HomeMy WebLinkAboutx2020-0967 - Permitsp° City of Newport Beach - Building Division IIIIII�IIIIIIIIIIHIIIIIIIIIIIIIIIIIIIIIIIIII� III COMB Permit: X2020-0967
cY - t 0o Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 0 0 9 6 7
t' Permit Counter phone (949)644-3288 Project NO : 0699-2020
v Inspection Requests Phone (949)644-3255
r r x'' Combination Type - GRAD Issued Date
6
Inspection Area: 4
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0511512023 OR PERMIT WILL BE INVALID
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: 1842 PORT SHEFFIELD PL NB
Description: SFRYARDDRAINAGE
Legal Desc.: N TR 6620 LOT 8
Owner. PURDY COURT B
Contractor:
REED R W COMPANY INC
Architect:
WALZ JOHN ROBERT
Address: 1842 PORT SHEFFIELD PL
Address:
419 MAIN ST #289
Address:
510 LARKSPUR AVE
NEWPORT BEACH, CA 92660
HUNTINGTON BEACH CA 92648
CORONA DEL MAR CA 92625
Phone:
Phone:
714-717-6380
Phone:
949-836-5977 State Lic:C031388
Applicant: WALZ JOHN ROBERT
Con State Lic: 376722
Engineer:
Address: 510 LARKSPUR AVE
Lic Expire:
11/30/2020
Address:
CORONA DEL MAR CA 92625
Bus Lic:
BT30062698
Phone: 949-836-5977
Lic Exp Date:
03/31/2021
Phone:
State Lic:
Code Edit: 2019
Worker's Compensation Insurance
Designer:
Type of Construction: VB
Carrier:
NO EMPLOYEES
Address:
Occupancy Group: U
Policy No:
Added /New sq.ft. Bldg: 0
Expire:
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 0
Building Setbacks
Rear. /
Special Conditions:
No of Units : 0
Front: /
Bldg Height: 0
Left: I
Bldg Sprinklers:
Right: /
INSPECTOR
Flood Zone: X
Use Zone:
Parkina Spaces: 0
Fire Hazard Zone : N
Construction Valuation: $0.00
Building Permit Fee: $0.00
Excise Tax:
$0.00 Planning Department
-
Fire Department
Plan Check Fee: $0.00
Additional Fee:
$0.00 Plan check Fee :
$0.00 Fire Inspection:
$0.00
Overtime Plan Ck: $0.00
Grading Bonds Fee:
$0.00 Fair Share :
$0.00 Fire Plan Rev
$0.00
Investigation Fee: $0.00
Grading PC Consultant:
$0.00 SJH Trans :
$0.00 Demolition Fee
Record Management: $6.00
Grading Permit Fee:
$312.00 In -lieu Housing Fee:
$0.00 Building Dept Adm
$0.00
Energy Compliance: $0.00
Grading PC Fee:
$312.00 Public Works Department -
General Service
$0.00
CA Seismic Safety: $0.00
WO Insp. Fee:
$0.00 Park Dedication :
$0.00
Refund Deposit
$0.00
Disabled Access: $0.00
PAN Plan Check:
$38.00
Grading Bond:
$0.00
Hazardous Mat $0.00
Electrical %:
$0.00 San Dist:
$0.00
Building Green Fee : $0.00
Mechanical %:
$0.00 NMUSD Fee:
$0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE : $668.00
Plan Check Fee: $668.00
Fee
Due at Permit Issuance :
$0.00
PROCESSED BY:
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GRADING APPROVAL: m APPROVAL TO ISSUE:
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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 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
not more than five hundred dollars ($500).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or L) 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
'.improved for the purpose of sale).
�i❑ 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).
❑ 1 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, 1 cannot legal)
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:hitp:/Ary .leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION _e ,r— }
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectlon,7 0 o Divi ion 3 of the Business and Pr44�f���551oa6 .odea d m�llfcense Is in full force
and effect. License Class License No Date 9� Contractor Signature)(
WORKERS' COMPENSATION DECLARATION h
WARNING: 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.
I 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 the
performance of the work for which this permit is issued. Policy No.
LJI 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
insurance carrier and policy: number are:
Carrier Policy Number Expiration Date
(ame of Agent - Phone #
LA,pertify that, in the performance of the 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 agree
that,)f I should becomes bjecj t W@TlUft1 ropensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of ApplicantY�
DECLARATION REGAPD NGI CONSTRUCTION LENDING AGENCY
I hereby affirm under pbnalty 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 owners behalf.
I have read this application and the information I have provided is correct.
1 agree to comply with all applicable city and county'dFdi-- " s an a laws relating to building construction.
I authorize representatives of this city or county t e v fied property for inspection purposes.
Signature of Property Owner or Authorized Agent 'Print Property Owners 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
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PERMIT EXPIRED El I SUBMITTED ASBESTOS NOTIFICATION TO i o •• • i �'®•
PERMITCANCELLEO EPA
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PERMIT EXTENDED qMD ,•--p w
PERMITFINAL ( S SBESTOS N T C IS NOT AP LI ABLE TO
PR OSED DEM� .>I • •• ,•••..w�w y•• �•• CERTIFICATE OF
OCCUPANCYISSUED .SIGNATURE:'.• `e •`" i ��.. es s i