HomeMy WebLinkAboutX2019-1539 - Permits�,wlg4
City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
tR
Inspection Requests Phone (949)644-3255
Combination Type - BLDG
IIIIIIIIiIIII�IIIIIIIIIIIIiI� II COMB Permit: X2019-1539
Project No : 1098-2019
Issued Date : 0810712019
Inspection Area : 5
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
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:
301 EVENING CANYON RD NS
Description:
SFR 8' X 47 LF BLOCK WALL (INSIDE PIL)
Legal Desc.:
'
Owner:
NIAMEYJERRI/NELSON
Contractor:
CONCRETE CONCEPTS
Architect:
'"'v`��CT��
Address:
301 EVENING CANYON
Address:
320 MARGUERITE AVE #C
Address:
, V IV -
CORONA DEL MAR CA 92625
NEWPORT BEACH CA 92625
Phone:
949-933-6000
Phone:
949-400-6639
Phone:
State Lic:
Applicant:
GRAVES ROBERT
Con State Lic:
928875
Engineer:
LOTHROP SHAWN DUANE ,
Address:
2152 DUPOI NT DR #255
Lic Expire:
02/2812021
Address:
29970 TECHNOLOGY DR, STE 212
IRVINE CA 92612
Bus Lic:
BT30055432
MURRIETA CA 92563
Phone:
949-955-1424
Lic Exp Date:
0613012020
Phone:
951-600-0032 x204 State Lic:S-005627 .. ,
Code Edit :
2016
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:
Flood Zone:
X
Construction Valuation:
$10,000.00
Building Permit Fee:
$412.00
Plan Check Fee: $365.00
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$8.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee:
$1.00
TOTAL FEE : $867
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Worker's Compensation Insurance
Carrier: EXEMPT
Policy No:
Expire:
Building Setbacks
Use Zone:
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: 6'
Front: 20'
Left: 6'
Right: 6'
'arkina Soaces
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee
0
Designer:
Address:
Phone:
Special Conditions:
Fire Hazard Zone : N
Planning Department -
Plan check Fee
Fair Share :
SJH Trans:
In -lieu Housing Fee:
Public Works Department -
Park Dedication:
$0.00
PAN Plan Check:
$41.25
San Dist:
$0.00
NMUSD Fee:
$0.00
Fire Department
$40.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$446.25 Fee Due at Permit Issuance : $421.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
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) 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, priorto its issuance, also requires the applicant for
:he 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
iot more than five hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended 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 employees' or personal effort, 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 Owner -Builder will have the burden of proving that it was not built 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).
I am exempt from licensors under the Contractors' State License Law for the following reason:
By 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 legall)
sell 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
Professions Code. is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of Property Orvner or Authorized Agent Date
LICENSED CON FRACTOR'S DECLARATION
I.hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Se ion 7 0) of Division 3 of t siness and Pr essio s Code, and my license i dl..ferse—
and effect. License Class License No D Con a r Signature
Ik/OPKERS' COMPENSATION DECLARATION
NPRNIN FAILURE 10 SEUIIRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FIN S UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COS- OF COMPENSAT ON, DAMAGES As PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
I hereby affirm under regally of perjury one of the following declarations:
D I have and well 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 th
performance of the, work for which this permit is issued. Policy No.
have and wll 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' compensatiol
IrPnce carrier and policy number are:
riPr _ Policy Number Expiration Date
pe of Agent Phone #
of
that, in the p^ o ance of the work for c ich this permit is issued, I shall not employ any person in any manner so as to become subject to the w cers compensation laws of California, and agre
!, if I should becom " bj to the workers' ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisiens.
into re of I' nt Date \!1d1
hereby affirm under penfIf perjury that( ore 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
.
3y my signature below, I dallify 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 ave provided is correct.
I agree to comply with all applicable city and c n ordinances and state laws relating to building construction.
I authorize representatives of this city county o ter the above -identified property for inspection purposes.
Signature Of Property Owner or Authon ent Print Pro ertOwner's or Authorized Aq6nts we dd`^ Date
ACTION DATE BY TECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED OEPA
PERMIT EXTENDED LIACMD
PERMIT FINAL `Q I ( J I (`i PC, ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO
CERTIFICATE OF 1 ll PROPOSED DEMOLITION
OCCUPANCYISSUED SIGNATURE: