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Home My WebLink AboutX2019-2161 - Permits.,� City of Newport Beach - Building Division COMB Permit: X2019-2161 GRAYSTONE CUSTOM BLDRS INC A + I IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 2 1 6 1 Project No: 0195-2019 0 Phone: Permit Counter Phone (949)644-3288 849-466-0900. :,. al Inspection Requests Phone (949)644-3255 Engineer: n 0313112020 Combination Type - BLDG PLUM Issued Date: 07/1212019 w*k° e loo' o° ° c Inspection Area : 1 ° oVOTAL FEE: $1,472.00 Worker's Compensation Insurance PERMITS EXPIRE 480 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Carrier STATE FUND Address: 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: 2132 SEVILLE AVE NB 08/1512019 Description: DEM SFR & GARAGE 1310 SF. SEWER CAP INCLUDED Legal Desca N TR 948 LOT 95 - Owner:: GORE TOMMY & KIM Address: 2128 MIRAMAR DR NEWPORT BEACH, CA 92661 - Phone: Building Permit Fee: $0.00. Applicant: GRAYSTONE CUSTOM BLDRS INC Address: 3419 VIA LIDO STE 455 Grading PC Consultant: NEWPORT BEACH CA 92663 Phone: 949.466.0900 Code Edit: 2016 .Type of Construction: V -B Occupancy Group: R31U Added /New sq.ft. Bldg: ` 1310 Added /New sq. ft. Garage:. 0 No of Stories: 2 No of Units : 1 Bldg Height:. 0 Bldg Sprinklers: 'PROCESSED BY: 0 ° o ZbNING AgOftoVAL: GRADING Apf f °OWAL: Contractor: Building Permit Fee: $0.00. Architect: Plan Check Fee: $0.00 3419 VIA LIDO STE 455 Overtime Plan Ck $0.00 Grading PC Consultant: Investigation Fee: $0.00 Grading Permit Fee: Record Management: $0.00 849-466-0900. °Erergy CompliwsE :, $0.00 Con State Lic: CAoS,ejsmic SlOty: o $0.00 Engineer: Disabled Access: $0.00 0313112020 .hsa,F�odous Mab $0.00 Bus Lic: ng Green °Fee ° $1.00 e loo' o° ° c 03131/2020 ° oVOTAL FEE: $1,472.00 Worker's Compensation Insurance Designer: Carrier 'PROCESSED BY: 0 ° o ZbNING AgOftoVAL: GRADING Apf f °OWAL: Contractor: GRAYSTONE CUSTOM BLDRS INC Architect: Address: 3419 VIA LIDO STE 455 Address: Grading PC Consultant: NEWPORT BEACH CA 92663 Grading Permit Fee: Phone: 849-466-0900. Phone: Con State Lic: 971085 Engineer: Lic Expire: 0313112020 Address: Bus Lic: BT30040067 Lic Exp Date: 03131/2020 Phone: Worker's Compensation Insurance Designer: Carrier STATE FUND Address: Policy No: 9216106-2018 Expire: 08/1512019 .Phone: State Lic FORBES DALE L 1800 E 16TH ST #B SANTA ANA CA 92701 714-835-2800 State Lic:C-030407 Building Setbacks Rear: I Special Conditions: TIGHT QUARTERS TO Front: I HAUL DEBRIS Left: Right: Use Zone: Excise Tax: $0.00 Additional Fee : $0.00 Grading Bonds Fee: $0.00 Grading PC Consultant: $0.00 Grading Permit Fee: $0.00 Grading PC Fee: $0.00 WQ Insp. Fee: $108.00 Electrical %: Mechanical %: Plumbing %: $0.00 $0.00 $0.00 Plan Check Fee 0 Fire Hazard Zone : N A n� Planning Department ;-0 i s 3 re Dle, �'mPlan check Fee : $000' Fire pEcti._ n Fair Share : J$q oq� aFr[@Ar�ew SJH Trans ; $0.00 Demolition Fee In -lieu Housing Fee: $0.00 Building Dept Adm Public Works Department - General Service Park Dedication $0.00 Refund Deposit P/W Plan Check : $0.00. Grading Bond: San Dist: $0.00 NMUSO Fee: $0.00 $0.00 Fee Due at Permit Issuance PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: $0.00 $0.00 $26.00 $210.00 $1,127.00 $0.00 $0.00 $0.00 $1,472.00 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 'rofessions 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 of more than five hundred dollars ($500). - I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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 n roved for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors to construct theproject(Section 7044, Business and Professions Code: The Contractors' State License Law does not pply to an owner ofpropertywho builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). 7 I am exempt from licensure under the Contractors' State License Law for the following reason: ly 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) ell 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 'rofessions 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 .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 00) of ivisi 3, of the Business and Professi n and my I' se is in full force nd effect. License Class License No Dat U Contractor Signatur IIORKERS' COMPENSATION DECLARATION ARMING: 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 OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 7706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I 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 th SP rmance of 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' compensatio 05, nce carrier and policy number are: r Policy Number Expiration Date Name of Agent Phone # ❑1 certify that, in the performanc t e work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre that, if I should become subjec orke ' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant k Date DECLARATION REGARDING C - TRUCTION LENDING AGENCY hereby 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, Civil Code). Lender's 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 have provi a is correct. : • • • ° • °"• I agree to comply with all applicable city and county ordin ces d state laws relating to building construction. , • , I authorize representatives of this city or county to ante -ide ' d property for inspection purposes. ;..... Signature of Property Owner or Authorized Anent Print Property Owner's or Authorized Agent's Name 12 —,402CDA Date ACTION DATE OY 'W ft`DECLAR&JDN OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY • ,••,. °�• REGULATIONS PART61 OFTITLE 40 ANDAQMD RULE :• • •• 1403 PERMITEXPIRED El I SUBMITTED ASBESTOS NOTIFICATION TO :�• • •• PERMITCANCELLED LIEPA PERMIT EMENDED• ° QMD • • ••• PERMITFINAL LIASBESTOS NOTIFICATION IS NOTAPPLICABLE TO •°• CERTIFICATEOF PROPOSED DEMOLITION •••°• OCCUPANCY ISSUED SIGNATURE: ••••