HomeMy WebLinkAboutX2020-1728 - Permits�v,rr, City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2020-1728
ii r�� 100.Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 0 1 7 2 8 Project No : 0201-2019
t�+ Permit Counter Phone (949)644-3288
u $ Inspection Requests Phone (949)644-3255
°:rA,,,,r, y.'" Combination Type - GRAD Issued Date : 07/3012020
Inspection Area : 4
PERMITEXP/RES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 07/31/2023 OR PERMIT INILL 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: 95 JASMINE CREEK DR NB
Description: SFR "CHANGE OF CONTRACTOR CITY STANDARD DRAINAGE
Legal Desc.: N TR 0427 LOT 11 •��
Z
Owner: GATES MARGART GATES
Contractor:
OWNER/BLDR
Architect:
Address: 424 VISTA FLORA
Address:
MARGARET GATES
Address:CD
NEWPORT BEACH CA 92660
Phone: 949-644-0962
Phone:
949-644-0962
Phone:
State Lie:
CD
Applicant: EVERSON TIM
Con State Lie:
O/B
Engineer:
Address: 9271 KREPP DR
Lie Expire:
Address:
0
HUNTINGTON BCH CA 92646
Bus Lie:
Phone: 714-745-2459
Lie Exp Date:
Phone:
State Lie:
Code Edit : 2019
Worker's Compensation Insurance
Designer:
Type of Construction:
Carrier:
Address:
Occupancy Group: U
Policy No:
DO
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: I
Bldg Height: 0
Left: I
Bldg Sprinklers:
Right: /
Flood Zone: X
Use Zone: Parking 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 :.
$36.00
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: $0.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee:
$0.00
Building Dept Adm
$0.00
Energy Compliance: $0.00
Grading PC Fee:
$0.00
Public Works Department-
General Service
$0.00
CA Seismic Safety: $0.00
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Refund Deposit
$0.00
Disabled Access: $0.00
P/W Plan Check:
$0.00
Grading Bond:
$0.00
Hazardous Mat $0.00
Electrical %:
$0.00
San Dist:
$0.00
Building Green Fee : $0.00
Mechanical W
$0.00
NMUSD Fee:
$0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE : $35.00
_ Plan Check Fee :
$0.00
Fee Due at Permit Issuance :
$35.00
PROCESSED BY:
'Eh/ 1. r'
`.
PUBLIC WORKS APPROVAL:
ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
APPROVAL TO ISSUE:
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors' Stale License Law for the mason(s) in
Section 7031.5, Business and Professions Code: Any city or countythat requires a permit to construct, alter, Improve, d
he permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State Licen:
professions Code) or that he or she is exempt from licensors and the basis for the alleged exemption. Any violation of SI
iot more than five hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, throur
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of co
mproved for the purpose of sale).
❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 70�
apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contrac
❑ 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 or
sell a structure that I have built as an owner -builder if it has not been constructed In its entirety by licensed contractors. I
Professions Code, is available upon request when this application is submitted or at the following Web sihshttp:/NAvw.le
Signature of Property Owner or Authorized Agent
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70t)0
and effect. License Class License No _ Date
VORKERS' COMPENSATION DECLARATION
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
DST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR 001
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 Dire
formance 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
Trance carrier and gli tey number are:
1e of Agent --i�.3.'. L. SY WJ L. ;'>I •'
certify that, In the performance of the work for which is permit Is issued, I shall not employ any person in any m:
, if I should become subject to the wo rs' IT lion provisions of Section 3700 of the Labor Code, I shall to
Iature of Applicant '\Z I .f% -
JLARATION RE(314KD GF TRU LENDING AGENCY
reby affirm under penalty of perjury t at there is a construction lending agency for the performance of the work for
der's Name Lender's Address
Try 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 re ling to b IdIng construction.
I authorize representatives of this city or coyatyA(b enter thp�6ove-identified r f spectlon purposes,
DATE
PERMIT EXPIRED
CERTIFIC4TEOF
OCCUPANCY IS5UE0
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
NOTIFICATION
Gated below by the checkmark(s) I have placed next to the applicable Items)
nolish, or repair any structure, prior to its issuance, also requires the applicant for
Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
lion 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
work, and the structure is not intended or offered for sale (Section 7044,
Aoyees' or personal effort, builds or improves the property, provided that the
on, the Owner -Builder will have the burden of proving that It was not built or
Business and Professions Code: The Contractors' State License Law does not
pursuant to the Contractors' State License Law).
that a copy of the applicable law, Section 7044 of the Business and
Date
on of the Business and Prof gssions C17 and my license is in full force
rirractor Signature
/,/�
AND CIVIL PINES UP TO ONE HUNDRED THOUSAND DOLLARS IN D0,000), IN ADDITION TO THE
of Industrial Relations as provided for by Section 3700 of the Labor Code, for
of the work for which this permit is Issued. My workers'
Date
so as to become subject to the workers'comyXinsation laws of California, and agre,
i comply with those provisions. \
1 this permit is Issued (Section 3097, Ofvil CodSJ.