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Home My WebLink AboutX2020-2922 - PermitsCity of Newport: `leach - Building Division .�' 100 Civic Center Drive, Newport Beach, CA 92660 ' Permit Counter Phone (949)644-3288 se - Inspection Requests Phone (949)644-3255 Combination Type- GRAD IIIIP��'lJil COMB Prit zo s 020-2922 Issued Date : 1211512020 Inspection Area : 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 1211612023 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: 1207 BLUE GUM LN NB Description: SFR YARD DRAINAGE (CITY STD PLAN) Legal Desc.: N TR 9620 LOT 11 Owner: KHUDIC STEFANIKHUDIC LISA LEE Address: 1207 BLUE GUM LN NEWPORT BEACH, CA 92660 Phone: 714-814-1011 Applicant: KHUDIC LISA Address: 1207 BLUE GUM LN NEWPORT BEACH CA 92660 Phone: 714-814-1011 Code Edit: 2019 Type of Construction: VB Occupancy Group: U Added /New sq.ft. Bldg: Added /New sq. ft. Garage: No of Stories: 0 No of Units: 0 Bldg Height: 0 Bldg Sprinklers: Contractor: OWNER/BLDR Architect: Address: KHUDIC LISA Address: - Phone: Phone: State Lie: Con State Lie: OIB Engineer: Lie Expire: Address: Bus Lie: Lie Exp Date: Phone: State Lie: Worker's Compensation Insurance Carrier: Policy No: Expire: Building Setbacks Rear: I Front: / Left: I Right: I Designer: KHUDIC LISA Address: 1207 BLUE GUM LN NEWPORT BEACH CA 92660 Phone: 714-814-1011 Special Conditions Building Permit Fee: $0.00 Excise Tax: $0.00 Planning Department - Plan Check Fee: $0.00 Additional Fee : $0.00 Plan check Fee: Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share: Investigation Fee: $0.00 Grading PC Consultant : $0.00 SJH Trans: Record Management: $2.00 Grading Permit Fee: $232.00 In -lieu Housing Fee: Energy Compliance: $0.00 Grading PC Fee: $195.00 Public Works Department - CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Disabled Access : $0.00 PAN Plan Check : $0.00 Hazardous Mat $0.00 Electrical W $0.00 San Dist: $0.00 Building Green Fee : $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 Plumbing %: $0.00 TOTAL FEE: $429.00 PROCESSED BY: ZONING APPROVAL: Plan Check Fee Fire Department $0.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: $0.00 Fee Due at Permit Issuance 9(„BLiC V30R'KS APPROVAL ♦ e a �a� a a PLAN CHECK BY: GRADING APPROVAL: 'XPPRQVVTOA"5UV!6 ;', o a a $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $429.00 OWNER -BUILDER DECLARATION 1 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) ction 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 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 Sectior 7000) of Division 3 of the Business and fessions 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 tht, applicant to a civil penalty of 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, iness 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 NFov �ments 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 ,d for the purpose of sale). U I, 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 p o 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: _ 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 legall7 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 sth�"app tali I sub rat t�he�ollpwi�rfg Web site:http:/Aw .leginfo.ca.gov/calaw.html. \ l signature of Property Owner or Authorized Agent 7i �� ii�Ci( �r I D3te'� 2 l ) rJ �20 ac .ICENSED CONTRACTOR'S DECLARATON hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force nd effect. License Class License No Date Contractor Signature VORKERS' COMPENSATION DECLARATION 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEN LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE DST 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: 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 th erformance of the work for which this permit is issued. Policy No. ]I 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' compensatiol isurance carrier and policy number are: I 3arrier Policy Number Expiration Date of Agent Phone# I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manned so as to become subject to the workers' compensation laws of California, and agre, hat, if I should become subject to the workers' compensation pproviisionns'Qf Section 3700 of the Labor Code, I shall forthwith comply with those provisions. / / signature of Applicant J TV 1.UA w Z//S(202.0 )ECLARATION RI DING COKSTRUCT ON LENDING AGENCY hereby affirm under of alty 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). _ender's Name Lenders 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 county ordinances and state laws relating to building construction. 1 authorize representatives of this city or count o ter th bove= a tified pro ertyfior inspection purposes. �1 G' Signature of Property Owner or Authorized Agent , 1 Print Property Owners or Authorized Agent's Nam L.ISQ. Kh Vd l C DO I Z) ACTION DATE By MCLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY - REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 • ••• a ••• ••• ••• PERMITEXPIRED LJ ISUBMIiTEOaASBESTOSNOTIFICATIONiFO • - PERMITCANCELLED EPA • • • • •• • • •• PERMIT EMENDED LJAQMD PERMITFINAL OASEIESTOS NOTIFICATION IS NOTAPPLICABLE TO CERTIFIC4TEOF PROPOSEQa1M6fl:IOjJ•• ••• ••• •�• OCCUPANCYISSUED SIGNATURE:• + • • + • a • a • s s ee eee e e ea •o eoe