HomeMy WebLinkAboutX2022-0305 - Permitsw1a� City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
- s Permit Counter Phone (949)644-3288
. Inspection Requests Phone (949)644-3255
F'aasrasu*'i* Combination Type - SFP ELEC PLUM
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COMB Permit: X2022-0305
Project No: 0220-2021
Issued Date : 03/02/2022
Inspection Area : 1
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 03/02/2025 OR PERMIT WILL BE INVALID
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: 1600 E BALBOA BLVD NB
Description: SFR *ADDITIONAL SCOPE* INTERIOR FIREPLACE, GASLINE TO BBQ, ELEC PANEL AND OUTDOOR SHOWER
Legal Desc.: BALBOA TR EAST SIDE ADD BLK 25 LOT 12
Owner:
GALVEZ KRISTINA & OSCAR
Address:
1600 BALBOA BLVD E
NEWPORT BEACH, CA 92661
Phone:
562/686-1188
Applicant:
MOSSMAN ERIC
Address:
2025 W BALBOA BLVD STE B
NEWPORT BEACH CA 92663
Phone:
949-675-1252
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: CARHARTT DEVELOPMENT INC
Address: 11511 GARFIELDAVE
SOUTH GATE CA 90280
Phone: 323-997-3282
Con State Lic:
1038854
Lic Expire:
05/31/2022
Bus Lic:
BT30075117
Lic Exp Date:
0413012022
2019 Worker's Compensation Insurance
V-B Carrier:
NO EMPLOYEES
R3/U Policy No:
0 Expire:
0
Building Setbacks
Rear: I
Front: /
Left: I
Right: /
Building Permit Fee: $382.00
Plan Check Fee: $332.34
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management :
$16.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access:
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $844.46
PROCESSED BY:
ZONING APPROVAL:
Architect: MOSSMAN ERIC
Address: 2025 W BALBOA BLVD STE B
NEWPORT BEACH CA 92663
Phone:
949/500-7212 State Lic:C019718
Engineer:
GOUVIS GEORGE A
Address:
3831 BIRCH ST
NEWPORT BEACH CA 92660
Phone:
949-766-1525 State Lic:C-029211
Designer:
Address:
Phone:
Special Conditions: REV22-0190
Excise Tax:
$0.00
Planning Department -
Additional Fee :
$0.00
Plan check Fee
Grading Bonds Fee:
$0.00
Fair Share
Grading PC Consultant :
$0.00
SJH Trans
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 W
$26.74
San Dist:
$0.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
Plumbing %:
$34.38
KQ
Plan Check Fee
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mm
Fire Department
$52.00
Fire Inspection:
$0.00
$0.00
Fire Plan Rev
$0.00
$0.00
Demolition Fee
$0.00
Building Dept Adm
$0.00
General Service
$0.00
Refund Deposit
$0.00
Grading Bond:
$0.00
$0.00
$0.00
$384.34 Fee Due at Permit Issuance: $460.12
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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)
(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 L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
Business 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
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner-Builderwill have the burden of proving that it was not built or
improved 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
apply 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).
EJ I am exempt from licensure under the Contractors' State License Law for the following reason:
By 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 legall,
sell 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
Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of D'vi ion 3 of the Business and Professions Code nd my license is in full force
and effect. License Class License No Dat J Z Contractor Signal
WORKERS' COMPENSATION DECLARATION ZZ^l -
NARNING: FAILURE TO SECURE WORKERS' 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
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
1 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
7erformance of the work for which this permit is issued. Policy No.
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'
rance carrier and policy number are:
Policy Number
Agent
Date
that, in the performance 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 workers' compensation laws of California, and agre
ould become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
of
hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code)
Ender's Name Lender's Address
Iy 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 ordinances and state laws relating to building construction.
I authorize representatives of this city or county to enter the above -identified property for inspection purposes.
:innahlre of Pmnerty Owner or Authorized Anent V 6//" � Print Property Owner(� Js or Authorized Apent's Name 1 Y t/CIA
ACTION DATE BY DECLARATION O'F COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY `
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
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PERMIT CANCELLED EPA ••• •... ••• ••• •• •••
PERMIT EXTENDED L 1AQMD
PERMITFINAL Z, QZ J rc LJ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATEOF v PROPOSED DEMOLITION •�• ••• ••• ••• �• i••
OCCUPANCY ISSUED SIGNATURE: : • ••
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Date