HomeMy WebLinkAboutX2022-0529 - PermitsCity of Newport Beach - Building Division
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COMB Permit: X2022-0529
4�i,o4r
p 100 Civic Center Drive, Newport Beach, CA 92660
X 2 0 2 2 0 5 2 9
Project No : 0478-2022
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type -GRAD PLUM ELEC
Issued Date
Inspection Area : 3
PERMIT EXPIRES 180 DAYS
AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE 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: 1527 DOROTHY LN NB
Description: SFR DRAINAGE, ELEC, GASLINE/WATERLINE
TO BBQ, FIREPIT AND SINK
Legal Desc.: N TR 1973 LOT 22
Owner: AMITOELAU SYLVIA E
Contractor:
OWNER/BLDR
Architect: BONDS DENNIS
L
Address: 1527 DOROTHY LN
Address:
AMITO'ELAU SAVAI'I Address: 661 SURF ST
NEWPORT BEACH, CA 92660
COSTA MESA
CA 92627
Phone:
Phone:
949-275-2727
Phone: 714-224-8587
State Lic:C011904
Applicant: BONDS DENNIS L
Con State Lie: Ole
Engineer:
Address: 661 SURF ST
Lie Expire:
Address:
COSTA MESA CA 92627
Bus Lie:
Phone: 714-224-8587
Lie 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
Building Setbacks
Rear: /
Special Conditions:
No of Units : 0
Front: /
Bldg Height: 0
Left: /
Bldg Sprinklers:
Right: /
Flood Zone:
Use Zone:
Parking Spaces:
0 Fire Hazard Zone : N
Construction Valuation: $7,000.00
1.
t
ai
Building Permit Fee: $389.00
Excise Tax:
$0.00
Planning Department -
Fire Departmen
Plan Check Fee: $267.00
Additional Fee,
$0.00
Plan check Fee : $52.00
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:
$237.00
In -lieu Housing Fee : $0.00
Building Dept Adm $0.00
Energy Compliance: $0.00
Grading PC Fee:
$199.00
Public Works Department -
General Service $0.00
CA Seismic Safety : $0.50
WQ 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
TOTAL FEE : $1${1,145.50
Plan Check Fee:
$319.00 Fee Due at Permit
Issuance : $826.50
PROCESSED BY:
PUBLIC V107KS APPROVAL:
ZONING APPROVAL:
ss__,,��
L V�'
PLAN CHECK BY:
GRADING APPROVAL:
4PPROVAL TO ISSUE:
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 U all of or (_) 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
impyoved for the purpose of sale).
as owner of the property, am exclusively contracting with license ontractors to c
ly to an owner of property who builds or improves thereon, an o contracts for the
m exempt from licensure under the Contractors' State a Law the followir
signature below I acknowledge that, except for my p s al resi in
structure that I have built as an owner -builder if it ha of been u ed in se
'rofessions Code, is available upon request whe t is li i b ad t
ignature of Property Owner or Authorized Agent
.ICENSED CONTRACTOR'S DECLARATJdR
hereby affirm under penalty of perjury that I A lice sed under p ovisions of Chapter 9
nd effect. License Class License No
(Section 7044, Business and Professions Code: The Contractors' State License Law does not
Ised Contractor pursuant to the Contractors' State License Law).
for at least one year prior to completion of the improvements covered by this permit, I cannot
contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
�httm//www.leainfo.ca.Dov/calaw.html. .... i1 n i
(commencing with Section 7000) of Division 3 of the Business and Professions Code, and
Date Contractor Signature
license is in full force
✓ORKERS' COMPENSATION DECLARATION
'ARNING: 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 TOT
OST 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:
1 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
erformance of the work for which this permit is issued. Policy No.
]I 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
Isurance carrier and policy number are: �� ^
of Agent
rtify that, in the pr
I should become
ure of Applicant L
Date
I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree
ction 3700 of the Labor Code, I shall forthwith comply with those provisions. ^�
Da /
:reby affirm under eliy of perjury thtat th a is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, 'vil Cod .
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 pr a owns shelf.
I have read this application and the information I hav pr ide Is rrect.
I agree to comply with all applicable city and count or na a state I s re in to building construction.
I authorize representatives of this city or county o art e -iden I for ins p ction purposes. '
nature of Property Owner or Authorized A en Print Property Owner's or Authorized Agent's Nam ar C
TION DATE DEC RATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AN D AQMD RULE
PERMITEXPIRED
LI I SUBMITTED ASBESTOS Nn i rICCTION TO
PERMITCANCELLED
EIEPA
PERMITEXTENDED
QMD -
PERMITFINAL
CERTIFICATEOF
OCCUPANCY ISSUED
ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION
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