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Home My WebLink AboutX2019-2526 - PermitsCity of Newport Beach - Building Division q 100 Civic Center Drive, Newport Beach, CA 92660 H - Permit Counter Phone (949)644-3288 i3. $ Inspection Requests Phone (949)644-3255 "ter u��a Combination Type - BLDG II oiiiii iiiii iiiii iiiii iiii iiiii iiiii iiiii 6i9 II COMB Permit: X2019-2626 Project No : 1720-2017 Issued Date : 08/09/2019 Inspection Area : 4 Construction Valuation: $8.000.00 Building Permit Fee: $412.00 Plan Check Fee: $365.00 Overtime Plan Ck 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: 15 DEERWOOD LN NB Energy Compliance: $0.00 ' Description: ADD'L SCOPE -RETAINING WALL 6'X 28' (REV19-1330) Disabled Access: $0.00 Legal Desc.: N TR 7636 LOT 101 - - - - Owner: DEERWOOD LLC Contractor:..` WATER MILL HOMES INC Architect: Address: 20151 SW BIRCH ST STE 150. Address: ' .20151 SW BIRCH ST #105 Address: NEWPORT BEACH, CA 92660 NEWPORT BEACH, CA 92660 Phone:. 949.250.4200 Phone: 949.250.4200 Phone: State Lic: Applicant:- KOZMA CRAIG Con State Lic: 941819 Engineer: VERDUGO-ZEPEDA GABRIEL Address: 20151 SW BIRCH ST STE150 Lic Expire: -. 01131/2020 Address: 11100 BEACH BLVD NEWPORT BEACH, CA 92660 Bus Lic: BT30034736 STANTON CA 90680 Phone: 949-250-4200 Lic Exp Date: 08131/2019 Phone: 714-527-2239 State LiaC-083660 Code Edit: 2016 Worker's Compensation Insurance Designer: _ Type of Construction: V -B Carrier: STATE COMP Address: Occupancy Group: U Policy No: 1606900 Added /New sq.ft. Bldg: 0. Expire: 01/01/2020 Phone: Added /New sq. ft. Garage:. 0 No of Stories: 0 Building Setbacks Rear: 20' Special Conditions: No of Units : 1 Front: 15' Bldg Height: 0 Left: 5' Bldg Sprinklers: - Right 5' _ Construction Valuation: $8.000.00 Building Permit Fee: $412.00 Plan Check Fee: $365.00 Overtime Plan Ck $0.00 Investigation Fee:. .$0.00 Record Management: $0.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access: $0.00 Hazardous Mat. $0.00 Building Green Fee : $1.00 Use Zone: PC8 Excise Tax: $0.00 Additional Fee: $0.00 Grading Bonds Fee: $0.00 Grading PC Consultant:. $0.00 Grading Permit Fee: $0.00 Grading PC Fee: $0.00 WQ Insp. Fee: $0.00 Electrical %: $0.00 Mechanical %: $0.00 Plumbing %: $0.00 II TOTAL FEE: $818.00 mo omo o < PROCESSED BY: o o i� o c opo ZONING APPROVAL: LC. OCv O 9 (i(O GRADING APPROVAL: oc. o �.c Wn. C c o ec. ooc c o 00 oc� cco 0 Planning Department - Fire Department Plan check Fee $40.00 Fair Share $0.00 SJH Trans Fire Plan Rev In -lieu Housing Fee: $0.00 Public Works Department - Park Dedication: $0.00 PNJ Plan Check: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: $0.00 $0.00 $818.00 Fire Department $40.00 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 Plan Check Fee: $0.00 Fee Due at Permit Issuance PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: $0.00 $0.00 $818.00 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 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 Irofessions 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 U 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 n roved for the purpose of sale). 1, 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). 7 I am exempt from licensure under the Contractors' State License Law for the following reason: ly my 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 legally ell 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 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. signature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7p0 of ivisi n 3 of the Business and Profes ns f�eA my lic nse is 'Royce nd effect. License Class License No Date`-� Contractor Signatu YORKERS' COMPENSATION DECLARATION 'ARNING: FAILURE TO SECURE WORKERS COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE ALT] AND CIVIL FINES UP TO ONE HUNDRED THOUSAND (DOLLARS , IN ADDITION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: I 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 Ice of the work for which this permit is issued. Policy No. 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' compenss carrier and policy number are: s of Agent _ ertify that, in the if I should becom rture of Applicant Policy Number Expiration Date Phone # of the work wh' h this permit is is I shall not employ any person in any manner so as to become subject to the workers' compen tion aws of California, and agree hew _orke comp sation prov'a' ns of ection 3700 of the Labor Code, I shall forthwith comply with those provisions. Date / ISR UCTION LENDIV AGENCY =,reby affirm under penalty of perju that there is a couction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil C de). Ider's Name Lender's Address By 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 hav provided is «e t. I agree to comply with all applicable, and county rdin�lgce" nd st a laws r Ing to ilding construction. I authorize representatives of this city or count to er the ov ' ified pert Inspection purposes. Signature of Property Owner or Authorized A ent Print Property Owner's or Authorized A ACTION DATE BY DECLAR TION OF 7COMP WITH CODE OF FEDERAL FOR OFFICE USE ONLY PART 61 qF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED I UEPA PERMITFINALU ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF �Z CR PROPOSED DEMOLITION OCCUPANCYISSUED SIGNATURE: Name • • • • • • • • • • • • • • • • • • • • •• • • QV