HomeMy WebLinkAboutX2017-3255 - Permits�1 KNIyj$
City of Newport Beach - Building Division
Address:
100 Civic Center Drive, Newport Beach, CA 92660
Record Management:
Permit Counter Phone (949)644-3288
.
Inspection Requests Phone (949)644-3255
Applicant:
Combination Type - SFP
COMB Permit: X2017-3255
IIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIII II
Project No: 1250-2016
Issued Date : 10/13/2017
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: 1653 BAYSIDE DR NB
Description: SFR CANTALEVER DECK *ADDITIONAL SCOPE* 200 SF
Legal Desc.: N TR 6927 LOT 2
Owner:
PSC STRATEGIC INVESTMENTS
Address:
27489 AGOURA RD
Record Management:
AGOURA HILLS, CA 91301
Phone:
818-435-7775
Applicant:
KENNY/BDR
Address:
P.O. BOX 410
Bus Lie:
AGOURA HILLS, CA 91376
Phone:
818-435-7775
Code Edit :
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 0
No of Units: 1
Bldg Height: 0
Bldg Sprinklers:
Construction
Contractor:
B D R INC
Address:
27489 AGOURA RD
Record Management:
AGOURA HILLS CA 91301
Phone:
818-435-7775
Con State Lic:
735996
Lie Expire:
0513112019
Bus Lie:
BT30061626
Lie Exp Date:
07/31/2018
2016 Worker's Compensation Insurance
Carrier: EVEREST NATIONAL
Policy No: CA10002812161
0 Expire: 0 811 612 01 8
0
Building Setbacks Rear: /
Front: /
Left: I
Right: I
Building Permit Fee: $367.00
Plan Check Fee: $319.29
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$4.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $691.29
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Architect
Address:
Phone: State Lie
Engineer:
DEIHIMI DAMIR HOSSEIN
Address:
23172 PLAZA POINTE DR STE 145
Additional Fee :
LAGUNA HILLS CA 92653
Phone:
949-954-7244 State Lic:C-078194
Designer:
$0.00
Address:
General Service
Phone:
Special Conditions
Excise Tax:
$0.00
Planning Department -
Fire Inspection:
Additional Fee :
$0.00
Plan check Fee:
Demolition Fee
Grading Bonds Fee:
$0.00
Fair Share
General Service
Grading PC Consultant:
$0.00
SJH Trans
Grading Bond:
Grading Permit Fee:
$0.00
In -lieu Housing Fee
Grading PC Fee:
$0.00
Public Works Department -
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
PAN Plan Check:
$0.00
Electrical %:
$0.00
San Dist:
$0.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
Plumbing %:
$0.00
Plan Check Fee
Zone : N
e e
me••e•
• e
ooeoJ -�
e
o e
P � O
O O
• • m� ynap� •m0
m emn
�oo
o m myaaas'Gat" o
eoo ® �[yySgi� o
o m
o a •ec'rd�:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$282.00 Fee Due at Permit Issuance : $409.29
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
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:
e e
me••e•
• e
ooeoJ -�
e
o e
P � O
O O
• • m� ynap� •m0
m emn
�oo
o m myaaas'Gat" o
eoo ® �[yySgi� o
o m
o a •ec'rd�:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$282.00 Fee Due at Permit Issuance : $409.29
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL 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)
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).
I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) 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 backnowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the in
a structure MV161%ge built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the appl
ifessions Code is available upon request when this application is submitted or at the following Web site:hftp://www.leginfo.ca.gov/calaw.htm].
'n'atu're of PropeAy owner or Authorized Agent
LENSED CONTRACTOR'S DECLARATION
a2pyldffirm undOr penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0) Divi ion 3 of the Business and
i effect. LicE:rl� gP Ass License No Dat d Contractor Signa
)R,j !RS' COMPENSATION DECLARATION
iyly : FAILURE:rO.SECtLRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE Huh
CpMPENSA31064AAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
Rgr46y affirm under penalty of perjury one of the following declarations:
vents covered by this permit, I cannot
law, Section 7044 of the Business and
Date
in full force
DOLLARS ($100,000), IN ADDITION TO THE
and vdig"41tain 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
ce of the work -for which this permit is issued. Policy No.
and wIM rgahAtlin 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
carrier•Snd policy number are:
Policy Number
Date
ne of Agent -vnone s
certify that, in the perf9fmance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the 11Z2
'mpensation laws of California, and agre
t, if I should become bject to the workers n provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applican .e1 CLARATION RE ARDIN CONSTRUCTI NDING AGENCY
:reby affirm and penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3ode).
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 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 county rdinances and state laws relating to building construction.
I authorize representatives of this city or county t orente he above-identifi erty for inspection purposes. 1�e�Gc lTrt55� / /te
nature of ProOertv Owner or Authorized Aqent Print Property Owner's or Authorized Agent's Name 'fes to �% �3 /•
ACTION
DATE
BY / FIECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED
U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED
EIEPA
PERMIT EXTENDED
QMD
PERMITFINAL
ASBESTOS 0011FICATION 15 NOT APPLIC TO
CERTIFICATEOOCCUPANCYISF
y c'�(1
, PR j7EM➢J TIO
OCCUPANCVISSUED
\ �!
TLIOSE
SIGNA7U �