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Home My WebLink AboutX2020-0405 - Permitswrrrq City of Newport Beach - Building Division 44. f r 100 Civic Center Drive, Newport Beach, CA 92660 ti a fF. n: Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - SFP Ili iiiiiiiiiiii II COMB Permit: Xe' Project No : 2491-2019 Issued Date : 02113/2020 Inspection Area : 5 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. 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: 4501 WAYNE RD NB Description: SFR -ADDL SCOPE (ADDED WINDOWS IN DINING AREA) Legal Desc.: N TR 3519 LOT 110 Owner: DE CARRIER JOHN Contractor: CARROLL RONALD L GEN CONTRACTORS INC Architect: INSPEA ra Address: 7642 W IRVINE PARK RD Address: P O BOX 7829 Address: NORRIDGE IL 60706 HUNTINGTON BEACH CA 92615 Phone: 847.343-2234 Phone: 714.749-0622 Phone: , State Lic: Applicant: JEHEBER ROD Address: 410 32ND ST STE 202 NEWPORT BEACH CA 92663 Phone: 949-723-4393 Code Edit : 2016 Type of Construction: VB Occupancy Group: R3/U Added /New sq.ft. Bldg: 0 Added/New sq. ft. Garage: 0 No of Stories: 0 No of Units: 1 Bldg Height: 0 Bldg Sprinklers: Construction Building Permit Fee: $328.00 Plan Check Fee: $285.36 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $18.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $693.16 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Con State Lic: 682756 Engineer: Lic Expire: 1013112020 Address: Bus Lic: BT30069697 Lic Exp Date: 1113012020 Phone: Worker's Compensation Insurance Designer: Carrier: WIC EXEMPT Address: Policy No: (NO EMPLOYEES) Expire: Phone: Building Setbacks Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: I Front: / Left: I Right: / king Spa $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0 FORBES DALE L 1800 E 16TH ST #13 ' SANTA ANA CA 92701 714-835-2800 State Lic:C-030407 JEHEBER ROD 410 32ND ST STE 202 NEWPORT BEACH CA 92663 Special Conditions: Planning Department - Plan check Fee Fair Share SJH Trans In -lieu Housing Fee: Public Works Department - Park Dedication : $0.00 P/W Plan Check: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 Fire Department $0.00 Fire Inspection: $0.00 $0.00 Fire Plan Rev $0.00 $0.00 Demolition Fee $0.00 Building Dept Adm $0.00 General Service $0.00 Refund Deposit $0.00 Grading Bond: $0.00 $0.00 $0.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $693.16 PUBLIC WORKS APPROVAL: pp�� PLAN CHECK BY: APPROVAL TO ISSUE: w/ \ 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 sale compensation, will do L) 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-Builderwill 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 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 Iicensure under the Contractors' State License Law for the following reason: By my signature velow 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 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 P. ofessicns Codq, iS AVPilable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Sicnature of Property Owner or Authorized Agent 1 Date L'CENSFD CONTRACTOR'S DECLARATION I herebv affirm une er penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) Divisio of the Business and Profe o d I full force and jffect. License Class License No Date Contractor Signature AIORKERS' COMPENSATION DECLARATION ' f VARNING:FAILURE TJ Sr -CURE 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 :OSI OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY's FEES. ;rlereby Rffirm under penalty of perjury one of the following declarations: I have and wi'l 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 r3rform2nce of th= work forwhich this permit is issued. Policy No. thave and will r,Iji,ltain 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 nsurance carrier and policy number are: :arrier Policy Number Expiration Date Vame of Agent Phone # :1I certify that, in the pe nce of the work for w 'ch this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' c pensation laws of California, and agre .hat, if I should become j e workers' co nsatidn provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant —�` )ECLARATION REGARDING CaNSTRUCTMOR 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). -ender's Name Lender's 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 he provided is correct. / I agree to comply with all applicable city and count ordinances and state laws relating to building construction. !/ I authorize representatives of this city or county to above -id d property for inspection purposes. Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Nam Date !� ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULW<NS PART 61 OF TITLE 40 AND AQMD RULE PERMIT EXPIRED rU I SU BMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED EPA PERMIT EXTENDED QMD PERMITFINAL CERTIFICATE OF OCCUPANCYISSUED S-Z`1-ZO p/ Vim-- A$BESTO FI ON IS NOT APPLICABLE TO P OSEDD I ��D IGN 1URF