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Home My WebLink AboutX2022-1187 - PermitsCity of Newport Beach - Building Division *X2022-1187* ` 100 Civic Center Drive, Newport Beach, CA 92660 ` Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - SFP ELEC COMB Permit: X2022-1187 Project No: 1091-2022 Issued Date : 0412812022 Inspection Area :5 AST VALID INSPECTION. PROJECTS MUSrBE COMPLETED BY OR PERMIT LL BE tC PERMT EXPIREt Lm. or Holidays to 6:30 and Saturday from 8:00 a.m. o 6.00 p.m. No work on Sundays or struct onSHourrs: MondayR Friday 7 00 a p.m. Job Address: 4515 SURREY DR NB PATIO COVER 140 SF & LIGHTS/ELEC Description: SFR ATTACHED Legal Desc.: N TR 3519 LOT 73 Contractor: HOBSON HOMES Architect: CHERSON ERIN JUSTINE Owner: SMITH JEREMY & DANA Address: 6462 ACACIA LN Address: 606 CENTRAL AVE Address: 4515 SURREY DR YORBA LINDA CA 92886 SEAL BEACH CA 90740 CORONA DEL MAR, CA 92625 Phone: 714-225-6365 Phone: P 949-351-6393 562-596-0495 State Lic:C032745 .. -- Phone: Applicant: HOBSON JEREMY Address: 6462 ACACIA LN YORBA LINDA, CA 92886 Phone: 714-225-6365 Code Edit: 2019 Type of Construction: V-B Occupancy Group: R3/U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 1 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Building Permit Fee: $389.00 Plan Check Fee: $267.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $34.00 Energy Compliance: $0.00 CA Seismic Safety : $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.0c Con State Lie: 930528 Lie Expire: 10/31/2022 Bus Lie: BT30073169 Lie Exp Date: 10/31/2022 Worker's Compensation Insurance Carrier: INS, CO. OF THE WEST Policy No: WSD505598801 Expire: 06/14/2022 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: I Front: I Left: / Right: / $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $27.23 $0.00 $0.00 11 TOTAL FEE: $770.23 Plan Check Fee PROCESSED BY: 7 J ZONING APPROVAL: An, ` K 0 Engineer: Address: Phone: Designer: Address: Phone: Special Conditions: Planning Department - Plan check Fee Fair Share SJH Trans In -lieu Housing Fee Public Works Department - Park Dedication : $0.00 PNV Plan Check : $0.00 San Dist: $0.00 NMUSD Fee: $0.00 State Lie: Fire Department $52.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building DeptAdm General Service Refund Deposit Grading Bond: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $319.00 Fee Due at Permit Issuance : $451.23 PUBLIC WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: 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) ind cated 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, dei nolish, 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 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 Sec tion 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). u I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U portions of Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of com i5im roved for the purpose of sale). I, as ownerDf the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044 ^pply to. an owner or property who builds or improves thereon, and who contracts for the projects with a licensed Contracts 0 1 am exempt from licensure under the Contractors' State License Law for the following reason: B,' my signature beluw I acknowledge that, except for my personal residence in which I must have resided for at least one Sefi a s6 ucture the. I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I ul Professions Code, is 3, Stable upon request when this application is submitted or at the following Web site:http://w .legit Signatu-e of Property C,wner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION I Nereuy affirm under odnalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7-000) t d„G �f,"ect. License Class License No Date.X y AORAERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL ,IFT OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 1,er9t,y affirm cinder penalty of perjury one of the following declarations: ipgve and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director o r�llrarice rmance of the work for which this permit is issued. Policy No. ave and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the p1 carrier and policy number are: :arrier Policy Number Jame of Agent he 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 letion, 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). ear prior to completion of the Improvements covered by this permit, I cannot legal, ierstand that a copy of the applicable law, Section 7044 of the Business and o.ca.gov/calaw.html. Date ,Division 3 of the Business and Profes ion e, and my license is in full force ZY 27 Contractor Signature IES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE 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 certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner o as to become subject to the workers' compensation laws of California, and if I should become subject tot workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwitticomply with those provisions_ .i /V nature of ,o�. I IVN M=bAKLLNIJ U STRUCTION LENDING AGENCY hereby affirm under penalty of p1bdury that there is a construction lending agency for the performance of the work for 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 ordinances and state laws relating to building construction. I authorize representatives of this city or county t✓✓o enter th/elabove-identified property for inspection purposes, ignature of Property Owner or Authorized Agent A / Print Propertv Owner's nI i Ivn OUATE BY DECLQI(ATION OF COMPLIANCE WITH CODE OF FEDEI REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED EPA PERMIT EXTENDED QM D PERMIT FINALV� ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO CERTIFICATEOF PROPOSED DEMOLITION OCCUPANCY155UED / Date permit is issued (Section 3097, Civil Code). FOR OFFICE USE ONLY -er uA X