HomeMy WebLinkAboutX2019-1206 - PermitsCity of Newport Beach- Building Division IIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIII
$344.00 - -
COMB Permit: X2019-1206
$0.00
Planning Department-
Fire Department
Plan Check Fee: $299.28
Additional Fee:
$0.00.
Plan check Fee:
$40.00
Fire Inspection:
$0.00
Overtime Plan Ck:
$0.00
ti4 100 Civic Center Drive, Newport Beach, CA 92660
X 2 0 1 9
1 2 0 6
$0.00
Project No:
F y Permit Counter Phone (949)644-3288
Investigation Fee:
$344.00
i Inspection Requests Phone (949)644-3255
$0.00
SJH Trans ;
.$0.00
Demolition Fee
Issued Date : 2019
�Ay°wyc� Combination Type - MFP ELEC MECH PLUM
$2.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee:
Inspection Arearea : 5
Building Dept Adm
$0.00
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
$0.00
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 S!i
A9'8fJ1t V&MIT
Job Address: 515 1/2 FERNLEAF AVE NB
General Service
Description:. MFR *DETACHED BACK UNIT" KITCHEN AND BATHROOM REMODEL 210 SF CITY STANDARD (STOP WORK) 119.0828
X
EXPOSE ALL
Legal Desc.:
WQ Insp. Fee:
C STRUCjURAL,
Owner: CDM FERNLEAF LLC Contractor: OWNER/BLDR
Architect:
� ypryT /t r�
ELECTRICAL PLUIVIDf1VG• /ANp
Address: 14917 RANCHONUEVO Address: DARNELL KEVIN
Address:
MECHANICAL
DEL MAR, CA. 92014
COMPQN5bJTJ
Phone. 949-633-0605 Phone:
Phone:.
State Lic:. • -'! ° °
Applicant: DARNALL WILLIAM KEVIN Con State Lic: O/B
Engineer.
Electrical %:
Address: 14917 RANCHONUEVO Lic Expire:
Address:
DEL MAR, CA 92014 Bus Lic:
a O'
,
Phone: 949.633-0605 Lic Exp Date:
Phone:
State Lic: •
NMUSD Fee: $0.00
-
Code Edit 2016 Worker's Compensation Insurance
Designer.
Type of Construction: V -B Carrier:
Address:
.... m•. m N �:
`
Occupancy Group; R3 Policy No:
°�°m°<,1
Added /New sq:ft.. Bldg: 0 Expire:
Phone:
Plan Check Fee
Added /New sq. ft. Garage: 0
$1,167.88
PROCESSED BY:
No of Stories:. 2 Building Setbacks Rear: /
Special Conditions:
OWNERIBLDR ATTACHED
No of Units : 2 Front: I
LLC ATTACHED ..
Bldg Height: 0 Left:. I
P14s
Bldg Sprinklers: Right:
PLAN CHECK BY:
Flood Zane: Use Zone: Parkino Spaces: 0
Fire Hazard Zone :
N
Building Permit Fee:
$344.00 - -
Excise Tax:
$0.00
Planning Department-
Fire Department
Plan Check Fee: $299.28
Additional Fee:
$0.00.
Plan check Fee:
$40.00
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:
$344.00
Grading PC Consultant:
$0.00
SJH Trans ;
.$0.00
Demolition Fee
Record Management:
$2.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee:
$0.00
Building Dept Adm
$0.00
Energy. Compliance:
$0.00
Grading PC Fee:
$0.00
Public Works Department-
General Service
$0.00
CA Seismic Safety:
$0.00
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 %:
$48.16
San Dist: $0.00
Building Green Fee :
$1.00
Mechanical %:
$27.52
NMUSD Fee: $0.00
-
$0.00
Plumbing %:
$61.92
$0.00
TOTAL FEE: $1,167.88
Plan Check Fee
: $0.00 Fee Due at Permit Issuance :
$1,167.88
PROCESSED BY:
PUBLIC WORKS APPROVAL:
ZONING APPROVAL:
P14s
PLAN CHECK BY:
c
l�
GRADING APPROVAL:
APPROVAL TO ISSUE:
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 ptnalty of,
more than five hundred dollars ($500).
J,,,as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
,iness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
rovements-are.not intendedor offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
roved for the purpose of'sale)'. -
I_I I, as owner ofthe,property, ant exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
apply 3o an-ownergjpioperty who builds or improves thereon, and who co acts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). - - - -- -
❑ I am exempPfjprp 9&hWre unde(the Contractors' State License L for the fol wing reason:
By mY,giQnatore�b�loyu-1 acknowladge that)-exoept for my-perso Iasi ence in is I must have resided for at -least one year prior to completion of the improvements covered by this permit -I -cannot legallt
seR a s[[rrcture that lilavebuilt as an owner -builder if i has n been nstru din s entirely by licensed contractors. I understand that a copy of the applicable law, Section 7 44 of t e Busi ass and
Pfgfessions Code, is availahle upon request whentIn applic tion is ubmit dor the following Web site:http:/lwww.leginfo.ca.gov/calaw.html. G
9TgrtatuJa of Property Owner or Authorized Agent Date 1 4 l l
LI�ENPED CQI�'j1WTOR'S DEC
I lneleby-affirm under peflalty of perjury that I am tensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions C de, and my license is in full force
and e$ect. Licence CAass License No Date Contractor Signature -
AWSRS' CON1P@NSATION DECLARATION
.....
NARNING: FAILURE TE WORMERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
CQ�dF�MPENSAjJON, ION, D4
D/�MAGE$ AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I Rereby Lffirm uRdWi 94alty of perjury one of the following declarations:
131 ...
have and will mairdain 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 the
oerUffiInce of thw4r0orwhich this permit is issued. Policy No.
❑1 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' compensatior
nsurance carrier and policy number are:
carrier Policy Number Expiration Date
Name of Agent I Phone #
:11 certify that, in the perfor ante of a Ork for ch is permit is issued, I shall not employ any person in any manner so as to become subject to the workers' c pensa'on laws of California, and agree
:hat, if I should become su act to w ars' co an fi provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /
Signature of Applicant Dat _ �P
DECLARATION REGA ING CON UCTION ENDING AGENCY
hereby affirm under p nalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 309 -/Civil Civil Code).
-ender's Name Lender's Address
3y my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owner' alf
I have read this application and the information I have provide)! a CITE .
I agree to comply with all applicable city and cou y ordinan s, d stat s relating to building construction.
I authorize representatives of this city or county enter th abo -iden I pr erty for inspection purposes. C t t l
Signature of Property Owner or Authorized A ant Print Property Owner's or Authorized Agent's Na V1 RIAAZI, Da
ACTION DATE BY DECLARkrII5N OF CMIMPUANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
135MLATIONS PART 61 OF TITLE 40 AND ACMD RULE
PERMITCANCELLED
PERMIT EXTENDED
CERTIFICATE OF
OCCUPANCYISSUED
I SUBMITTED ASBESTOS NOTIFICATION TO
SIGNATURE:
NOTAPPLIkABLJ TO
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