HomeMy WebLinkAboutX2019-0783 - Permitsr wl•rat. City of Newport Beach - Building Division 1111111111111111111111111111111111111111111111 it II COMB Permit: X2019-0783
{ 4 100 Civic Center Drive, Newport Beach, CA 92660 x 2 0 1 9 0 7 6 3 Project No : 0526-2019
H ''• + Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255 Issued Date: 03/1912019
Combination Type - BLDG
Inspection Area : 8
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
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:
23 EGRET CT NB
Description:
SFR ADD 16" TO TOP OF EXTG ENTRY BLOCK WALLS (6 LF TOTAL) "AS -BUILT'
Legal Desc.:
N TR 12530 LOT 34
Owner:
VICTORIA CAMPBELL
Contractor:
OWNERLBLDR
Address:
23 EGRET CT
Address:
AUTH AGENT:
NEWPORT BEACH, CA 92660
ALBERT ARCIERO
Phone:
Phone:
Applicant:
ARCIERO AL
Con State Lie:
O/B
Address:
23 EGRET COURT
Lie Expire:
NEWPORT BEACH CA 92660
Bus Lie:
Phone:
949.636-3292
Lie Exp Date:
Code Edit: 2016
Type of Construction:
Occupancy Group: U
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 0
No of Units : 0
Bldg Height: 0
Bldg Sprinklers:
Worker's Compensation Insurance
Carrier:
Policy No:
Expire:
Building Setbacks
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
State Lie:
State Lic:
ARCIERO AL
23 EGRET COURT
NEWPORT BEACH CA 92660
949-636.3292
Rear: I Special Conditions: OWNER/BLDR ATTACHED
Front: I
Left: I
Right: I
W�snocoe n Fire Hazard Zone : N
Building Permit Fee:
$104.00
Excise Tax:
$0.00
Planning Department -
$40.00
Fire Department
Fire Inspection:
$0.00
Plan Check Fee: $90.48
Additional Fee :
Fee:
$0.00
$0.00
Plan check Fee :
Fair Share: $0.00
Fire Plan Rev
$0.00
Overtime Plan Ck:
Investigation Fee:
$0.00
$0.00
Grading Bonds
Grading PC Consultant:
$0.00
SJH Trans : $0.00
Demolition Fee
Record Management:
$2.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee : $0.00
Building Dept Adm
General Service
$0.00
$0.00
Energy Compliance:
$0.00
Grading PC Fee:
$0.00
$0.00
Public Works Department -
Park Dedication : $0.00
Refund Deposit
$0.00
CA Seismic Safety:
$0.00
WQ Insp. Fee:
PAN Plan Check : $0.00
Grading Bond:
$0.00
Disabled Access :
Hazardous Mat
$0.00
$0.00
Electrical %:
$0.00
San Dist: $0.00
$0.00
Building Green Fee :
$1.00
Mechanical %:
$0.00
NMUSO Fee: $0.00
$0.00
Plumbing %:
$0.00
TOTAL FEE : $237.48
Plan Check Fee
: $0.00 Fee Due at Permit Issuance :
$237.48
PUBLIC WORKS APPROVAL:
PROCESSED BY:
PLAN CHECK BY:
ZONING APPROVAL:
APPROVAL TO ISSUE:
GRADING APPROVAL:
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
r9fffessions 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
k
re thanfive hundred dollars ($500).
s 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 far sale (Section 7044,
ss 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 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 La Wret
Iy my signature below I acknowledge that, except for y personal re mce ied for at least one year prior to completion of the improvements Dovered b this permit, I cannot legally
ell a structure th:t I`Iave built as an owner -builder ' it has not bee construced contractors. I understand that a copy of the applicable lw, Setion 70 4 of the Business and
'rofessions Code. Is, available upon request when is applicatio Is submi ite:http://www.leginfo.ca.gov/calaw.html.
ignatu:e of Property Owner or Authorized Agent Date '—
.ICENSED CONTRACTOR'S DECLARAT N
heresy affirm under penalty of perjury that I a licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions C e, and my license is in full force
nu effdct. License Class License No Date Contractor Signature
yORKERS' CO"MFENSATION DECLARATION
ARK"'. 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 (6100,000), IN ADDITION TO THE
DST OF COMPENSATON, UAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby,affirm undo, 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 thI
3rtirmonce of tFtp. work for which this permit is issued. Policy No.
11 hn' e 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' compensatior
�Suranre carrier and pa!icy number are:
carrier Policy Number Expiration Date
Jame of Agent Phone #
:1I certify that, in the perto ce of ark whic is perms s issued, I shall not employ any person in any manner so as to become subject to the workers' co ensation laws of California, and ogre
hat, if I should become sub' Ct to worke ' omp tion talons of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
signature of Applicant Dated/S
)ECLARATION REGA ING EN ENCY
hereby affirm under p alty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. ivil Code).
_ender's Name Lender's Address
3y my signature beta , 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 ve provided is correct.
I agree to comply with all applicable city and co ty ordinances and state laws relating to building construction.
I authorize representatives of this city or county o enter the above -identified propert for inspection purposes.
signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name
ACTION DATE BY F1 DEC TION C LI CE WIT ODE OF FEDERAL FOR OFFICE USE ONLY
R TIO P I TITLE 0ANDAQIV1D RULE
PERMIT EXPIRED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATEOF
OCCUPANCYISSUED
NOTIFICATION TO
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