HomeMy WebLinkAboutX2022-1830 - Permitsr City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288 -
U Inspection Requests Phone (949)644-3255
Combination Type - SFP
IIIIIIIIIIIIIIII�II�IIIIIIIIIIIIill II COMB Permit: X2022-1830
Project No : 2996-2021
Issued Date: 07/05/2022
Inspection Area : 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST SE COMPLETED BY 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: 1227 BERKSHIRE LN NB
Description: DEMO DETACHED GARAGE
Legal Desc.: N TR 3031 LOT 19
Owner: RUCKER LLOYD
Contractor:
OWNER/BLDR
Architect:
Address: 260 NEWPORT CENTER DR
Address:
Address:
NEWPORT BEACH, CA 92660
Phone:
Phone:
Phone:
State Lic:
Applicant: RUCKER LLOYD
Con State Lic:
O/B
Engineer:
Address: 260 NEWPORT CENTER DR
Lic Expire:
Address:
NEWPORT BEACH, CA 92660
Bus Lic:
Phone: 949-463-4509
Lic Exp Date:
Phone:
State Lic:
Code Edit : 2019
Worker's Compensation Insurance
Designer:
Type of Construction:-
Carrier:
Address:
Occupancy Group: U
Policy No:
Added /New sq.ft. Bldg: 0
Expire:
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 0
No of Units : 0
Building Setbacks
Rear: /
Front: /
Special Conditions:
r
N, I kr
Bldg Height: 0
Left: /
Bldg Sprinklers:
Right: /
Flood Zone:
Use Zone: Parldng Spaces:
0
Fire Hazard Zone : N
Construction Valuation: $1,000.00
Building Permit Fee: $110.00
Excise Tax:
$0.00
Planning Department
-
Fire Department
Plan Check Fee: $0.00
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 W
$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
TOTAL FEE: $111.00
Plan Check Fee :
$0.00
Fee Due at Permit Issuance :
$111.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
°
PV;I,_IC,V1(,O12KS `A�431AL.:
0 0 000 o a®°
PLAN CHECK BY:
APelkOVALIC SaSUl
0 0
oJo 0 0
o0 ova .. a o0 0o c,�o
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)
;action 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair anystructure, prior to its issuance, also requires the applicant for
ie 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
3t more than five hundred dollars ($500).
1, as owner of the property, or my employees with wages as their sole compensation, will do U 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
iprovements 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
1proved for the purpose of sale).
J 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
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).
J I exempt from licensure under the Contractors' State License Law for the following reason:
gMFgWtM=
ture below I acknowledge that,except for my personal residence in which I must have resided at least oneure that I have built as an owner -builder if it has not cor}�tructe In its entirety by licensed ntractors. I uCode, is available upon request whellehis a to stfbinitte or at the following Web sitep://www.legif Property Owner or Authorized Age�ns �D CONTRACTOR'S DECLARATIO��irm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing withction 7000) License Class License No Date Contractor Signature
COMPENSATION DECLARATION
ING: 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
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 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
ormance of the work for which this permit is issued. Policy No.
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' compensa
trance carrier and policy number are:
a of Agent
ertify that, in the performance of the work for
if I should become subLect_ta thi Workipis' co
of
Policy Number
Date
permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation ws of California, and ogre
I provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �/
Dat ` za1,2__
)ECLARATION REGAITD114G CASTRUC'TION LYNDING 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, D 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 and county ordinances and stat/larelating to building construction.
I authorize representatives of this city or count to me o=dentperty for inspection purposes. f/ � GG }
3ignature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Nam 4-&0
ACTION DATE BY DEC ATION OF CO PLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART i OFTITLE40ANDAQMD RULE
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PERMIT EXPIRED OLI SUBMITTED ADBESTa NOTIRCATr0,N TO
PERMITC4NCELLED • P
PERMIT EXTENDED LJAQMD
PERMITFINAL %f LJ
ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFIC4TE OF �'�•�� PR0*P:AEly8Ff Ql!1T•IOd• ••• ••
OCCUPANCY ISSUED SIGN$TUR • • • • e • e e
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