HomeMy WebLinkAboutX2020-1727 - Permitsj>WI°flpry City of Newport Beach - Building Division IIIIIIII II�IIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2020-1727
a� w 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 0 1 7 2 7 Project No : 0201-2019
. Perdilfft Mdter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - MFP MECH ELEC PLUM Issued Date : Area
: 2020
+Wpe11E
Inspection Area 4
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0713112023 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: 95 JASMINE CREEK DR NB
Description: MFR *CHANGE OF CONTRACTOR* ADD 115 SF & REMODEL 931 SF _
Legal Desc.: N TR 8427 LOT 11
Owner: GATES MARGARET
Contractor:
OWNER/BLDR
Architect:
Address: 424 VISTA FLORA
Address:
MARGARET GATES
Address:
NEPORT BEACH CA 92660
Phone: 949-644-0962
Phone:
949-644-0962
Phone:
State Lie:
Applicant: SCOTT BRIAN
Con State Lie:
O/B
Engineer:
SALEH ZOUHEIR
Address: 962 NHARWOOD ST
Lie Expire:
Address:
14917 VAN NESS AVE
ORANGE CA 92867
Bus Lie:
GARDENA CA 90249
Phone: 562-964-1272
Lie Exp Date:
Phone:
562-235-4572 State Lic:C-042881
Code Edit: 2016
Worker's Compensation
Insurance
Designer:
Type of Construction: V-B
Carrier:
Address:
Occupancy Group: R3/U
Policy No:
Added /New sq.ft. Bldg: 115
Expire:
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 1
Building Setbacks
Rear: 15'
Special Conditions: Waste Mgmt to
No of Units : 3
Front: 15'
haul debris
Bldg Height: 0
Left: 0'
Bldg Sprinklers:
Right: 5'
46
Flood Zone: X
Use Zone: PC-13
Parking Spaces:
2
Fire Hazard Zone : N
Construction Valuation: $0.00
Building Permit Fee: $0.00
Excise Tax:
$0.00
Planning Department-
Fire Department
Plan Check Fee: $0.00
Additional Fee:
$35.00
Plan check Fee :
$0.00 Fire Inspection:
$0.00
Overtime Plan Ck: $0.00
Grading Bonds Fee:
$0.00
Fair Share :
$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
$0.00
Energy Compliance: $0.00
Grading PC Fee:
$0.00
Public Works Department -
General Service
$0.00
CA Seismic Safety: $0.00
WQ Insp. Fee:
$0.00
Park Dedication:
$0.00
Refund Deposit
$0.00
Disabled Access : $0.00
PNJ Plan Check:
$0.00
Grading Bond:
$0.00
Hazardous Mat $0.00
Electrical %:
$0.00
San Dist:
$0.00
Building Green Fee : $0.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
$0.00
Plumbing %:
$0.00
$0.00
IITOTAL FEE: $35.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $35.00
PROCESSED BY: ^.^� PUBLIC WORKS APPROVAL:
ZONING APPROVAL: PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
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OWNER -BUILDER DECLARATION
I hereby affnn under penalty of perjury that I am exempt from the Contractors' State License Law for thereason(s)
Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, Improve,
he permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State Lice
Irofessions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of
at more than 0ve hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U portiom
Iusiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, thro
nprovements are not intended or offered for sale. If, however, the building or Improvement is sold within one year of r
nproved for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7
pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contr.
1 am exempt from licensure under the Contractors' State License Law for the following reason:
fy my signature below I acknowledge that, except for my personal residence in which I must have resided for at least r
ell a structure that 1 have built as an owner-bulider if it has not been constructed in its entirely by licensed contractors.
Irofessions Code, is available upon request when this application is submitted or at the following Web site:hftp://w .1
signature of Property Owner or Authorized Agent
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70[
nd effect. License Class License No Date
VORKERS' COMPENSATION DECLARATION
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION SLUM OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
7 I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Direct+
er orm mce 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 th
Isurance carrier and number are:
arrler Polio imb r �:
ame of Agent-
31 certify that, In the performance of the work for which t is permit Is issued, I shall not employ any person in any man
let, if I should become subject to the wo IS, lion provisions of Section 3700 of the Labor Code, I shall fort)
ignature of Applicant_. _-r—
ueby affirm under penalty Of perjury ffa�tChem is a construction lending agency for the perfannance of the work
Ider's Name Lender's Address
my signature below, I certify to each of the following:
1 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 re ling to b Iding construction.
I authorize representatives of this city or coygtyfto enter th%915ove•ldentified of f soectlon oumoses.
uLIIAHq ❑UIN OF COMFZMCE WITH CODE OF FEDEr
REGULATIONS PART 61 OF TITLE 40 ANO AOMD RULE
PERMIT
LVASBESTOSNOTIFICATION
CERTIFICATEOF IL Y ocRonccn ncranr,.r.,.,
Called below by the chackmark(s) I have placed next to the applicable item(s)
nolish, or repair any structure, prior to its issuance, also requires the applicant for
Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Lion 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
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
9etion, 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
r pursuant to the Contractors' State License Law).
year poor to completion of the Improvements covered by this permit, I cannot let
nderstand that a copy of the applicable law, Section 7044 of the Business and
Business and Profgssjons Cgge :and my license is In full force
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS IS1 0,000), IN ADDITION TO
of Industrial Relations as provided for by Section 3700 of the Labor Cade, for
performance of the work for which this permit is issued. My workers'
Date
p as to become subject to the workers' com nsation laws of California, and agre
comply with chose provisions.
this permit is Issued (Section 3097, dfvil Codef.
USE ONLY