HomeMy WebLinkAboutX2022-1269 - Permitsa1sr„4, City of Newport Beach - Building Division "X2022-1269* COMB Permit: X2022-1269
100 Civic Center Drive, Newport Beach, CA 92660 Project No : 1171-2022
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - SFP ELEC MECH PLUM i � �i"6'^'`-r`t'% Issued Date : 06/14/2022
� - x' ::-h.__r S %_.f' Inspection Area : 4
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 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: 17 BOARDWALK NB
Description: SFR REMOVE 172 SF OF GARAGE, NEW DECK 474 SF & NEW GLASS DOORS AT PATIO AND DECK LEVEL. NEW SITE IMPROVEMENTS
Legal Desc.: N TR 15478 LOT 13
Owner:
SACKS TERRI
Contractor:
Address:
17 BOARDWALK
Address:
NEWPORT BEACH, CA 92660
Phone:
Phone:
Applicant:
WHEELER MARK
Con State Lic:
Address:
4918 E ATHERTON ST
Lic Expire:
LONG BEACH, CA 90815
Bus Lic:
Phone:
562-619-3990
Lic Exp Date:
Code Edit :
2019
Type of Construction:
V-B-SPR
Occupancy Group:
R3/U
Added /New sq.ft. Bldg:
0
Added /New sq. ft. Garage:
0
No of Stories:
2
No of Units :
1
Bldg Height:
0
Bldg Sprinklers:
Y
Flood Zone:
X
Building Permit Fee: $1,537.00
Plan Check Fee: $1,337.19
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$44.00
Energy Compliance:
$105.00
CA Seismic Safety:
$19.50
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$6.00
TOTAL FEE : $4,750.B4
PROCESSED BY:
ZONING APPROVAL:
HASKETT JIM CONSTRUCTION INC Architect
PO BOX 379
Address:
SURFSIDE CA 90743
714-894-4800
Phone:
State Lic:
738498
Engineer:
ARMSTRONG SCOTT DANIEL
08/31/2023
Address:
41870 KALMIA ST #165
BT30060773
MURRIETA CA 92562
10/31/2022
Phone:
714-225-7056 State Lic:C-074715
Worker's Compensation Insurance
Carrier: STATE COMPENSATION INS FUND
Policy No: 9166656
Expire: 10/01/2022
Building Setbacks
Use Zone:
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WO Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: 5
Front: 15
Left: 5
Right: 5
'arking Space
$0.00
$0.00
$0.00
$0.00
$237.00
$199.00
$0.00
$107.59
$61.48
$138.33
Designer: WHEELER MARK
Address: 4918 E ATHERTON ST
LONG BEACH, CA 90815
Phone: 562-619-3990
Special Conditions: HAULER: JD
Fire Hazard Zone :
Planning Department -
Plan check Fee
Fair Share
SJH Trans
In -lieu Housing Fee:
Public Works Department -
Park Dedication :
$0.00
P/W Plan Check:
$50.75
San Dist:
$0.00
NMUSD Fee:
$0.00
Fire Department
$52.00
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
$27.00
$265.00
$564.00
$0.00
$0.00
$0.00
Plan Check Fee : $1,439.94 Fee Due at Permit Issuance : $3,310.90
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL: 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) indic
coon 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, dem
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License L
fessions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Secti
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 tl
liness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through c
rovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of comp
roved for the purpose of sale).
1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044,
IIy to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor
d below by the checkmark(s) I have placed next to the applicable item(s)
,h, or repair any structure, prior to its issuance, also requires the applicant for
(Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
work, and the structure is not intended or offered for sale (Section 7044,
oloyees' or personal effort, builds or improves the property, provided that the
on, the Owner -Builder will have the burden of proving that it was not built or
and Professions Code: The Contractors' State License Law does not
to the Contractors' State License Law),
LJ I am exempt from licensure under the Contractors' State License Law for the following reason: I
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 PE
sell a struciu.t Inat 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
ProfessionF C ,Ce, is available upon request when this application is submitted or at the following Web site:http://www.leginf".ca.gov/calaw.html.
Sirnature or Property Owner or Authorized Agent Date
LICE145ED 0^14TRACTOR'5 DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000yof ill 3 of the Business and Profess! Code, and se is in fu rce
and effect. License Class License No Date b �G Contractor Signature
WORKERS COMPENSATION DECLARATION
NARAING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALT ES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMYENSf TION, 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:
�LJ I have and will. maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of
p�rcfor. nance �f thU work for which this permit is issued. Policy No.
,have and will rretntain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the ps
,insurance carrzr aUd policy number are:
,insurance
Policy Number
of Agent
cannot
Iss and
Relations as provided for by Section 3700 of the Labor Code, for
of the work for which this permit is issued. My workers'
Date
certify that, in the performance of the wor for which ermit is issued, I shall not employ any person in any manners as to become subject to the workers' compensation laws of California, and agree
;, if I should become sub co nsation provisions of Section 3700 of the Labor Code, I shall forthwith omply with those provisions.
nature of Applicant Date
J=CLARATION REGAIRRIRwCOMTRUCTION LENDING AGENCY
hereby affirm under penaffy of perjury that there is a construction lending agency for the performance of the work for which his permit is issued (Section 3097, 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'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 t7n�,enter the above -identified property for inspection purposes.
31gnature of Property Owner or Authorized Agent / rv[ $IN05- 5 Print Property Owner's or Aut orized Agent's Name
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE SE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERMIT EXPIRED I I I U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT EXTENDED LJAQM D
PERMITFINAL '! f2_1 ASBESTOS NOTIFICATION�I/LJTI)APPLICABLE TO
CERTIFICATE OF r PROPOSED DEMOLITION/
OCCUPANCY ISSUED I SIGNATURE: