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Home My WebLink AboutX2019-1762 - PermitsCity is Newport Beach - Building Division IIIIII1111111111111111 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit :X2019-1762 a u 100 Civicunter hone°P49)64d.!l2J8 ;CA n2°6Fi0 *� Permit Counter shone°(y49)Ega-;2ti8 m" a o X 2 8 1 9 1 7 6 2 4 Inspection Requests'PMne j9491r;44-�p m ° ® Project No: 2276-2017 P°;~rrhvrtsr Combination Type - BLDG Issued Date :06/04/2019 ° ®® Inspection Area : 4 ri'd EXPIRE Y80 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Constir�rion Tours: l�lontlny -Friday fa00 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: 3621 SAUSALITO°DR MB ° ° ° ° ° ° ° Description: (2) 5' PILASTERS (INSIDE P/L) 12"X12^ (CITY STANDARD) Legal Desc.: N TR 6229 LOT 6 Owner. E 21 SAUS GARY Contractor. G D M LANDSCAPE Address: COR SAUDELITO R, Address: 31878 DEL OBISPO, STE 918 4435 CORONA DEL MAR, CA Phone: Applicant: GRANT/GDM LANDSCAPE Address: 31878 DEL OBISPO #11-435 SAN JUAN CAPISTRANO CA 92675 Phone: 949433-0057 - -.Code Edit 2016 Type of Construction: V.B 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: $0.00 Plan Check Fee: $0.00 Ovenime 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: $125.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Phone: SAN JUAN CAP CA 92675 Planning Department 949-433-0057 Con State Lic: 881282 Lic Expire: 09/30/2019 Bus Lic: BT30048427 Lic Exp Date: 09/30/2019 Worker's Compensation Insurance Carrier: SECURITY NATIONAL INS CO Policy No: SWC1231168 Expire: 03/21/2021 Building Setbacks Rear: 6 Front: 6 Left: 6 Right: 6 Excise Tax: Additional Fee: Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: $0.00 $124.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Plan Check Fee: Architect Address: Phone: Engineer: !AeH6 Address: 12M'N' F�E Phone: Designer: Address: Phone: Special Conditions: 0 Fire t Planning Department $0.00 Plan check Fee $0.00 Fair Share Fire Plan Rev SJH Trans $0.00 In -lieu Housing Fee Public Works Department -. Park Dedication : $0.00 P/W Plan Check.: ' $0.00 San Dist; $0.00 NMUSDFee: $0.00 State Lic: $0.00 Fee Due at Permit Issuance : $125.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: 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 j"r` $0.00 3 GYadir}g Vona^.., ] $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $125.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: .. ......... .. ... OWNER -BUILDER DECLARATION P I � � W .T .� @ I hereby afprm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) indicated below by tha o� rrN�r�wilh�6ection�7e of Divis on c:next to the applicable the eBusiness and ;Ilion 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or reai a str t e, r r I I sua ce, also requires the applicant for I permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 too 3fessions 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 t more than five hundred dollars ($600). all of or ortions of the work, andlhe structure is not iuttNided or-oifeevot oro le (Section 70 that the 44, I io . owner of properly who, through employees' �yQrsoQal e1foQ„I�uil@s or ihlPjOvg 1 ,P P Y. provided I, as owner of the properly, or my employees with wages as their sole compensation, will do (_) I_ P Isiness and Professions Code: The Contractors' State License Law does not apply provements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Orv� �r-B �i�der will have she burden of pawing that it was not w or proved for the purpose property, sale).-- and ions Code: The ' I, as owner of I to an ownertof proprty who builds or imp oveactors' State Loense s thereon, a d who contracts for the projects with a I tensed Contract r pursu nt to he ContrLatW)s' State license Law does no PY I am exempt from licensure under the 11 Contractors' State License Law for the following reason: yll a structure below l have built le anethe Iownere-builder�f R has not been constructed in itslentisety by I tensed t have iesided contractors. I understand that a copy of thiefion of eapplicable law. Section 7044ofthe Buhis lsinessnand not ega rofessions Code, is available upon request when this application is submitted or at the following Web site:http://Www.leginfo.ca.gov/calaw.html. Date ignature of Property Owner or Authorized Agent d m license is in full force ICENSED CONTRACTOR'S DECLARATION, Contractor Signat hereby affirm under penalty of perjury that I am licensed under cnsoe INo ns of Chapter 9 (commencing with Section 7000 f Di ision 3 of the Business and P of ssi o e, Y nd effect. License Class YORKERS' COMPENSATION DECLARATION HE !OSTIOF COMPENSATOION CDAMAOES AS PROVIDED FORURE TION IN SECTION COVERAGE7 I$ UNLAWFUL, AND SHALL THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. RIMINAL PENALTIES PND CIVIL FINEe UP TO ONE HUNDRED THODSANO LARS IE�aD,00a1, IN ADDITION TO T NG: FAILURE hereby 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 rmance of the work for which this permit is issued. Policy No. for the erformance of the work for which this permit is issued. My workers' compensatio rl Lave and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, P nsu rice carrier and policy number are: Expiration Date Policy Number phone # ier lame of Agent is issued, that,ifI certify that, bethe performance ers' ork or which this erwlisions of Selct on113not 700 ofthe LaboPCode II shall forthw th complybwith hose pI cutis ons. to the workers' co �pen� t�S laws of California, an agreDat2�i��ooSignature of Applican DECLARATION REG TION LENDING AGENCY I hereby affirm under penat there is a construction lending agency for Lendeer's Address of the work for which this permit is issued (Section 3097, CivilCode). Lender's Name 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 have provided is correct. I agree to comply with all applicable city and county ordinr�a-nccte,�sand state laws relating to building construction. � L A(' /�,.� �p Date I authorize representatives of this city or county to enter �5�1V "be -identified property for inspection operty Owners a Authored Agents Name or Authorrzea Agent DATE BY DECLARATI OF COMPLIANCE W ITN CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMIT EXTENDED PERMIT FINAL ASBESTOS NOTIFICATION IS NOT APPLICABLE TO OCCUPANCYISSUFnk! PROPOSED DEMOLITION CERTIFICATE OF ir0 �G- SIGNATURE