HomeMy WebLinkAboutX2022-1191 - Permitsx, City of Newport Beach - Building Division *X2022-1191* COMB Permit: X2022-1191
a - 100 Civic Center Drive, Newport Beach, CA 92660 Project NO : 1102-2022
"�+� Permit Counter Phone (949)644-3288
v.. ,, Inspection Requests Phone (949)644-3255 i
�'�zrs<�ur''� - Combination Type - BLDG ELEC PLUM GRAD Issued Date : 04/29/2022
Inspection Area : 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST 8E COMPLETED BY OR PERMIT WI 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 Sunday��Holidays
Job Address: 1827 TOYON LN NB
Description: SFR GASLINE & ELEC TO BBQ & DRAINAGE 6g 3
Legal Desc.: N TR 3763 LOT 77
Owner:
MYER ANDREW
Address:
1827 TOYON LN
NEWPORT BEACH, CA 92660
Phone:
Applicant:
ELLISON PAUL
Address:
24642 VIA RAZA
LAKE FOREST, CA 92630
Phone:
949-683-9861
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 : 0
Bldg Height: 0
Bldg Sprinklers:
Building Permit Fee: $110.00
Plan Check Fee: $0.00
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$6.00
Energy Compliance:
$0.00
CA Seismic Safety :
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $460.60
PROCESSED BY:
ZONING APPROVAL:
Contractor:
ALEX WOODARD
Address:
25 BLACKWOOD STREET
MISSION VIEJO, CA 92692
Phone:
(949)228-2804
Con State Lic:
1060810
Lic Expire:
1113012023
Bus Lic:
BT30078599
Lic Exp Date:
04/30/2023
Worker's Compensation Insurance
Carrier: STATE COMP
Policy No: 9305856
Expire: 0912212022
Building Setbacks
Use Zone:
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: /
Front: /
Left: /
Right: /
parking Spa
$0.00
($110.00)
$0.00
$0.00
$237.00
$199.00
$0.00
$7.70
$0.00
$9.90
Architect: -O )
Address:
Phone: State Lic:"+,
Engineer:
Address:
Phone: State Lic
Designer:
Address:
Phone:
Special Conditions:
Planning Department -
Plan check Fee
Fair Share
SJH Trans
In -lieu Housing Fee
Public Works Department -
Park Dedication :
$0.00
P/W Plan Check :
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Plan Check Fee: $199.00
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:
a'$0.ti0.
a Ja
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Fee Due at Permit Issuance : $261.60
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
u
eaa••
• o
e oeaa•
a
•
aea•
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the. eason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s)
ction 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
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
fessions 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
more than five hundred dollars ($500).
J I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions
lusiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, throu
nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of a
nproved for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7C
pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contra
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 o
ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors.
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.1(
Iignature of Property Owner or Authorized Agent
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700�
nd effect. License Class License No Date 1
COMPENSATION DECLARATION
the work, and the structure is not intended or offered for sale (Section 7044,
employees' or personal effort, builds or improves the property, provided that the
Dletion, the Owner -Builder will have the burden of proving that it was not built or
Business and Professions Code: The Contractors' State License Law does not
pursuant to the Contractors' State License Law).
e year prior to completion of the improvements covered by this permit, I cannot
understand that a copy of the applicable law, Section 7044 of the Business and
of the Business and Pro
tractor Signature
in full force
ING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$100,000), IN ADDITION TO THE
OF COMPENSA,'L)W pAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
:by affirm Unger penalty of perjury one of the following declarations:
I3Aje and Nfl1•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 th
rmance of thew:xlafor 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' compensatiol
arp carrier and policy number are:
gr_ ` • ` ' Poliximber Expiration Date
:E9f Agent _•'_
teltify that, in the4,mraltyof
the or or w this permit is issued, I shall not employ any person in any me
t,9441 ould becomthe rk s' co ensation visions of Section 3700 of the Labor Code, I shall fo
nature of Apl ["R
CLAPTION 5ET TION LENDING AGENCY
Me'Uy affirm Imderry that there is a construction lending agency for the performance of the work for
Ider's Name . . Lender's Address
my signature belo I certify to each of the follov
I am the property owner or authorized to act on
I have read this application and the informatig"
I agree to comply with all applicable city an cD
I authorize representatives of this city or co my
of
PERMIT EXPIRED
PERMIT CANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCYISSUED
Owner or Authorized
(0,
so as to become subject to the workers' compen. a on 1 awy of California, and agre
t comply with those provisions.
t this permit is issued (Section 3097, Civil Code)
1.6r 'fianc � a state s relating to building construction.
n rthe b e-ide edthe pro gl Inspection
Print Property Owner's or Authorized Ag
D6GIARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND) RULE i
ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION
SIGNATURE:
Name