HomeMy WebLinkAboutX2017-2861 - PermitsCity of Newport Beach - Building Division
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COMB Permit: X2017-2861
100 Civic Center Drive, NewportBeach, CA 92660
X 2 0 1 7 2 8 6 1
Project No : 1988-2017
Permit Counter Phone (949)644-3288)Inspection
a
Requests Phone (949)644-3255
Combination Type - SFP ELEC
Issued Date : 10/25/2017
Inspection Area : 5
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: 262 MORNING CANYON RD NB
Description: SFR INTERIOR REMODEL 4308 SF
Legal Desc.: N TR 1116 LOT 85
Owner: CL PROPERTIES 2017 TRUST Contractor:
R D M S INC
Architect:
OLSON DAVID ROLF
Address: 233 ENERALD BAY Address:
250 E BAKER
ST # 300 Address:
470 WALD
LAGUNA BEACH CA 92651
COSTA MESA
CA 92626
IRVINE, CA 92618
Phone: Phone:
714448-9835
Phone:
949450-0093 State Lic:C019424:'"°
Applicant: WAN STEPHEN Con State Lie: 815672
Engineer:
DAILEY TIMOTHY
Address: 470 WALD Lie Expire:
12/31/2018
Address:
9332 WINTERWOOD CIR
IRVINE CA 92618 Bus Lie:
6730008726
HUNTINGTON BEACH CA 92626 • e m o
Phone: 949450-0093 Lie Exp Date:
0113112018
Phone:
714-962-6903 State Lie:C-039489 •
•`�..:U°
Code Edit: 2016 Worker's Compensation Insurance
Designer:
Type of Construction: V-B Carrier:
EVERST NATIONAL INS Address:
Occupancy Group: R31U Policy No:
7600015443
Added /New sq.ft. Bldg: 0 Expire:
09101/2018
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 3 Building Setbacks
Rear: I
Special Conditions: FUEL MOD/HAZARD
No of Units: 1
Front: I
Bldg Height: 0
Left: /
Op0°O
Bldg Sprinklers:
Right: /
Flood Zone: Use Zone:
Parking Spaces:
0 Fire Hazard Zone : Y ° V
Construction Valuation: $230.000.00
Building Permit Fee: $1,745.00 Excise Tax:
$0.00
Planning Department-
Fire Department
Plan Check Fee: $1,518.15 Additional Fee :
$0.00
Plan check Fee:
$37.50 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: $28.00 Grading Permit Fee:
$0.00
In-lieu Housing Fee :
$0.00 Building Dept Adm $24.00
Energy Compliance: $0.00 Grading PC Fee:
$0.00
Public Works Department -
General Service $197.00
CA Seismic Safety : $0.00 WQ Insp. Fee:
$0.00
Park Dedication : $0.00
Refund Deposit $564.00
Disabled Access: $0.00
PM/ Plan Check: $76.00
Grading Bond: $0.00
Hazardous Mat $0.00 Electrical %:
$122.15
San Dist: $0.00
Building Green Fee : $10.00 Mechanical %:
$0.00
NMUSD Fee: $0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE: $4,321.80
Plan Check Fee:
$775.17 Fee
Due at Permit Issuance: $3,546.63
PROCESSED BY:
PUBLIC WORKS APPROVAL:
ZONING APPROVAL:
PLAN CHECK BY:
UkO
GRADING APPROVAL:
APPROVAL TO ISSUE:
OWNER -BUILDER DECLARATION
1 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 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
rfessions 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).
I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
$iness 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
)rovements 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
)roved for the purpose of sale).
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
)ly 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). --
I am exempt from licensure under the Contractors' State License Law for the following reason: _
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 lega111
I 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
rfessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
,nature of Prolj4W QJner or Authorized Agent Date
;ENSg:D CONTRACTOR'S DECLARATION �.j/ j
're" urjdtf p@clotty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0) of Division 3 of the Business and Pro ssio% icense is in full force
I effect. License -Sloss License No Date e) S—I l Contractor Signatur
tDRktFRS' COMPENSATION DECLARATION
IARNING: FAILURE TO SFF��CUQE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, ANO SHALL SUBJECT AN EMPLOYER TO CRI INAL PENALTIES AND CIVIL FINES UP TO ONE HU DRED THOUSAND DOLLARS ($700,000), IN ADDITION TO T
:QS�rpFCQMPENSiI!Tj(jN; D AGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
Iferetfj+'affirm uWj P6nalty of perjury one of the following declarations:
3 I have and will mehtain 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
P aance of the work for which this permit is issued. Policy No.
V
..••
I ,
.'end will CVjpj4n 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' compensal
Isurance carrier and policy number are:
""'; . ..• Expiration Date
:arrier. _ _ Policy Number P
Iameof Agent •• rlluHux
31 certify that, in th=perjury
he work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' co pensation laws of California, and agre
iat, if I should becorkers' c e s tion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
signature of Applica/te
IECLARATION RE RIDINGRUCTION LENDING AGENCY
hereby affirm unde that there is a construction lending agency for the performance of the work for which this permit is issued (Section 30ode).
order's Name Lender's Address
ly 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 coup ord' nces and s to laws relating to building construction.
I authorize representatives of this city or county t en r t ovep/d n property for inspection purposes. �%
•,...,.,....e, f or.. ,, n—nar..r A„rhnrioad Anuni ` Print Prooerty Owner's or Authorized ADent's Name t��Uw.
DATE BY / DECLARATION OF REGULATIONS PART 61 OF ILT E 40 AND AQMD RULECE WITH CODE OF FOR OFFICE USE ONLY
PERMIT EXPIRED
U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED
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PERMITEXTENDED
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PERMITFINAL
ASBESTOS OTIFICAN�IS,NOT (C�AB,LrE TO
CERTIFICATE OF
PROPOSED D P rN /A/P�P
OCCUPANCY ISSUED
SIGNATOR . ` L-`— _ `
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