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HomeMy WebLinkAboutX2020-2817 - PermitsCity of Newport Beach - Building Division 1111111111i�E!EI!�o1�11111o���1!11!�11�91111 COMB Permit: X2020-2817 100 Civic Center Drive, Newport Beach, CA 92660 Project No: 0773-2020 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Issued Date: 12/02/2020 r n. Combination Type - BLDG GRAD Inspection Area: 5 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 12l03/2023 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: 26 GONDOLIERS BLUFF NB Description: SFR YARD DRAINAGE Legal Desc.: a Owner 7 SCORE PROPERTY Address: 26 GONDELIERS BLF NEWPORT COAST CA 92657 Phone: Applicant: JONSSON JEFFREY Address: 946 CALLE AMANECER #C SAN CLEMENTE CA 92673 Phone: 949-412-3955 Code Edit: 2019 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: Construction Valuation: $0.00 Building Permit Fee: $0.00 Plan Check Fee: $0.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $2.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access: $0.00 Hazardous Mat $0.00 Building Green. Fee: $0.00 TOTAL FEE: $429.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Contractor: LESLIE SAM CONSTRUCTION Architect: Address: P O BOX 58 Address: BONSALL CA 92003 Phone: 760-468-2020 Phone: Con State Lie: 452391 Engineer: Lie Expire: 07/31/2021 Address: Bus Lie BT30072967 Lie Exp Date: 0911712021 Phone: Worker's Compensation Insurance Designer: Carrier: EXEMPT Address: Policy No: No employees Expire: Phone: State Lie: State Lie: Building Setbacks Use Zone: Rear: / Front: / Left: / Right: / Parking Spaces: 0 Special Conditions: Fire Hazard Zone: N Excise Tax: $0.00 Planning Department - Fire Department Additional Fee: $0.00 Plan check Fee: $0.00 Fire Inspection: Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev Grading PC Consultant: $0.00 SJH Trans: $0.00 Demolition Fee Grading Permit Fee: $232.00 In -lieu Housing Fee: $0.00 Building Dept Adm Grading PC Fee: $195.00 Public Works Department - General Service WQ Insp. Fee: $0.00 Park Dedication: $0.00 Refund Deposit PM Plan Check: $0.00 Grading Bond: Electrical %: $0.00 San Dist: $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 Plumbing %: $0.00 ' t. $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $429.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: Cc 0 0 000000 0 0 0 0 0 0 0 00 0 0 0 0 0 0 00 0 00000 0 moo�a 000000 0 0 0 0 0 000000 0 0 0000 OWNER-BUILDERI'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 Rem(s) (Section 7031.5, Businessand 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 U 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, 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 propertyjwho 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 Ilcensu el under the Contractors' State License Law for the following reason: By my signature below [;'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 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 ayaillable upon request when this application is submitted or at the following Web sKe:http://Www.leginfo.ca.gov/calaw.htmI. Signature of Pr6l56ffy owner pr Authorized Agent Date LICENGED CO�NTRACTO;R'S DECLARATION 1-hereby^affirm ender penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 00� �f D,>SG3iof the Business and Prof Ionlicense is in full force and effect. License Class License No Date L CContractor Signature .� DECLARATION V f,-RNIN,-S: 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 Il l i OF COMPENsk- �cP DAMAGES As PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under, p€salty of perjury one of the following declarations: have and will IT formsnce of thew, r c o have and wNl and c 11rrc ,aq Carrier and n "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 vOich this permit is issued. Policy No. wlorkers' 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' compensa number are: Policy Number Expiration Date e of Agent Phone N # I certify that, in the perfo lance of �WbIP Wwhhis permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensatio laws of California, and agreifI should become u eet'tion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. cl- Signature of Applicant Date1 DECLARATION REGA N RUCTION LENDING AGENCY I hereby affirm under pen Ity of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, JViI bode). Lenders Name Lender's Address By my signature below, I Ge try 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 i c I agree to comply with all applicable city and coqn rdinan aws relating to building construction. G Zl I authorize representatives of this city or countynter e-identified property for inspection purposes.e`F vi Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name DV ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGU TIONS PART 61 OF TITLE 40 AND AQMD RULE 14 PERMIT EXPIRED,llI SUBMITTED ASBESTOS NOTIFICATION TO PERMIT C4NCELLED UEPA PERMIT EXTENDED QM D PERMIT FINAL JASBEST, NOTIFICATION IS O CERTIFIC4TEOF'�, OSEMOLITION OCCUPANCY ISSUED ssrnln IRF k