HomeMy WebLinkAboutX2019-0859 - PermitsIr
City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
COMB Permit: X2019-0859
100 Civic Center Drive, Newport Beach CA 92660
X 2 6 1 9
0 8 5 9
Project NO : 0581-2019
Building Permit Fee:
�,.
Permit Counter Phone (949)644-3288 -
$0.00
Planning Department-.
Fire Department''
ex1,
Inspection Requests Phone (949)644-3255
`Plan Check Fee: $243.60
Additional Fee.:
$0.00
: Plan check Fee:
`Yrtarr;a
s Combination Type -SFP
$0.00
Issued Date: 03/1812019
Overtime Plan Ck:
$0.00
Grading Bonds Fee:
$0.00
Fair Share `..
Inspection Area : 1
Fire Plan Rev
$0.00
'
PERMITS EXPIRE
180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
'Grading PC Consultant.:
, $0.00
SJH Trans:
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
Demolition. Fee
Job Address:
819 VIA LIDO SOLID NB
Record Management :.
$4.00
Grading Permit Fee:
$0.00
Description:
SFR REPAIR (E) COPING @ BASEMENT WALLISEA WALL >`
Building Dept Adm
$0.00'
Energy Compliance:
Legal Desc.:
' TR 907 LOTS 304/3051306
$0.00
Public Works Department -
_
$0.00
CA Seismic Safety:
$0.00
WQ Insp. Fee:
$0.00
Owner:
RESIDENTIAL HOLDINGS M2, LLC Contractor
SHELLMAKER INC -
Architect:
....
Disabled Access
Address:
2220 UNIVERSITY OR Address:
837 W 17TH STREET
Address:
° o.
$0.00
NEWPORT BEACH CA 92660
COSTA MESA CA 92627
$0.00
Electrical %°:
o
I•
Phone:
- Phone:
949-548-5359
Phone: State Lie:
•
$1.00
Mechanical %:
. $0.00:.:
NMUSD Fee: $0.00
Y-
°• o
Applicant.
EARLEY BRAIN Con State Lie:
561434.
Engineer: PETROV PLAMEN
e.a71°""1pi
- $0.00
Address:
120 W MATLAND ST Lie Expire:
03131/2019
Address: 28161 CASITAS CT
eO°�
ONTARIO CA 91762 Bus Lic
BT00009706
LAGUNA NIGUEL CA 92677
°�'�•
°
Phone:
909-635-5883 - Lie Exp Date:
01/31/2020
Phone: .714-717-7542 State Lic:C-066947
° • ��,�.:
° ° ° °� ° °
Code Edit:
2016 Worker's Compensation Insurance.
Designer.
e°
Type of Construction: VB Carrier:
LONGSHORE
Address;
.....
e. •1
Occupancy Group: R3/U Policy No:
L&H-90494517
APPROVAL TO ISSUE:
Added /New sq.ft. Bldg: 0 Expire:
07111/2019
Phone:
Added /New sq. 8. Garage: 0
° *•®
No of Stories:
- 2- Building Setbacks
Rear. I -
Special Conditions: LIQUEFACTION AREA
✓1�. ,.7"-�.
No of Units :
1
Front; /
'Bldg Height....
0
Left: /
n.." .
Bldg Sprinklers:
Right /�..�.,
Flood Zone:
X Use Zone: Parking Spaces: 0
Fire Hazard Zone : N
Construction. Valuation:
$13,000.00
Building Permit Fee:
$280.00
Excise Tax:
$0.00
Planning Department-.
Fire Department''
`Plan Check Fee: $243.60
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.
$0.00
'Grading PC Consultant.:
, $0.00
SJH Trans:
.$0.00
Demolition. Fee
Record Management :.
$4.00
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
PM Plan Check: $0.00
Grading Bond:
$0.00
Hazardous Mat
$0.00
Electrical %°:
$0.00
San Dist: $0.00
' Building Green Fee :
$1.00
Mechanical %:
. $0.00:.:
NMUSD Fee: $0.00
-
$0.00
Plumbing %:
- $0.00
$0.00
TOTAL FEE : $568.60
Plan Check Fee:
$243.60 Fee Due at Permit Issuance :
$325.00
PROCESSED BY
PUBLIC WORKS APPROVAL:
APPROVAL:
ZONING
PLAN CHECK BY:
GRADING APPROVAL;
APPROVAL TO ISSUE:
I
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 apAcara ft
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 L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
driess 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 ofcompletion, 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 ownpG4f 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 exelrfpj¢prplicensure under the Contractors' State License Law for the following reason:
my eignaturre 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 legally
IS14ructurathat 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
fessions Cddb, Wavailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
naFure of Property Owner or Authorized Agent i Date
t hSED CONJUCTOR'S DECLARATION
e6y affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio/e-,3"
of Division 3 of the Business and Prof sipp,5�rs Code, and�1y license is in full force
effect. Licepsa8lass License No Da -I 8-E Contractor Signatur �M,0;._
IRKERS' CO�IIPENSATION DECLARATION
MitJP.: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGES UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMILTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS (6100,000), IN ADDITION TO THE
.TdN COMPENSATION, IJAMAGES AS PROVIDED FOR IN SECTION 6706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
rebyeffirm urMePrEMalty of perjury one of the following declarations:
F hyo and willemaintain 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
`emrance of fhpy &It 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
ie of Agent
Date
I certify that, in the perfor once 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
that, if I should become su act to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant D e 5 -(-(
DECLARATION REGA IN CONSTRUCTION LENDING AGENCY
I hereby affirm under p alty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3 7, Civil Code).
Lender's Name Lender's Address
Bylmy signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owner's behalf.
1 have read this application and the information I har! provided is correct.
I agree to comply with all applicable city and coun ordinances and state laws relating to building construction.
1 authorize representatives of this. city or countye r the above -identified property for inspection purposes..
Signature of Pro a Owner or Authorized A ent Print Property Owner's or Authorized Agent's Na e i i n C,1 -o D
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
EXPIRED I 1 `1 LJ I SUBMITTFD ASBESTOS NOTIFICATION TO 1
PERMIT FINAL b� / ' ROP BESTDOMOhFj ONION IS NOiAPPLICABLE TO
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