HomeMy WebLinkAboutX2019-0582 - Permits��Nnok} City of Newport Beach - Building Division IIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIII�i111III
0 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 0 5 8 2
ti n Permit Counter Phone (949)644-3288
v �„ M. Inspection Requests Phone (949)644-3255
�e ° t,r,iuµ`' Combination Type - BLDG GRAD
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALI SPECT
Construction Hours: Monday - Friday 7:00 a.m, to 6:30 p.m. and Saturday from 8:00 to 6:00 p.m. o
Job Address: 324 HAZEL DR NB
Description: SFR REPAIR RETAINING WALL WI CAISSONS
Legal Desc.: TRACT NO 673 BLK A LOT 51 AND POR ABAND STR (GLEN DRIVE)
Owner: TILLNER CHAD Contractor: OWI
Address: 324 HAZEL DR Address:
CORONA DEL MAR, CA 92625
Phone: 949.362-8673 Phone: ,
Applicant: TILLNER CHAD Con State Sic' O/B
Address: 324 HAZEL DR Lie Expire. -
CORONA DEL MAR, CA 92625 Bus Lic:
Phone: 949-362-8673 .<'Lic Exp Date:
Code Edit: 2016 .,r's Worker's Cwoemiati s
Type of Construction: V-B > ` C ier
Occupancy Group: U .d�`j •! olicy N
-Added /New sq.ft. Bldg: 0 �. Exp,
Added /New sq. ft. Garage: 0
No of UnisStories: Bu s S�e�tb;$ck Rear:
No of Units : ' �4+' � Fronj;:.
Bldg Height: - 0 rate, g {
Bldg Sprinklers. ® Ct, t
Flood 7nne: se Zone: in
IL_C oq; 90 0.00
Building Permit Fee: $1.;043100 '
Plan Check Fee: $61.00
Ovemme Plan Ck
'$0.00%
InvLadgatlon Fe=
$0.00
-Peco:d Management:
$0.00
Ene•cy Compliance:
$0.00
CA Seismic Safety:
$0.00 .
Disabled Accees :
$0.00
:1a"rJuus Mat
$0.00 .
Building Green Fee _
$4.00
TOTAL FEE: $2,316.37
PROCESSED BY:
ZONING APPROVAL:
Excisea $0.00
dditiosup. ($616.38)
ding e: $0.00
G 'ng P it Fee:: : $67 1
Gr Permit Fee: $ (jam
g PC Fee: $1
O Insp. Fe°°°e►►►: 6/a0�\ $(�.e
Electr al 91 T �� 0.00
a al O(�� $0.00
COMB Permit: X2019-0582
Project No: 0478-2018
Issued Date : 05/28/2019
Inspection Area : 5
work on Sundays or Holidays
u
�,,p4lghfBl:�� �n
O Phone:
O�C7 sneer: SURPRENANT MI
O((� Address: 9975 BUSINESSPP
�r SAN DIEGO CA 92'
W �O Phone: 619-531-0757
Lic:
#A
A �"0 Designer:
Address: .^
Phone: �f�',�J
Special C do SIB FORM ATTACHED
0 11211% lne : N
rA .
�II ��O�yv- i
Planni partmeT+t- �rwfieD rtment
Plan check Fee : 0.00 Inspection: $0.00
Fair Share : $010's ire Plan Rev $0.00
SJH Trans : . 0 Demolition Fee
In -lieu Housing $0 Building Dept Adm $0.00
Public Work apartment General Service $0.00
P r icat!on : $0 Refund Deposit $0.00
Ian Che k . .75 Grading Bond: $0.00
an Dist: $0.00
NMUS as, $0.00 $0.00
$0.00
$0.00 Fee Due at Permit Issuance : $2,316.37
PUBLIC WORKS APPROVAL: ✓F-
PLAN CHECK BY: Iv1"
GRADING APPROVAL: Ji rq 0 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 reasons) 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 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 Pena% 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 (_) portions of the work, and the structure is not intended or offered for sale (Section 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
5my
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).
exempt from licensure under theContractors' State License Law for the following reason:
ignature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to compI a impro merits covered by this permit, I cannot legalll
ucture that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand opy of the applicabl law, Section 7044 of the Business and
ons Code, is available upon request whe t is application is submitted or at the following Web site:hftp://www.legin v/calaw.hi ml.
Signature of Property Owner or Authorized Agent Date✓te� s
LICENSED CONTRACTOR'S DECLARATION' d
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (Com with Section 700 go'lo iSAiii 3 of the By�iflp�s� tl-Profess ns Code, and my license is in full force
and effect. License Class License No Dat� aaa p�i C §r Signature
WORKERS' COMPENSATION DECLARATION Q`�'0/0 OC
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UL, AND SH ECT A YE R TO CRIMINAL P�JAL77ES AND CIVIL FINES UP TO ON RED THOU No DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTI THE LABOR D5, ATTORNEY'FEES.
hereby affirm under penalty of perjury one o owing declar3<pSRs. ��rN,�h�C'i�•
❑ 1 have and will maintain a e of consent to self -in or workers' compensation issued. by the DirectAQflodustrial Relations as provided for by Se 'on 3700 of the Labor Code, for th
eerformance of the work for w h this per If s.issue Icy No.
❑1 have and will malntalr,iOor rs' c sation insurance -,as req Pik by Section 37(0, the Labor Code, for the performance of the work for which this permit i issued. My workers' compensatiol
nsurance carrier and policy!Wm er are: -�
of Agent- '
rtify that, in the performance
I should become sub'ect to I
ure of Applicant
yWk
rreby affirm under penalty of perjury at th I
Ider's Name
my signature below, I certify to each dithe
I am the property owner or authorize o act
I have read this application and the in!
mat
I agree to comply with all applicable cit nd
I authorize representatives of this city o oIl
ACTION I DATE
PERMIT CANCELLED
PERMIT EXTENDED
ta.
Ph this permit is Issued,+l 9FFV `15j dtfilo U IM-yopeIS
pensaticn provisions of Section 3700 of the Labor Cc
ENgING AGENCY ,
a constructeq Wlidfig agency for the performance of
ir_ , Lender's Address
the property owner's behalf.
�tofyy{trdrit.
O al
12
I have pro ed
r
t�aiqg to building col
a �,ct,bJM4
for inspection p
DECLARATION OF C(
REGULATIONS PART
1403
FEDERAL
PERMITF/NAL UASBESTUS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF PROPOSED DEMOLITION
OCCUPANCYISSUED SIGNATURE:
Expiration Date TA
Phone #
manner so as to become subj t t mpensa'on laws of California, and ag*
forthwith comply with thosisi s \!!A (�
Dat
w h permit i puecuti n 3097, Civil Code).
C
in+t\a\5'
's or Authorizad7caent' qi (,,llh l°P nate 5'2b'-/9
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