HomeMy WebLinkAboutX2019-0752 - Permitsrn City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
F _ Permit Counter Phone (949)644-3288
" Inspection Requests Phone (949)644-3255
Combination Type - CIP ELEC MECH PLUM GRAD
COMB Permit: X2019-0752
x 2 9 1 9 0 7 5 2 Project No : 0804-2018
Issued Date: 0 310 712 01 9
Inspection Area : 7
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: 4321 BIRCH ST NB ta_ t �t Mre
Description: COMM EXTERIOR REPAIR, NEW WINDOWSIDOORS AND SITE WORK 11.411 SF •. F,,m�€$ p
Legal Desc.: N TR 5169 LOT 5
Owner: 4321 BIRCH PTNRS LTD Contractor: D B A C INC .Architect: MARTIN RICHARD K _ "+•• a :i"`
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Address: 28023 ACERO #160 Address: 101 SHIPYARD WAY #A Address: 1400 QUAIL ST #120 a '•
MISSION VIEJO, CA 92691
Phone
Applicant: MARTIN RICHARD K
Address:. 1400 QUAIL ST #120
NEWPORT BEACH CA 92660
Phone: 949.851-3044
Code Edit: 2016
Type of Construction: vis -41K
Occupancy Group: B
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 7 -
No of Units: 0
Bldg Height: 0
Bldg Sprinklers: y
Building Permit Fee: $3,268.00
Plan Check Feer $0.00 `
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management :
$154.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access:
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$18.00
TOTAL FEE: $6,615.12
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
NEWPORT BEACH CA 92663
Phone: 949-723-0147
Con State Lic:
637651
Lic Expire:
02/29/2020
Bus Lic:
.BT00016282
Lic Exp Date:
10131/2019
Worker's Compensation Insurance
Carrier: STATE COMP
Policy No: 9117372
Expire: 11/1112019
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical W
Mechanical %:
Plumbing %:
Rear: 0
Front: 15'
Left: 0
Right: 0
Parkina Spaces
$0.00
$0.00
$0.00
$0.00
$1,171.00
$0.00
$108.00
$457.52
$359.48.
$294.12
Plan Check Fee
Phone:
Special Conditions:
Planning Department -
NEWPORT BEACH CA 92660
Phone:
949-851.3044 State Lic:C014204
Engineer:
MONTOYA HERNAN
Address:
22421 GILBERTO, STE E
In -lieu Housing Fee
RANCHO SANTA MARG CA 92688
Phone:
949/713-7824 State Lic:S-002819
Designer:
P/W Plan Check:
Address:
San Dist:
Phone:
Special Conditions:
Planning Department -
Fire Department
Plan check Fee:
Fire Inspection:
Fair Share:
Fire Plan Rev
SJH Trans :
Demolition Fee
In -lieu Housing Fee
Building Dept Adm
Public Works Department -
Park Dedication :
$0.00
P/W Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
$0.00
$0.00
$24.00
$197.00
$564.00
$0.00
$0.00
$0.00
$0.00 Fee Due at Permit Issuance : $6,615.12
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:�
APPROVAL TO ISSUE:
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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
$24.00
$197.00
$564.00
$0.00
$0.00
$0.00
$0.00 Fee Due at Permit Issuance : $6,615.12
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:�
APPROVAL TO ISSUE:
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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)
Iction 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
Ifessions 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 ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
siness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
)rovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
)roved for the purpose of sale).
I, as ownerp?Wproperty, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
Ay to an ownetof property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
.1"i exemt$ frpnf ))censure under the Contractors' State License Law for the following reason:
MY"
y signature below I acknowledge that, except for my personal residence in which 1 must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legal
I.a s�t6ucture 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
�fAtions Code,jr. available upon request when this application is submitted or at the following Web site:http://www.leginfo.Ca.gOV/Galaw.htmi.
natere of PrOWItyPOrvner or Authorized Agent Date
%MED CQNTMCTOR'S DECLARATION
''ably affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section ) o�itinessndProfessi ode, 1y lice is i fu
Lett. UcMse Class License No a Bate or Sig
DECLARATION
ING,FA1LURr.i).SE6YRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ON RED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
�b••
Y affirm un tler�pe3ialty of perjury one of the following declarations:
have and wlilMaintain 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 thi
rmance of the work for which this permit is issued. Policy No.
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'
carrier and policy number are:
Policy Number
of Agent
Date
ertify that, in the performance a wor r whi this permit 1 ' su , I shall not employ any person in any manner so as to become subject to the
if I should become subject to rhe om nsation pr000gse6f Sectiok3700 of the Labor Code, I shall forthwith comply with those provisions.
of
hereby affirm un er pena y o p rjuryXat there is a construction lending agency for the performance of the work for which this permit is issued (Section
-ender's Name Lender's Address
3y my signature below, I certifyeach 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 un y o an sands e s relati to building construction.
I authorize representatives o city o my tc ant abov Ified prop for ins ection poses. ^j�,
3i nature of Property Owne r Authorized Agent Int Property Owne' or Aut zed Agent's Nampa/ (i
ACTION DATE DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FO ICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED OERA
PERMIT EXTENDED UACMD
PERMIT FINAL S TOS NOTIFI TIO IS NOT AP IC E TO
OCCUPANCY ICERTIFICATE ISSSUED �,) SAE
/ SERE:E� TI
compensation laws of California, and
Civil Code).
`7/