HomeMy WebLinkAboutX2020-2678 - Permitsr�w•to4, City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
r: t Permit Counter Phone (949)644-3288
-sa IC Inspection Requests Phone (949)644-3255
Combination Type - SFP
COMB Permit: X2020-26
Project No : 0687-2020
Issued Date : 11/1812020
Inspection Area : 4
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 1111912023 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:
340 VISTA TRUCHA NB
Description:
MFR *ADDITIONAL SCOPE" ADD NEW PLYWOOD TO ROOF
Legal Desc.:
N TR 6885 LOT 14
Owner:
STONE IRENE Contractor:
HARRISON BUILDING Architect:
Address:
340 VISTA TRUCHA - Address:
4533 MAC ARTHUR BLVD #578 Address:
NEWPORT BEACH, CA 92660
NEWPORT BEACH CA 92646
Phone:
Phone:
949-278-1727 Phone: State Lic: "
Applicant: AUDENIS PATRICK
Con State Lic:
951412
Engineer:
YAGHI SHUCRI I
°
Address: 22162 LAGUNA CIR
Lic Expire:
03131/2021
Address:
112 E. CHAPMAN #D
HUNTINGTON BEACH CA 92646
Bus Lic:
BT30071474
ORANGE CA 92866
Phone: 949-278-1727
Lic Exp Date:
0313112021
Phone:
714-997-9120 State Lic:C-043205
Code Edit: 2019
Workers Compensation Insurance
Designer:
Type of Construction: V-B
Carrier:
NOVA CASUALTY
Address:
'
Occupancy Group: R3IU
Policy No:
10000866
Added /New sq.ft. Bldg: 0
Expire:
04/06/2021
Phone:
"
Added /New sq. ft. Garage: 0
'
No of Stories: 2
Building Setbacks
Rear: /
Special Conditions:
No of Units : 1
Front: I
Bldg Height: 0
Left: /
Bldg Sprinklers:
Right: /
Flood Zone:
Use Zone: Parking Spaces:
0
Fire Hazard Zone : N
Construction Valuation: $3,600.00
Building Permit Fee: $144.00
Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee: $126.28
Additional Fee :
$0.00
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
PNJ Plan Check:
$0.00
Grading Bond:
$0.00
Hazardous Mat $0.00
Electrical %:
$0.00
San Dist:
$0.00
Building Green Fee : $1.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
$0.00
Plumbing W
$0.00
$0.00
TOTAL FEE: $270.28
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Plan Check Fee
$0.00 Fee Due at Permit Issuance : $270.28
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
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)
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
to 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 (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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
pply 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).
I am exempt from licensure under the Contractors' State License Law for the following reason:
ly my signatur, hilo.v 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 legally
ell a structure that I nave 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
'mrEs;ions CoJe, is Available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
signature of Property Dwner or Authorized Agent I Date
.ICENSED CONTRACTOR'S DECLARATION
he. Lby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 00) f Division 3 of the Business and Pro sions Code, and my license is in fulforce
nd Effect. LiLEnse Glass License No //_i�T� Date Contractor Signature
VO.:KERS' C,rOMPENSATION DECLARATION
I111:0:G: FAIW RE,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
OST 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 ha•:e and g ill 'Ina'ntain 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 thi
ertorrlrnce of the work for which this permit is issued. Policy No.
F,FI ha+e and will run?main 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' compensatior
IsDr.@,nce carrier and policy number are:
Policy Number
ie of Agent
Date
JI certify that, in the peVormance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the
m e workers' mpensation laws of California, and agre
tat, if I should becoubject to the workers' DO provisions
of 3700 of the Labor Code, I shall forthwith comply with those provisions. r-7
;ignature of Applicant �i`c.
)ECLARATION REGAgDIt�jB-CONSTRUCTION LENDING AGENCY I \ /
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 have provided is correct.
I agree to comply with all applicable city an c my ordinances and state laws relating to building construction.
I authorize representatives of this city or cou t
3i nature of Property Owner or Authorized o enter the bove-i n ' d property fo inspection purposes.
Agent Print Property Owner's or Authorized Agent's Name Date
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
RE ATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERMIT EXPIRED i /j LIISUeMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED it—� it EPA
PERMIrFINAL TO
CERTIFICATE OF �Jlgf'7 uOPOUR DSEMQCTTIONI lC�E
OCCUPANCY ISSUED ,�{�, ��