
714-376-3742
Phone:
949433-0057
Applicant:
G D M LANDSCAPE
Con State Lic:
881282
Address:
31878 DEL OBISPO, STE 118 #435
Lic Expire:
09/30/2021
SAN JUAN CAP CA 92675
Bus Lic:
BT30048427
Phone:
949433.0057
Lic Exp Date:
0913012021
Code Edit : 2019
Type of Construction:
Occupancy Group: U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 0
No of Units : 0
Bldg Height: 0
Bldg Sprinklers:
Construction Valuation:
Building Permit Fee: $110.00
Plan Check Fee: $95.70
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$2.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $254.95
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Worker's Compensation Insurance
Carrier: SECURITY NATIONAL INS CO
Policy No: SWC127774
Expire: 03/20/2021
Building Setbacks
Excise Tax:
Additional Fee:
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: 5'
Front: 5'
Left: 5'
Right: 5'
Architect:
ROBERTS DANIEL
Address:
150 LOCKWOOD PARK PL
TUSTIN CA 92780
Phone:
State Lic:C031417
Engineer:
SKUDLARSKI JASON
Address:
9751 OLYMPIC DR
HUNTINGTON BEACH CA 92646
Phone:
949-752-1612 State Lic:C-067712 ;.....
Designer:
Address:
Phone:
Special Conditions:
'arking Spaces:
0 Fire Hazard Zone : N
$0.00
Planning Department -
Fire Department
$0.00
Plan check Fee : $46.25
Fire Inspection:
$0.00
Fair Share : $0.00
Fire Plan Rev
$0.00
$0.00
SJH Trans : $0.00
Demolition Fee
$0.00
In -lieu Housing Fee : $0.00
Building Dept Adm
$0.00
$0.00
Public Works Department -
General Service
$0.00
$0.00
Park Dedication : $0.00
Refund Deposit
$0.00
PM Plan Check: $0.00
Grading Bond:
$0.00
$0.00
San Dist: $0.00
$0.00
NMUSD Fee: $0.00
$0.00
$0.00
$0.00
Plan Check Fee:
$0.00 Fee Due at Permit Issuance :
$254.95
PUBLIC WORKS APPROVAL:
_
PLAN CHECK BY:
APPROVAL TO ISSUE:
/�
/ \I . 0-0
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
1e 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
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 applicant for a permit subjects •the applicant to a civil penalty of
of more than five hundred dollars ($500).
7 I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
Iusiness 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
n roved 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' Stale 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).
I am exempt from licensure under the Contractors' State License Law for the following reason:
ly 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 legally
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.
lignature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Cha�]pCte.�r 9 (commencing with Sect' n 7 00) of Di ision 3 of the Busines nd Professi ode and my license is in full force
nd effect. License Class License No 'T \ llj i.Y/L D Contra Ignature
VORKERS' CFT-NPFNSATION DECLARATION
:ARNING:-AILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUBAr DOLLARS ($100,000), IN ADDITION TO THE
UJi (.F COMPENSATION,."MAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm u&rr 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 Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for IN
rmance of thJ A; k for which this permit is issued. Policy No.
3a 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' compensatior
rce carrie', dhp policy number are:
'rr•irr Policy Number Expiration Date
mr if Agent Phone #
:1I certiry that, in Chu, p rforma a he rk for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' comp nsati n laws of California, and agre(
14 if I uhould become bjec a ork s' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
lignature of App!' r te_ Gv
)ECLARATION RE ARDIN RUCTION LENDING AGENCY 41111,
affirm
hereby under penalty of p hat there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
.ender's Name Lender's Address
ly 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 o In ce state laws relating to building construction. I authorize representatives of this city or county to to ent�a oveA entified property for inspection entified property for inspection purposes.
>i nature of Property Owner or Authoriz ge Print Property Owner's or Authorized Agent's to
ACTION DATE Y DEC IAR N OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REG TIO PART 61 OFTITLE 40 AND AQMD RULE
PERMIT EXPIRED
U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED
LIEPA
PERMIT EXTENDED
UAQMD
PERMIT FINAL
El ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
�?
CERTIFICATEOF
(�J�?
PROPOSED DEMOLITION
OCCUPANCYISSUED
SIGNATURE: