HomeMy WebLinkAboutX2021-0391 - Permits�rwrrl�r City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2021-0391
yt 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 1 0 3 9 1 Project NO
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Issued Date : 02119/2021
Combination Type - BLDG ELEC
Inspection Area : 5
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 02/20/2024 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:
503 FERNLEAF AVE NB
No
Description:
SFR BLOCK WALLS 1'X25' & 2' X 25' (WIIN T INSIDE P/L). CITY
STANDARD DRAINGE. 4 OUTLETS
CON pT
Legal Desc.:
CORONA DEL MAR BLK 532 LOT 3
9 1�}^1r
f L.1
Owner:
PULINO JULIE Contractor:
PACIFIC BREEZE LANDSCAPE
Architect:
Address:
503 FERNLEAF AV Address:
15512 GRAHAM ST
Address:
CDM CA 92625
HUNTINGTON BEACH CA 92649
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Phone:
Phone:
667-259-7718
Phone: apt®��S
61r-!
Applicant:
PACIFIC BREEZE LANDSCAPE Con State Lie:
1019675
Engineer:
Address:
15512 GRAHAM ST Lie Expire:
04130/2021
Address:
HUNTINGTON BEACH CA 92649 Bus Lie:
NEW LIC
Phone:
657-259-7718 Lie Exp Date:
0212812022
Phone: State Lie:
Code Edit: 2019
Type of Construction: V-B
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:
Worker's Compensation Insurance Designer: ACEVEDO JOSE
Carrier: MARKEL INS CO Address: 15512 GRAHAM ST
Policy No: MWC017466001 HUNTINGTON BEACH CA 92649
Expire: 0912712021 Phone:
Building Setbacks Rear: 5' Special Conditions: 121-0469 t�
Front: 15' HIGH DENSITY �y{T
Left: 3'
Right: 3'� v J
Use Zone: Parking Spaces: 0 Fire Hazard Zone : N
Construction Valuation:
$6,000.00
Building Permit Fee:
$178.00
Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee: $154.86
Additional Fee :
$0.00
Plan check Fee : $46.25
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:
$178.00
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
PAN Plan Check : $0.00
Grading Bond:
$0.00
Hazardous Mat
$0.00
Electrical %:
$12.46
San Dist: $0.00
Building Green Fee :
$1.00
Mechanical %:
$0.00
NMUSD Fee: $0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE : $570.57
Plan Check Fee
: $0.00 Fee Due at
Permit Issuance :
$570.57
PROCESSED BY:
PUBLIC WORKS APPROVAL:
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_ _
ZONING APPROVAL:
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PLAN CHECK BY:
GRADING APPROVAL: 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
is 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 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
of more than five hundred dollars ($500).
] I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
usiness 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).
1, 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 licensure under the Contractors' State License Law for the following reason:
y 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
=_ll 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 this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
ignature of Property Owner or Authorized Agent Date
ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectjpn Z000) of Division 3 of the Business and PrQfessi ode, and my license is in full force
nd effect. License Class License No a 9 ✓/1 �( Contractor Signature _�
/ORKERS' COMPENSATION DECLARATION (/`1,
ARNING: 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
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
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
Trance of the work for which this permit is issued. Policy No.
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'
carrier and policy number are:
Policy Number Expiration Date
of Agent
JI certify that, in the performance 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 agree
iat, if I should become Hsu/bje/pC/jo the worr/kers' compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with those provisions.
signature of Applicant Ju / /� / L Dat� ?rr C-t —� I
)ECLARATION REGARDI CON TR CTION LENDING AGENCY
hereby affirm under penalty of perjury that there 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
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 countytoenyefjhe abovP„I-'dentified property for inspection purposes. .. e _ _ _ �I Ir G n
BY
PERMIT EXPIRED
PERMITCANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATEOF
OCCUPANCYISSUED
OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
PART 61 OF TITLE 40 AND AQMD RULE
1403
I SUBMITTED ASBESTOS NOTIFICATION TO
NOTIFICATION IS NOTAPPLICABLE TO
PROPOSED DEMOLITION