HomeMy WebLinkAboutX2019-0548 - PermitsCity of Newport Beach-;30-fing Division llrl��� 111 I�IL���I II
I��I I��III�� I II
COMB Permit: X2019-0548
')rive., Civic Cente-')rive., Newport dedct, CA F26,30 X 2 0 1 9
-
0 5 4 8
Project No : 2187-2018
H Permit Counter Phone (949)644-3288 -
v x Inspection Requests Phone (949)644-3255
h^�<eruwsr,' Combination Type - BbDG ^
Issued Date : 02/20/2019
Inspection Area : 2
PERM, TS EXPIRE1$O GAYS AF(ER ISSUANGc OP!.AST
VALID INSPECTION.
Construction Hours: Monday - Friday 7:00 a.m.'tg'6:30 p.m. and Saturday from 8:00
a.m. to 6:00 p.m. No work on Sundays or Holidays
Job Address: 333 HOLMWOOD DR NB
Description: BLOCK WALL 6' X 73', RET WALL 6' X 20', SHORING WALL 30 LF
Legal Desc.: N TR 1136 LOT 15
Owner: ATKINS JEFFERY S Contractor: CLAYTON BUILDERS INC
Architect:
Address: 333 HOLMWOOD DR Address: 735 FARAD STREET
Address:
NEWPORT BEACH, CA 92663 COSTA MESA, CA 92627
Phone: Phone: 949-279-5910
Phone:
State Lic:
Applicant: GUIDERO BILL Con State Lic: 846631
Engineer:
PURKIS DAVID ALAN
Address: 425 30TH ST STE 23 Lic Expire: 09/30/2020
Address:
32521 CARRETERRA DR
NEWPORT BEACH CA 92663 Bus Lic: BT30043010
SAN JUAN CAP CA 92675
Phone: 949-675-2626 Lic Exp Date: 04/3012019
Phone:
949-661-6381 State Lic:C-042810
Code Edit: 2016
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:
Flood Zone:
Building Permit Fee: $412.00
Plan Check Fee: $365.00
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 :
$2.00
TOTAL FEE: $440.10
PROCESSED BY:
ZONING APPROVAL:
Workers Compensation Insurance
Carrier: NO EMPLOYEES
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: 0
Front: 10
Left: 4
Right: 4
Parkina Soaces
$0.00
($378.90)
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee
Designer:
GUIDERO BILL
Address:
425 30TH ST STE 23
NEWPORT BEACH CA 92663
Phone:
949-625-2626
Special Conditions: VA278
0
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
PEC
Fire Department
$40.00
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 : $440.10
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
OWNER -BUILDER DECLARATION _ - -
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State LicenseLaw fer the +easoi;(s) indi" ated below by The chectimorV,(s) i Fave paced next to the applicable item(s)
'Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, .nprova, demolish, or repair ahy structure, prior to its issuance, also requires the applicant for
:he 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-i pernit subjecte tha applicant to a civil penalty of
iot more than five hundred dollars ($500). - - - - - - - -
❑ 1, as owner of the property, or my employees with wages as their sole compensatioP, will do U all of or U-portion.: of the work, and the-structJre is not intended or affe+ed fir sale (Section 7044,
Business and Professions Code: The Contractors' State License Law does not apply to aii bw-.ia•^ of prnperty who, through e. np.oyees' or Farsonal 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 cuwple ;on, the Owner -Builder will have the burden of proving that it was not built or
i�m roved for the purpose of sale).
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
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).
❑ I am exempt from licensure 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 legally
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 /�77
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) vision the Business and Professio S a cgy j I f 111 force
and effect. License Class License No Date �i0 Contractor Signatur
WORKERS' COMPENSATION DECLARATION
NARNING: 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 ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
❑ 1 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 the
performance of the work for which this permit is issued. Policy No.
have 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
Trance carrier and policy number are:
Tier Policy Number Expiration Date
Nn of Agent Phone#
ce fy that, in the performance of the work for whi'vh this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation la s of California, and agree
I, if should become, subject t th rkers' corm a ion pr � iD of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant X Date
CLARATION REGARMNG CONSTRUCTION LENDING ENCY
„dreby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civl Code).
-ender's Name Lender's Address
3y 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 coun ordin n es and st a aws rel ing to building construction.
I authorize representatives of this city or cou t e i n ro r inspection purposes.
Signature of Property Owner or Authorized AgenVO� Print Property Owner's or Authorized Agent's Nam
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED I U I SUBMITTED ASBESTOS NOTIFICATION
PERMITCANCELLED I UEPA
PERM/TFINAL —30-Z3 11�yN.t✓ LJ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF (,I}XJ' PROPOSED DEMOLITION
OCCUPANCY ISSUED SIGNATURE:
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