HomeMy WebLinkAboutX2022-1100 - Permits�n'6N n04 City of Newport Beach - Building Division
C. r
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
F .in Inspection Requests Phone (949)644-3255
Combination Type - BLDG ELEC PLUM
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2022-1100
Project No : 1006-2022
Issued Date : 06/08/2022
Inspection Area : 5
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 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: 30 WHARFSIDE DR NS
Description: SFR BLOCK WALL 5' X 11'6" (CITY STD, INSIDE P/L) & PLMB/ELEC FOR BBQ & FIRE PIT
Legal Desa56K SK
: U,
Rkq- -5 ^�
Owner: MANLEY MICHELLE
Contractor:
TESERRA
Architect:
A
Address: 30 WHARFSIDE
Address:
P O BOX 1280
Address:
a--�
NEWPORT COAST CA 92657
COACHELLA CA 92236
Phone:
Phone:
760-398-9222
Phone: State Lie:
Applicant: ELLISON PAUL
Con State Lie:
656128
Engineer: BIEDENBACH CHRISTOPHER
Address: 24642 VIA RAZA
Lie Expire:
10/31/2022
Address: 1201 N TUSTIN
..�
LAKE FOREST CA 92630
Bus Lie:
BT30078953
ANAHEIM CA 92807
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Phone: 949-683-9861
Lie Exp Date:
0613012023
Phone: 714-630-6100 State Lic:C-074003
Code Edit: 2019
Worker's Compensation Insurance
Designer:
Type of Construction:
Carrier:
STARSTONE
Address:
Occupancy Group: U
Policy No:
T10200999
Added /New sq.ft. Bldg: 0
Expire:
01/01/2023
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 0
Building Setbacks
Rear: 0'
Special Conditions:
No of Units : 0
Front: 10'
Bldg Height: 0
Left: 0'
Bldg Sprinklers:
Right: 0'
Flood Zone: X
Use Zone: Parking Spaces:
0 Fire Hazard Zone : N
Construction Valuation: $2,000.00
Building Permit Fee: $110.00
Excise Tax:
$0.00
Planning Department - Fire Department
Plan Check Fee: $95.70
Additional Fee :
$0.00
Plan check Fee : $52.00 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
PNV Plan Check : $50.75 Grading Bond:
$0.00
Hazardous Mat $0.00
Electrical %:
$7.70
San Dist : $0.00
Building Green Fee : $1.00
Mechanical %:
$0.00
NMUSD Fee: $0.00
$0.00
Plumbing %:
$9.90
$0.00
TOTAL FEE : $327.05
Plan Check Fee :
$147.70 Fee Due at Permit Issuance :
$179.35
PROCESSED BY:
PUdI-,C WC,RKS APPROVAL:
ZONING 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) 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
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 Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
not more than five hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or (_) 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).
❑ 1 am exempt from licensure 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 legally
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 Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 7000 of Di�{gi9qn 3 of the Business and Pro essi s d and y rC hse is in full force
and effect. License Class License No Date 6144` Contractor Sig natur
WORKERS' COMPENSATION DECLARATION
NARNING: 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 I$100,0001, IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
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
:e of the work for which this permit is issued. Policy No.
and will fain workers' cDy_�ensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers'
carrier nd policy numbeir apt; 1
Date
id -of Agent
1 certify that, in the perfor anc irk
r for this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' Xcompensation la s of California, and agre
that, if I should become su act t the ' c ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �O Signature of Applicant U 2/
DECLARATION REG(E)WtSNDING AGENCY
I hereby affirm under natty f perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Lender's Name Lender's Address
By my signature below, I certify to each of the following:
I am the property owner or authorized to act on th;w6rint
ehalf.
I have read this application and the information I ect /
I agree to comply with all applicable city and couSt I s rela g to building construction. /_
I authorize representatives of this city or county tt' d pr y for inspection purposes. d�, 1Q
Signature of Property Owner or Authorized Agentrint Property Owner's or Authorized Agent's Name vV•v W Dat
ACTION DATE BY DECLAR T F COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMITEXPIRED LJ ISUBMITTED ASBESTOS NCTIF'CATION TO '-
PERMITCANCELLED LJEPA
PERMIT EXTENDED LJAQMD
PERMITFINAL �_ ('(��L I�L- ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF V PROPOSED DEMOLITION _
OCCUPANCYISSUED SIGNATURE: