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HomeMy WebLinkAboutX2017-2492 - PermitsCity of Newport Beach - Building Division >3 100 Civic Center Drive, Newport Coeach, CA 92660 -_. Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - SFP COMB Permit: X2017-2492 IIIIIII�II�I0IIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIII� II Project No: 1328-2016 Issued Date : 0 810 812 01 7 Inspection Area : 4 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: 2615 BLUE WATER DR NB ... •' Description: DELTAS, ADD 137 SF (REV17.1256) , • ® •. ®o e e a Legal Desc.: N TR 6385 LOT 41 • • • • • • • , Owner: NICHOLSON TOM Address: 1 CORPORATE PLAZA #110 Record Management: NEWPORT BEACH, CA 9266 Phone: 949-872-9067 Applicant: CRAMERJIM Address: 1 CORPORATE PLAZA #110 Hazardous Mat NEWPORT BEACH, CA 9266 Phone: 714.390-3614 Code Edit : 2016 Type of Construction: V -B -SPR Occupancy Group: R3/U Added /New sq.ft. Bldg: 137 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Y Valuation: Building Permit Fee: $736.00 Plan Check Fee: $0.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $56.00 Energy Compliance: $56.00 CA Seismic Safety: $3.21 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 Contractor: NICHOLSON CONSTRUCTION CO Address: 1 CORPORATE PLZ #110 $0.00 NEWPORT BEACH CA 92660 Phone: 949-872-6637 Con State Lic: 660295 Lic Expire: 12/31/2018 Bus Lic: BT98032850 Lic Exp Date: 0 413 012 01 8 Workers Compensation Insurance Carrier: STATE FUND Policy No: 9074255 Expire: 10101/2017 Building Setbacks Use Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant: Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: 6' Front: 20' Left: 6' Right: 6' $28.77 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 II TOTAL FEE : $1,133.06 Plan Check Fee PROCESSED BY: G_ ZONING APPROVAL: _ 1 / I/' V' GRADING APPROVAL: Architect: TOBLESKY KENNETH Address: P.O. BOX 1261 $0.00 CHINO HILLS, CA 91709 Phone: 909-217-1866 State Lic:CO23571 Engineer: DEIHIMI DAMIR HOSSEIN Address: 23172 PLAZA POINTE DR STE 145 LAGUNA HILLS CA 92653 Phone: 949-954.7244 State Lic:C-078194 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 PAN Plan Check : $0.00 San Dist: $0.00 NMUSD Fee: $252.08 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $1,133.06 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: o e • e e ee e e • e e •• e •000e e •eooa oeeeco ® o 0 • e ••eeoo 0 •eoo� 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 : $1,133.06 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: o e • e e ee e e • e e •• e •000e e •eooa oeeeco ® o 0 • e ••eeoo 0 •eoo� 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 U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Pr ofIssions 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 improvementsare noteintended 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 improvVd for thdPodrpose of sale). 04,0* owneEofAe property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply.to an owndr df�roperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). L�l `j111 exempt {ram licensure under the Contractors' State License Law for the following reason: by my signaturptVM,1 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, cannot Iegaly pita Structure thatf Aave 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 Profftions Coda, is available upon request when this application is submitted or at the following Web site:http://v w .leginfo.ca.gov/calaw.htmi. Signature of PrSgft dwner or Authorized Agent Date kBC3BNSED COttTRACTOR'S DECLARATION 4heiieby affirm under pValty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 � f the Business and Pro e i Co , and license is in full force I;rld'effett. Licsnse-Olass License No Date i e. Contractor Signature WQRK6RS' COM ff VVSATION DECLARATION YJA@yIN(a: FAILURPT05ECURE WORKERS' COMPENSATION COVERAGES UNLAWFUL, ANO SHALL SUBJECT AN EMPLOYER TO CRIMI AL PENALTIES AND CIVIL FINES UP TO ONE H THOUSAND DOLUIR3I$'100,000), IN ADDITION T OTHE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: ❑ 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 th p ormance 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' compensatiol Insu - carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # 131 certify that, in the erf ance of the work w ch this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' c ensation laws of California, and agre that, if I should beco s ' to the w corn nsation provision iGP-3=0..of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant Da/9 DECLARATION REG NG R ION LENDING AGENCY - I hereby affirm undo of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 30(7, Civil Code). Lender's Name Lender's Address By my signature b ow, 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 ty ordinances and state 15* relating to building construction. I authorize representatives of this city or coun he ab v e f pr rty for inspection purposes. ;1n ^ n ,q-,� �� Signature of Property Owner or Authorized Agent Property Owner's or Authorized Agent's Na WL Lod 7'" I D ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED 0 1 SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED LIEPA PERMIT EXTENDED QMD PERMITFINAL Q ESTO NO TION ISaTPPLICABLE TO CERTIFICATE OF 12,j�"i� PROPOSED DEM OCCUPANCYISSUED SIGNATURE: