HomeMy WebLinkAboutX2022-1361 - Permits£w,'rykr City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II 4 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 2 1 3 6 1
Permit Counter Phone (949)644-3288
t". Inspection Requests Phone (949)644-3255
Combination Type - BLDG PLUM
COMB Permit: X2022-1361
Project No : 1262-2022
Issued Date: 0511112022
Inspection Area : 2
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY
OR PERMIT WILL BE INVALIu
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:
2661 CRESTVIEW DR NB
Description:
DEMO DETACHED GARAGE 400 SF
Legal Desc.:
N TR 1014 LOT 68
Owner:
Address:
ROOT DAVID
3500 SAN JOAQUIN PLZ
Contractor: OWNER/BLDR Architect:
Address: Address:
NEWPORT BEACH CA 92660
�".,�--�
Phone:
7601419-9902
Phone: Phone:
State Lic:
Applicant: ROOT DAVID
Con State Lic: O/B
Engineer:
Address: 3500 SAN JOAQUIN PLZ
Lic Expire:
Address:
NEWPORT BEACH CA 92660
Bus Lic:
Phone: 7601419-9902
Lic Exp Date:
Phone:
State Lic
,
Code Edit: 2019
Worker's Compensation
Insurance
Designer:
' >>
Type of Construction:
Carrier:
Address:
Occupancy Group: R3
Policy No:
.,
Added/New sq.ft. Bldg: 0
Expire:
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 0
Building Setbacks
Rear: /
Special Conditions:
,
No of Units : 1
Front: /
Bldg Height: 0
Left: I
Bldg Sprinklers:
Right: I
Flood Zone:
Use Zone:
Parking Spaces:
0 Fire Hazard Zone : N
Construction Valuation: $4,000.00
Building Permit Fee: $144.00
Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee: $0.00
Additional Fee :
$0.00
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
Adm
$0.00
Record Management: $0.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee : $0.00
Building Dept
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
$0.00
Disabled Access : $0.00
PAN Plan Check: $0.00
Grading Bond:
Hazardous Mat $0.00
Electrical %:
$0.00
San Dist: $0.00
$0.00
Building Green Fee : $1.00
Mechanical %:
$0.00
NMUSD Fee: $0.00
$0.00
Plumbing %:
$12.96
TOTAL FEE : $157.96
Plan Check Fee
: $0.00 Fee Due at Permit Issuance :
$157.96
PROCESSED BY:
PUBLIC WORKS 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 forth a 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
ie 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
'rofessions Code) or that he or she is exempt from Iicensure 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).
)`_t as owner of the property, or my employees with wages as their sole compensation, will do $a11 of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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
nproved 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
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 Iicensure 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 legall
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 t is application is s Itted r he following Web site:http://w .leginfo.ca.gov/calaw.htmi.
signature of Property Owner or Authorized Age Date S le Z L
.ICENSED CONTR,4CTOR'S DECLARAI{bN
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
nn effort License Class License No Date Contractor Signature j
VORKERS' COMPRN'SATION DECLARATION
IAINI"'G: 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 ($100,000), IN ADDITION TO THE
OjT OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
helaby affirm under F3i^.Ity 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 the
eifula,ance of the AoA for which this permit is issued. Policy No.
1 have 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' compensatiortl
IsurPnce.carrier and policy number are:
Carrier Policy Number Expiration Date
N.-rne of Rgent _ Phone #
I certify that, in ti 16 per,ormance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
that, if I should lbecomAsubject t he yyorker;' corpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature ofA IicanSll//1,cc\\ 1�/t/ode//lle&lr Date S
DECLARATION REC.RDIN�ONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of er thatVQer a cons uction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil ode).
Lenders Name w � Lender's Address
By my signature below, I cert o 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 count to nter the ab -ide " ie ropert for inspection purposes. /
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name D e � 1r Z
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED
I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED
EPA
PERMIT EXTENDED
M D
PERMIT FINAL
CERTIFICATE OF
I
ASBESTO
PROPOSED
NOTIFICATION IS NOTAPPLICABLETO
� UTIONig '�/
OCCUPANCY ISSUED
UI
IJ
SIGNATURE:
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