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HomeMy WebLinkAboutX2019-1912 - Permitsa City of Newport Beach - Building Division IIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIII COMB Permitc X2019-1912 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 1 9 1 2 Project No : 1385-2019 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - SFP ELEC Issued Date : 0711812019 Inspection Area : 6 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: 24 WHITESANDS DR NB Description: SFR INSTIL (2) TESLA BATTERY BACKUP SYSTEMS Legal Desc.:. Owner: BRADLEY MARK COHEN Address: 24 WHITESANDS DR. Record Management : NEWPORT BEACH CA 92657 Phone: 949-533-5947 Applicant: HUITRON ANTHONY Address: 10192 CONSTITUTION DR Hazardous Mat HUNTINGTON BEACH CA 92646 Phone: 562-743-6877 Code Edit : 2016 Type of Construction: VB 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: Flood Zone: Valuation: Building Permit Fee: $312.00 Plan Check Fee: $271.44 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management : $14.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access: $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $907.28 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Contractor: URBAN ENERGY Architect: Address: 10192 CONSTITUTION DR Address: 06/01/2020 HUNTINGTON BEACH CA 92646 $0.00 Phone: 562.447.4971 Phone: Con State Lie: 944115 Engineer: Lie Expire: 12/31/2019 Address: Bus Lie: BT30064688 Lie Exp Date: 09/3012019 Phone: Worker's Compensation Insurance Carrier: STATE FUND Policy No: 9021421 HUNTINGTON BEACH CA 92646 Expire:. 06/01/2020 Building Setbacks Rear: / I o Front:. / 1 a Left: I ' Right: I r Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee Electrical %: Mechanical %: Plumbing %: INSPECIUK State Lic: State Lie: Designer: MENDOZA MARK Address: 10192 CONSTITUTION DR Phone: Special Conditions: $0.00 Planning Department - $40.00 $0.00 Plan check Fee Fire Plan Rev $0.00 Fair Share $0.00 $0.00 SJH Trans General Service $0.00.. In -lieu Housing Fee: $0.00 Public Works Department - $0.00 Park Dedication :. $0.00 PNJ Plan Check, $0.00 $40.84 San Dist: $0.00 $0.00 NMUSD Fee: $0.00 $0.00 Plan Check Fee : $558.44 Boom 0 0 000m eom o m o bo m m o c00000 0 0e e 0 0 0 00 . 0 o` 000co 0 0 e00000 c c o m e m o om o 0 0 0 0 0 ee o 00000 0 00000 oomcoo c c o 0 0 0 0o c o c o 0000 0000 $0.00 $228.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fee Due at Permit IssLAnce : $348.84 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE:. Fire Department $40.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: Boom 0 0 000m eom o m o bo m m o c00000 0 0e e 0 0 0 00 . 0 o` 000co 0 0 e00000 c c o m e m o om o 0 0 0 0 0 ee o 00000 0 00000 oomcoo c c o 0 0 0 0o c o c o 0000 0000 $0.00 $228.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fee Due at Permit IssLAnce : $348.84 PUBLIC WORKS APPROVAL: PLAN CHECK BY: 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) 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 (_) 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 -Builder will 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 improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ tam exempt from licensure under the Contractors' State License Law for the following reason: By my signature below-r'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 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.govlcalaw.htmi. 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 00) of f the usiness and Profess' an y�ic nas is in full force and effect. License Class License No ` tractor Signature NORKERS' G6fAVMSATION DECLARATION VARNING6 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 SOM01 EOM PENLATIONPDANIAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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 forglance of 11%vl(gr: 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' compensa YPpc arriarUa bplicy number are: p siva CA� Q-� CaM (1- JrrLS. Fl l„�.. �r�S. Fay r .. Policy Number /oar K a" Expiration Date �/( a- a :ertiiy that, lrf 9l)-Drformance 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 works ' compensation laws of California, and agrei IN 2hould Pecomesubject tolto workers? c�om e—nsation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. / Stu e PPMaei14�x/119Y� IJM ALAI 'r RCVAMIJHNV LVlN RUV I IVIY LCIYUIIYV XVCIYLI I hereby affirm nder penalty of perj0y that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Name Lender's Address By 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 applicabl y and county ordin ces and state la relating to building construction. I authorize representatives of city or county to a above= tifi property for inspection purposes. > ,Signature of Prthorized Agent Print Property Owners orAuthorized Kj ACTION 6ATBY DECLARATI OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE 1403 PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED DEPA PERMIT EXTENDED 0ACMD PERMITFINAL"j / ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO CERTIFICATEOF /� la PROPOSED DEMOLITION OCCUPANCY ISSUED 1 SIGNATURE: i .N, 0 ,c a) N N N a) ` p w t O 2 a) -O '�_ a) E Ll 'S � cu w 'C N afn 0 C .O, OE Cc N y O cc CL 0 N 7 O p 0 i 0 a O m N LO of \_ U •C C N U >� `" y 0 0 3 m \\ O) a�oi �X X30 n m(A yd 3— ° No °moo Q- cC�c oC 3a N E 7 U M a) v =O s c c9— o LO o w afOi con a) ma > 0 `o E c 2v 0 d s 'x o w c0 M O c O N 3 C CL O C O .0+ O 1. 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