HomeMy WebLinkAboutX2021-0959 - Permitsw.p0 City of Newport Beach - Building Division
;7 100 Civic Center Drive, Newport Beach, CA 92660
µ Permit Counter Phone (949)644-3288 .
si Inspection Requests Phone (949)644-3250
Combination Type -GRAD ,
IIIP�X 20 2 1 0 9 59111 COMB Permit: zD021-0959
Issued Date: 04/23/2021
Inspection Area: 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0412312024 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: 1737 SKYLARK LN NB
Description: SFR YARD DRAINAGE
Legal Desc.: N TR 3097 LOT 13
Owner:
DANIEL WILLIAM
Contractor:
OWNER/BLDR
Address:
1737 SKYLARK LN
Address:
DANIEL WILLIAM
NEWPORT BEACH, CA 92660
Phone:
714-907-7064
Phone:
Applicant:
DANIEL WILLIAM
Con State Lie:
O/B
Address:
1737 SKYLARK LN
Lie Expire:
NEWPORT BEACH, CA 92660
Bus Lie:
Phone:
714-907-7064
Lie Exp Date:
-
Code Edit: 2019
Type of Construction:
Occupancy Group: U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 0
No of Units: 1
Bldg Height: 0
Bldg Sprinklers:
Worker's Compensation Insurance
Cartier:
Policy No:
Expire:
Building Setbacks Rear: /
Front: /
Left: I
Right: /
Architect:
Address:
INS Ir"E f -s
•os•
Phone: State Lie: ......
...•°
Engineer: RASHEED ZOHER :...
Address: 641 GALLOPING COLT ....
WALNUT CA 91789 °
Phone: 626-912-3366 State LIc:C-058615
Designer:
Address:
Phone:
Special Conditions: REV21-0618
ood Zone:
Use Zone:
Parking Spaces:
0
Fire K
Construction Valuation:
$0.00
Building Permit Fee:
$0.00
Excise Tax:
$0.00
Planning Department -
Plan Check Fee: $0.00
Additional Fee :
$0.00
Plan check Fee:
Overtime Plan Ck:
$0.00
Grading Bonds Fee:
$0.00
Fair Share :
Investigation Fee:
$0.00
Grading PC Consultant:
$0.00
SJH Trans:
Record Management:
$2.00
Grading Permit Fee:
$232.00
In -lieu Housing Fee:
Energy Compliance:
$0.00
Grading PC Fee:
$196.00
Public Works Department -
CA Seismic Safety:
$0.00
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Disabled Access,
$0.00
PAN Plan Check:
$0.00
Hazardous Mat
$0.00
Electrical %:
$0.00
San Dist:
$0.00
Building Green Fee :
$0.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
Plumbing %:
$0.00
TOTAL FEE: $429.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Plan Check Fee
Fire Department
$0.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00 Fee Due at Permit Issuance : $429.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
•
..••.•
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OWNER -BUILDER DECLARATION I
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 periiny of
not more than five hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
iigHKgved for the purpose of sale).
Kas owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section A
p ly to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contra
❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason:
By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least o
sell a structure thy J pave built as an owner -builder if has not been constructed in its entirety by licensed contractors.
Professions Code.ii ayailable upon request whaq LWTs appflc do Is submitted at the following Web site:hftp://www.li
Signature of Property Owner or Authorized Agen
LIMlikD CdAfl$ACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700
Sod Effect. LlcensO Class License No Date _
4, Business and Professions Code: The Contractors' State License Law does not
for pursuant to the Contractors' State License Law).
e year prior to completion of the improvements co red by this permit I cannot legal
understand that a copy of the applicable law, Se on 7044 of the,Business and
linfo.ca.gov/calaw.html.
at 4C12`3 �2 1
of Division 3 of the Business and Professions Code, and my license is in full force
Contractor Signature
3RS' COUR'@SATION DECLARATION
RAILURE TbgECI&E WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
MMPENS►TION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
affirm Un rgenalty of perjury one of the following declarations:
.WV and will 4naintain a certificate of consent to self -insure for workers' compensation, issued by the Dire
mnat; ce of the wo FWor which this permit is issued. Policy No.
Iran and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for
WgI carrier rV,gp}icy number are:
ier ' Policy Number
Agent
:ertify thej, in the performance of the work for which this permit is issued, I shall not employ any person in any
if I sppujp become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
CLARATION REGARDING CONSTRUCTION LENDING AGENCY
Ireby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for
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 owners 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 cciity or cc my to enter the abov ntified property for inspection purposes.
nature of Pronertv, Owner or Authon3ld/tDent G 1s7i &W/ Print Prooertv Owner's
DOLLARS ($100,0001, IN ADDITION TO THE
of Industrial Relations as provided for by Section 3700 of the Labor Code, for
performance of the work for which this permit is issued. My workers'
Date
so as to become subject to the 'compensation laws of California, and
r comply with those provisions. work
4L, 3l�
DATE r jRY DECLARATION OF I MPLIANCE WITH CODE OF FEDE
REGULATIONS PART 061 OF TITLE40 AND AQMD RULERAL I FOR OFFICE
PERMIT EXPIRED I I I V I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT EXTENDED L.1AQMD
PERMITFINAL LJ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF Z'S' Z� PROPOSED DEMOLITION
OCCUPANCY ISSUED SIGNATURE:
this permit is issued (Section 3097, Civil Code).
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