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Home My WebLink AboutX2017-2376 - PermitstF$ City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2017-2376 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 7 2 3 7 6 Project No : 1687-2017 Permit Counter Phone (949)644-3288 ' Inspection R€quests'P'hone (949)644-3255 „�'� Combination Type - BLDG Issued Date: 07131/2017 0zrar u Inspection Area : 7 Applicant: D M & M CAPITAL INC Con State Lic: PERMITS EXPIRE 780 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Address: 5482-G OCEANUS DRIVE Lic Expire: 01131/2018 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 Surfd Holidays Bus Lic: Job Address: 3990 WESTERLY PL NB Lic Exp Date: y 1 Code Edit: 2016 Description: COMM NON-ILLUM WALL SIGN "PROSUM" Carrier: r C, Occupancy Group: U Legal Desc.: P BK 39 PG 18 PAR 3 Added /New sq.ft. Bldg: 0 Expire: 06/24/2018 Added /New sq. ft. Garage: 0 $0.00 No of Stories: 0 Owner: OW -ABERDEEN WESTERLY OWNER LLC Contractor: D M & M CAPITAL INC Architect: y_ Front: I Address: 315 W 9TH ST #808 Address: 5482-G OCEANUS DRIVE Address: Bldg Sprinklers: $0.00 Right: I LOS ANGELES CA 90015 HUNTINGTON BEACH CA 92649 $0.00 WQ Insp. Fee: Phone: Park Dedication : Phone: 714.891.2670 Phone: State Lic: Refund Deposit Applicant: D M & M CAPITAL INC Con State Lic: 830654 Address: 5482-G OCEANUS DRIVE Lic Expire: 01131/2018 HUNTINGTON BEACH CA 92649 Bus Lic: BT30060046 Phone: 714-891-2670 Lic Exp Date: 07131/2018 Code Edit: 2016 Worker's Compensation Insurance Type of Construction: Carrier: OHIO SECURITY Occupancy Group: U Policy No: XWS57917854 Added /New sq.ft. Bldg: 0 Expire: 06/24/2018 Added /New sq. ft. Garage: 0 $0.00 No of Stories: 0 Building Setbacks Rear: I No of Units : 0 In -lieu Housing Fee : Front: I Bldg Height: 0 Building Dept Adm Left: I Bldg Sprinklers: $0.00 Right: I Construction Valuation: Building Permit Fee: $127.00 Plan Check Fee: $110.49 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $0.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access: $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $275.99 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Engineer: Address: Phone: State Lic: Designer: MCKEE MICHAEL Address: 5462-G OCEANUS DR HUNTINGTON BEACH CA 92649 Phone: Special Conditions: PLANS ATTACHED TO PERMIT Fire Hazard Zone : N Excise Tax: $0.00 Planning Department - Fire Department Additional Fee : $0.00 Plan check Fee : $37.50 Fire Inspection: $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 Grading PC Consultant : $0.00 SJH Trans : $0.00 Demolition Fee Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 Grading PC Fee: $0.00 Public Works Department- General Service $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 PAN Plan Check : $0.00 Grading Bond: $0.00 Electrical %: $0.00 San Dist: $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $275.99 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, priorto its isauance,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 U 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 -Builder will have the burden of proving that it was not built or improved for the purpose of sale). ❑ 1, 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). ❑ 1 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 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.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 700�u�sion 3 of the Business and Profq�sprrs an¢�glyy I�psR js in full force and effect. License Class License No Date 1'I Contractor Signature) �V �-'�� WORKERS' COMPENSATION DECLARATION WARNING: 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. I hereby affirm under penalty of perjury one of the following declarations: ❑ I 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 the o"ance 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' compensatior insurance carrier and policy number are: )) Carrier LA'('.�S,R—M <wUCWiv' Policy Number w S 51 `il �� BS Expiration Date '�� l L S Name of Agent Phone # certify that, in the performance . if I should become subject to I of 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 egret compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 1I Date CLARATION REGIjfQDING CONSTRUCTION LENDING AGENCY �reby 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 ider's Name Lender's Address 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 \,enter�Y/hy��}.','0 e-ideen�ttiified�property for inspection purposes. �A nature of Prooertv Owner or Authorized Aaent \W�"t ' \VV�"�^'. Print Property Owners or Authorized Agent's Name IV ACTION DATE 89 RDECLARATION I EGULATIONS OF COMT 61 LIANCE E WIT40 H CODE ADMF FEDERUDERAL FOR OFFICE USE ONLY PERMITEXPIRED.\4j•\� U I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED1 DEPA PERMIT EXTENDED I LIAOMD NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF SIGNATURE: DEMOLITION OCCUPANCYISSUED Civil Code). Date, tX� 1-7