HomeMy WebLinkAboutX2021-0363 - Permits��"rrJkr City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2021-0363
100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 1 0 3 6 3 Project No: 0362-2021
n Permit Counter Phone (949)644-3288
ss S Inspection Requests Phone (949)644-3255
Issued Date : Combination Type - BLDG GRAD Area
: 2021
IYIIY
Inspection Area 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 03/09/2024 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: 1723 TERRAPIN WAY NB
Description: SFR DET. SOLID PATIO COVER 280 SF, 6' X 13 LF CMUITV WALL, CITY STD YARD DRAINAGE t� I
Legal Desc.: N TR 3097 LOT 26 g p
Owner:
HAWKINS DANIELISARAH
Contractor:
OWNER/BLDR
Architect:
Address:
1723 TERRAPIN WAY
Address:
AUTH AGENT:
Address:
NEWPORT BEACH, CA 92660
LINDSAY ESPIN07A
Phone:
Phone:
949-370-7759
Phone:
Applicant:
OLSON LINDSAY
Con State Lic:
O/B
Engineer:
Address:
267 MAGNOLIA ST
Lic Expire:
Address:
COSTA MESA CA 92660
Bus Lic:
Phone:
949.370-7759
Lic Exp Date:
Phone:
Code Edit : 2019
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:
Flnnd 7nne: X
Construction
Building Permit Fee: $381.00
Plan Check Fee: $266.75
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$12.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.50
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee .
$4.00
TOTAL FEE: $1,137.50
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Worker's Compensation Insurance
Carrier:
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: 6
Front: 20
Left: 6
Right: 6
'arkina Spaces
$0.00
$0.00
$0.00
$0.00
$232.00
$195.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee
%.�l ZL; I OR
State Lic:
WICKSTROM ERIC
28581 VIA PRIMAVERA
SAN JUAN CAPISTRANO CA 92675
949-454-8045 State Lic:S-003989
Designer: OLSEN LINDSAY
Address: 267 MAGNOLIA ST
COSTA MESA CA 92660
Phone: 949-370-7759
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
Fire Department
$46.25
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
$508.00 Fee Due at Permit Issuance : $629.50
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
is pemrit 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 L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
Iusiness 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
kpplova:
d for the purpose of sale).
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
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).
7 I am exempt from licensure 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 -bull er If It has not n constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Sectio 70 4 of t e B iness and
'rofessions Code, is available upon request whe applic b itt d or at the ll=ite:http://�.leginfo.ca.gov/calaw.html.
site:http://www.leginfo.ca.gov/calaw.html. �j �. 2
signature of PrDp ,xt Owner or Authorized Agent VVVVVV /l4 it 4 � �i� — Date
.ICENSED CCETRACTOR'S DECLARATI
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 Cod , nd my li nse is in full force
no rffect. License Class License No Date Contractor Signature
:RKERS' COMPENSATION DECLARATION
'LJING: FAILUPF 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
T OF COMPSNSATIO(l, DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
reoy affirm under penalty 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 thl
'Drmance of the work for which this permit is issued. Policy No.
bade 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'
"arce carver aiid policy number are:
Policy Number
of Agent
Date
JI certify that, in the perform nceof 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
iat, if I should becom subje t orkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
ignature of Applicant Date L/
IECLARATION REGA CONSTRUCTION LE NG AGENCY
hereby affirm under pre alty of perjury that there is onstruction lending agency for the performance of the work for which this permit is issued (Section 3097, Ci it 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, o Fences and state laws relating to building construction. VI
I authorize representatives of this city or county t4�r}e above -identified property for inspection purposes. �' ten^ _ ., /
Owner's or
BY V r*( L'ARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
A5BE5TO5 NOTIFICATION TO
PERMIT CANCELLED
PERMIT EXTENDED
PERMIT FINAL 'LCA ^ T
\TAPPLICABLE TO
ftopCCER CERTIFICATE OFHE
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