HomeMy WebLinkAboutX2018-0300 - Permits�w1wy City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit: X2018-0300
''- 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 8 0 3 0 0 Project No : 0252-2018
Permit Counter Phone (949)644-3288
v fit Inspection Requests Phone (949)644-3255
Combination Type - BLDG PLUM Issued Date : 12018
Inspection Area: 1
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: 1045 IN BALBOA BLVD NB
Description: DEMO 2 -UNIT BLDG 1110 (4 BDRM TOTAL),. ,
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Legal Desc.: N TR 234 BLK 10 LOT 12 C's
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Owner: PACK INVESTMENT GROUP LLC Contractor. BURKHART BROTHERS CONSTR Architect: LIN JUINTOW 't � 9
Address: 2288 N. BATAVIA ST Address: 12 BALBOA COVES Address: 392 CAMINO DE ESTRELLA
ORANGE CA 92865 NEWPORT BEACH CA 92663 SAN CLEMENTE CA 92672
Phone: 714323-7860 Phone: 714-350-3892 Phone: 949.325-3001 State Lic:C033054
Applicant:. BURKHART BROTHERS CONSTR
Address: 12 BALBOA COVES
NEWPORT BEACH CA 92663
Phone: 714-350-3892
Code Edit: 2016
Type of Construction: VB
Occupancy Group: R1/U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units : 2
Bldg Height: 0
Bldg Sprinklers:
Building Permit Fee: $217.00
Plan Check Fee: $0.00
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'
FEE: $237.53
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Con State Lic:
905510
Lic Expire:
1 013 112 01 9
Bus Lic:
BT30026859
Lic Exp Date:
0313112018
Worker's Compensation Insurance
Carrier: STATE COMP
Policy No: 9041905
Expire: 02101/2018
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
al %:
I%:
Rear: I
Front: /
Left: I
Right: I
'arkino Spaces
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$19.53
Plan Check Fee
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
Special Conditions: JD DEMO
NO TREES
Planning Department -
Fire Department
Plan check Fee:
Fine Inspection:
Fair Share :
Fire Plan Rev
SJH Trans :
Demolition Fee
In -lieu Housing Fee
Building Dept Adm
Public Works Department -
Park Dedication :
$0.00
PAN Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
$0.00 Fee
PUBLIC WORKS APPR
PLAN CHECK BY:
APPROVAL TO ISSUE:
State Lic:
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Fire Department
$0.00
Fine Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
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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 thecheckmark(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 applicantfor a permit subjects the applicant to a civil penalty of
not more than five hundred dollars ($500).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U 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
im roved 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 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 7 00) Division 3 of the Business and Pro essi ode, and my license is in full force
and effect. License Class License No Date Contractor Signature ®/J .�
NORKERS' COITAPI%SATION DECLARATION
,...
NRRNING: RAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINA PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (S100,000), IN ADDITION TOTHE
:( rOP BQMPENSATJbJ%gPrAGES AS PROVIDED FOR IN SECTION 3703 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
heleby.affirm under perralty of perjury one of the following declarations:
I e• 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
)e*rml) ce of to Work jor which this permit is issued. Policy No.
3Jt• 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' compensatiol
naur De carrieraad pe4oy number are:
ISMIav • • Policy Number Expiration Date
Jamie of agent Phone #
it certify'that, it 6% Mormance 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 agree
hAP, 4f19(lould berg subject t he workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
3i nature ofA lice • D
)ECLARATION RE ARDING CONSTRUC O LENDING AGENCY
hereby affirm and 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).
.enders 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 countyle aRteril(e abgve-identified property for inspection purposes. ,/1 „ , I n _ ✓ J.. ._
vner's or Authorized AG
DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 11
NOTIFICATION TO
PERMITEXTENDED
PERMITFINAL /.i-61-( V.�.' UASBESTOS NO (CATION IS NOT APPLICABLE TO
CERTIFIC4TEOF / PROPOSEDDEM TION —
000UPANCYISSUED RIr,NAr11RF-