HomeMy WebLinkAboutX2020-1188 - Permits�t�,ar�rD�� City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2020-11
vi 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 0 1 1 6 6 y Project No : 0909-2020
E» '� Permit Counter Phone (949)644-3288
s"i 'ip Inspection Requests Phone (949)644-3255
�''�ix.�u+"' Combination Type - 5FP ELEC MECH PLUM Issued Date : 06126/2020
Inspection Area : 5
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 06/27/2023 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: 4621 ROXBURY RD NB
Description: SFR INTERIOR REMODEL (KITCHEN & ADD FIREPLACE TO
MASTER BED)
Legal Desc.: N TR 3357 LOT 35
Owner: LEONARD KEVIN C
Contractor:
OWNER/BLDR
Architect: CHILDS CYNTHIA
Address: 4621 ROXBURY RD
Address:
LEONARD VICTORIA
Address: 2732 E COAST HWY #B
CORONA DEL MAR, CA 92625
CORONA DEL MAR CA 92625
Phone: 949-244-5218
Phone:
949-244-5320
Phone: 949-718-3528 State Lic:CO22985
Applicant: LEONARD KEVIN C
Con State Lic: O/B
Engineer:
Address: 4621 ROXBURY RD
Lic Expire:
Address:
CORONA DEL MAR, CA 92625
Bus Lic:
Phone: 949-244-5218
Lic Exp Date:
Phone: State Lic:
Code Edit : 2019
Worker's Compensation Insurance
Designer:
Type of Construction: V-B
Carrier:
Address:
Occupancy Group: R3/U
Policy No:
Added /New sq.ft. Bldg: 0
Expire:
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 1
No of Units : 1
Building Setbacks
Rear: I
Front: I
OV8
Special Conditions: �A r� ry� C�
Bldg Height: 0
Left: I
iY�••r
Bldg Sprinklers:
Right: /
Flood Zone: X
Use Zone:
Parking Spaces:
0 Fire Hazard Zone : N
Construction Valuation: $40.000.00
Building Permit Fee: $652.00
Excise Tax:
$0.00
Planning Department- Fire Department
Plan Check Fee: $567.24
Additional Fee :
$0.00
Plan check Fee : $41.50 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: $26.00
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: $42.50 Grading Bond:
$0.00
Hazardous Mat $0.00
Electrical W
$45.64
San Dist: $0.00
Building Green Fee : $2.00
Mechanical %:
$26.08
NMUSD Fee: $0.00
$0.00
Plumbing %:
$58.68
$0.00
TOTAL FEE : $1,461.64
Plan Check Fee :
$634.57 Fee Due at Permit Issuance : $827.07
PROCESSED BY:
PUBLIC WORKS APPROVAL:
`�yY�ry1!
,�,Q�
ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
APPROVAL TO ISSUE:
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)
iection 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
is 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
rofessions 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
of more than five hundred dollars ($500).
] I, as owner of the property, or my employees with wages as their sole compensation, will do J all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
usiness 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
nprovements 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
nproved 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
PH to an owner of property who builds or improves thereon, and who contracts for the pmjects with a licensed Contractor pursuant to the Contractors' State License Law).
am exempt from licensure under the Contractors' State License Law for the following reason:
y y 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 legalq
ell a structure that I have built as an owner -builder if it has not been constru ad 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 whenwhen I Hation is submi or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
'signature of Property Owner or Authorized Agent
.ICENSED CONTRACTOR'S DECLAF / �—
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
IARNING: 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
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 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' compensatio
lsurance carrier and policy number are:
f Agent
fy that, in the performance of the work for
Policy Number
Date
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
C d I h II forth ith corn I with those rovisions
:M" 1 1 should become s � to the workers c—pensatlon provisions of Section 3700 of the Labor o e, s a o wI p y P r7
ature of Applicant ^ D['D
IECLARATION REG ING ONSTRUC N 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, ivil Code).
Ender's Name Lenders Address
ly 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.
I authorize representatives of this city or county to epEer the above- 'led property for inspection purposes.
lionature of Pronertv Owner or Authorized Agent V[ 1��' Print Property Owners or Authorized Agent's Name �/l r-i� a— t O.r� Date
ACTION DATE
PERMIT EXPIRED
PERMITCANCELLED
PERMIT EMENDED
PERMIT FINAL
CERTIFICATEOF
OCCUPANCYISSUED
BY IDECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
I SUBMITTED
TO
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