HomeMy WebLinkAboutX2020-0209 - Permits�,y,NPp4, City of Newport Beach - Building Division
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100 Civic Center Drive, Newport Beach, CA 92660
F _ Permit Counter Phone (949)644-3288
v C Inspection Requests Phone (949)644-3255
Combination Type - BLDG
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2020-0209
Project No: 0177-2020
Issued Date: 0112312020
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: 4 MAIDSTONE DR NB
Description: SFR -BLOCK WALLS (WAN T OF P/L) X X 6' (TOTAL LF)
Legal Desc.: N TR 15390 LOT 16
Owner:
GUPTA PRACHI
Contractor:
BURNS COMPANY THE
Address:
4 MAIDSTONE DR
Address:
630 S EL CAMINO REAL STE B6
NEWPORT BEACH, CA 92660
SAN CLEMENTE CA 92673
Phone:
Phone:
949-388-5928
Applicant:
ELLISON PAUL
Con State Lic:
605145
Address:
24642 VIA RAZA
Lic Expire:
01/3112021
LAKE FOREST CA 92630
Bus Lic:
BT30047416
Phone:
949-683-9861
Lic Exp Date:
05131/2020
Code Edit: 2019
Type of Construction:
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:
Building Permit Fee: $412.00
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 :
$1.00
Worker's Compensation Insurance
Carrier: NAT'L LIABILITY & FIRE INS CO
Policy No: V9WC089367
Expire: 0510712020
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: / O
Front: /1$
Left: / il)
Right: / B
king Space;
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTAL FEE: 11 $413. � Plan Check Fee
PROCESSED BY:
ZONING APPROVAL: Vwj
0
Architect:
Address:
Phone:
State Lic:
Engineer: WALLACE SCOTT
Address: 22706 ASPAN ST #402
LAKE FOREST CA 92630
Phone: 949-455-9875 State Lic:S-003613
Designer:
Address:
Phone:
Special Conditions
Fire Hazard Zone : N
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
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
$0.00 Fee Due at Permit Issuance : $413.00
PUULI+I WORKS APPROVAL:
[.
PLAN CHECK.?Y: '
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 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
the 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 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
not more than five hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Sectior:. 7044,
Business 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
improvements 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).
❑ 1, as owner of the property, am exclusively contracting with licensed Contractors t0 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).
❑ 1 am exempt from Iicensure 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 legall
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:http://www.leginfo.ca.gov/calaw.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 Section 7000 f Di ision 3 of the Business and Profes Rod , eqy lic is in full force
and effect. License Class License No Dat Contractor Signature
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUS.IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001, IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one Of the following declarations:
lhave 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 th
manceof the work for which this permit is issued. Policy No.
ave 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' compensationte carrier and policy number are:r Policy Number Expiration Date
of Agent Phone #
I certify that, in the perform nce f - ork f which i ermit is issued, I shall not employ any person in any manner so as to become subject to the workers' compen lion I ws of California, and ogre
that, if I should become subje t to t w rke compe ion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant Dat-i Z�
DECLARATION REG DING STRUCTION LENDING AGENCY (f(
I hereby affirm under penalty o erjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Lenders Name Lender's Address
By 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 he rovided is t.
I agree to comply with all applicable city and coun o i e nd to elating to building construction.
I authorize representatives of this city or county to e e o -Idenf property for inspection purposes. 2
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name �Dat 3 ,
ACTION DATE BY ECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED 1SGdMI— ED A56E, T 05 NOTIFICATION TO
PERMIT CANCELLED
PERMIT EXTENDED ❑AQMD
PERMITFINAL �20�z0-CkvAC ASBESTOS NOTIFICATION IS NOTAPPUChBLE TO
CERTIFICATE OF qn� , PROPOSFD DEMOLITION
OCCUPANCY ISSUED SIGNATURE:
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