HomeMy WebLinkAboutX2017-2360 - Permits(9)
City of Newport Beach - Building Division IIIIIIIIIIIII I IIIII IIIIIIIIIII IIII COMB Permit: X2017-2360
100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 7 2 3 6 0 Project No: 2029-2010,Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255Issued Date : 07/27I2017
Combination Type - BLDG
Inspection Area : 8 ,
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
Construction Hours. Monday - Friday7.00 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:
20352 KLINE DR NB
Description:
DET GAR RERROF R/R COMP SHINGLES
6 SQS CLASS A (X2016-2929)
-
Legal Desc.:
Owner:
Address:
GOLSON GARY
7924 DALEN ST
DOWNEY CA 90242
Contractor: JASON GOLSON CONSTR INC Architect:
Address: 20352 KLINE DR Address:
NEWPORT BEACH CA 92660
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E`r, .�'�•'�
Phone:
Phone: 714-391-1392 Phone:
State Lie:
Applicant:
GOLSON SUNSHINE
Address:
20352 KLINE DR
NEWPORT BEACH CA 92660
Phone:
714-723-8499
Code Edit: 2016
Type of Construction: VB
Occupancy Group: U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 1
No of Units : 1
Bldg Height: 0
Bldg Sprinklers:
Flood Zone: X
Construction Valuation: $2,100.00
Building Permit Fee: $304.00
Plan Check Fee: $0.00
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$0.00
Energy Compliance:
$0.00
CA Seismic Safety :
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $305.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Con State Lie:
993270
Lie Expire:
0513112018
Bus Lie:
BT30056465
Lie Exp Date:
09130/2017
Worker's Compensation Insurance
Carder: NO EMPLOYEES
Policy No:
Expire:
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: /
Front: I
Left: I
Right: /
Lin Spa
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
0
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
Special Conditions:
Planning Department -
Plan check Fee
Fair Share
SJH Trans
In -lieu Housing Fee
Public Works Department -
Park Dedication :
$0.00
PAN Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Zone : N
State Lie:
Fire Department
$0.00
Fire Inspection:
$0.00
$0.00
Fire Plan Rev
$0.00
$0.00
Demolition Fee
$0.00
Building Dept Adm
$0.00
General Service
$0.00
Refund Deposit
$0.00
Grading Bond:
$0.00
$0.00
$0.00
Plan Check Fee : $305.00 Fee Due at Permit Issuance : $0.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
OWNER-BUILUER DECLARATION
I ne,eby affirmunder 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 7031.0, 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
she 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 hunnred dollars ($500).
0 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or C_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
DJLi,,Lss and Frofessions 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
�prrvaments 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).
3 I, as owner o`!5a 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).
0.I,wTi exempt fmm 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:hftp://www.leginfo.ca.govlcalaw.htmi.
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 70 0) of f Division 3 of the Business and Pro si n Code ense is in full force
and effect. License Class License No Date^ �--�� Contractor Signatu
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 ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES As PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNETS 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
Drmance of the work for which this permit is issued. Policy No.
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' compensa
ranee carrier and policy number are:
Agent
drtify that, in the performance of the work
if I should become subjepttto the worksrg'
of
Policy Number
Date
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
ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
DaCs�
iECLARATION REGARDIKWCONSTRUC'TION 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
y 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 county tp enterpfjhe above id�nyied property for inspection purposes.
ACTION DATE BY DRCLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED
PERMITEXTENDED
PERMIT FINAL 5 _
CERTIFICATE OF
OCCUPANCYISSUED
I SUBMITTED ASBESTOS NOTIFICATION TO
IS NOTAPPLICABLE TO
101