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HomeMy WebLinkAboutX2019-2825 - PermitsaCity of Newport Beach - Building Division >:� r 100 Civic Center Drive, Newport Beach, CA 92660 H Permit Counter Phone (949)644-3288 fi Inspection Requests Phone (949)644-3255 Combination Type - BLDG COMB Permit: X2019-2825 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II Project No : 2012-2019 Issued Date: 11/08/2019 Inspection Area : 3 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: 2141 INDIAN SPRING LN NB Description: SFR (2) RETAINING WALLS 6'x 85 LF TOTAL (SOUTHEAST & EAST SIDES) �s r �� 4'A�@ Legal Desc.: N TR 6689 LOT 1 u��iii"' rl Owner: CHASON CLIFTON Contractor: SWAN POOLS OF SOUTHERN CA Architect: Address: 2141 INDIAN SPRING LN Address: 24512 BRIDGER ROAD Address: NEWPORT BEACH, CA 92660 LAKE FOREST CA 92630 Phone: Phone: 949-859-8466 Phone: State Lie: ° ° • ° Applicant: ELLISON PAUL Con State Lie: 440333 Engineer: LACHER TODD • ° e°C°,. `.. Address: 24512 BRIDGER RD Lie Expire: 03/31/2020 Address: 1201 N TUSTIN AVE LAKE FOREST CA 92630 Bus Lie: BT96008994 ANAHEIM CA 92807 Phone: 949-859-8466 Lie Exp Date: 07/3112020 Phone: 714-630-6100 State Lic:C-067656 .... ° o o Code Edit: 2016 Worker's Compensation Insurance Designer: • °O.O o • a`<. Type of Construction: Carrier: STATE FUND Address: 00 o co Occupancy Group: U Policy No: 9228545 ° ° ° ° ° ° ° .1°11 Added /New sq.ft. Bldg: 0 Expire: 04/01/2020 Phone: ° ° ° C C ` Added /New sq. ft. Garage: 0 0°1 No of Stories: 0 Building Setbacks Rear: 6' Special Conditions: SOME LANDSLIDE o C ° C C' C No of Units : 0 Front: 20' .... o : Bldg Height: 0 Left: 6' © C C C C C °•o°°° Bldg Sprinklers: Right: 6' Flood Zone:- X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $10.710.00 Building Permit Fee: $412.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $365.00 Additional Fee : $0.00 Plan check Fee: $40.00 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 WO Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access: $0.00 PAN 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 %: $0.00 $0.00 TOTA =$818.00 Plan Check Fee : $405.00 Fee Due at Permit Issuance : $413.00 PROCESSED BY: '�- PUBLIC WORKS } ICI UMD nE:n ZONING APPROVAL: Y PLAN CHECK BY: 44 GRADING APPROVAL: APPROVAL TO IS 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). ❑ 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, 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). ❑ 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 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 licensure under the Contractors' State License Law for the following reason: By 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 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 ProfessiognpVI;: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 Owner or Authorized Agent Date L6dENSEDCOMTRACTOR'S DECLARATION I hereby affirm unAr penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 00 Iv Sin 3 of the Business and Professi s C e, nd I lice e� in full force •• arld effect. License Class License No Date Contractor Signatur • WORKERS OOMPENSATION DECLARATION • • ARIIING: FAILUaGIIe 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 WET OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. Hereby affk � vn der penalty of perjury one of the following declarations: • • • 1 have and. ill 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 thI • • Pie anteQf the ydork for which this permit is issued. Policy No. ,,,, I ve 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' compensatior • Ih a carper and policy number are: Policv Number Expiration Date of Agent I•none a ertify that, in the perfor anc o e rk r w ' is permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensationZUSO California, and agree If I should become subj ct t rke co sation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.itureofApplicant D S CLARATION REGA O ST ON DING AGENCY ;reby affirm under pe alty of erjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). ider's Name Lender's Address 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 icily antic I ha r ides is c Ct. I agree to comply with all applicable city and coun ordin c d sta relating to building construction. L I authorize representatives of this city or county t enter ab ve-i tiff grope y -for inspection purposes. `L innhim ^f Drnn,, %, nutner „r AIINVVI7Pfl AOPnt Print Prooertv Owner's or Authorized ADent's Name DATE BYRUC OTNS PARTCOMPLIANCE 61 O TIITLE 40A D AOMD RULE FEDERAL FOR OFFICE USE ONLY PERMIT FINAL ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATEOF l'jd PROPOSED DEMOLITION OCCUPANCYISSUED o� SIGNATURE: W l