HomeMy WebLinkAboutX2019-3409 - Permitss11>, City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
s # Inspection Requests Phone (949)644-3255
Combination Type - SFP
IIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII IICOMB Permit: X2019-3409
x 2 5 1 9 3 4 6 9 Project No: 2935-2018
Issued Date : 11107/2019
Inspection Area : 2
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: 38 LINDA ISLE NB
Description: SFR -ADD (4) WINDOWS 8: (1) DOOR (DELTA 6)
Legal Desc.: N TR 4003 LOT 38
Owner: SUTHERLIN Contractor: PMR CONSTRUCTION Architect: MARTINEZ DANIEL /11SP8
Address: 4680 95TH AVE NE Address: 2061 FAIRWEATHER RD Address: 1445 GLENNEYRE ST #B ^�
YARROW POINTWA 98004 SANTA ANA, CA 92705 LAGUNA BEACH CA 92651 9V•
Phone: Phone: 714-231-7272 Phone: 949-494-7272 State Lic:CO20483
Applicant:
MARTINEZ DANIEL
Address:
1445 GLENNEYRE ST #B
Occupancy Group:
LAGUNA BEACH CA 92651
Phone:
949.494.7272
Code Edit:
2016
Type of Construction:
V -B -SPR
Occupancy Group:
R3IU
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:
0.2 PCT
Building Permit Fee: $136.00
Plan Check Fee: $118.32
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$28.00
Energy Compliance:
$0.00
CA Seismic Safety:
- $0.00
Disabled Access:
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $221.32
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Con State Lie:
716745
Lie Expire:
12131/2019
Bus Lie:
30053615
Lie Exp Date:
01/3112020
Worker's Compensation Insurance
Carrier: NATIONAL LIABILITY
Policy No: A9WC973439
Expire: 1210512019
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: I
Front: /
Left: /
Right: /
Parkins Soaces
$0.00
($62.00)
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee
Planning Department -
Fire Department
Plan check Fee
Engineer:
MOKHTARTAREK
$0.00
Address:
31645 S COAST HWY
In -lieu Housing Fee:
$0.00
LAGUNA BEACH CA 92651 m .... m
Park Dedication :
Phone:
0
949-499-6254 State Lia:S-004189
.
San Dist:
o e
om°seo
Designer:
moo°mm
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Address:
NO CONSTRUCTIONA,01SE°°0
Phone:o
moc,m
° °
m o
me
Special Conditions:
o
$0.00
Ao
°
ON THE WEEKEND
ommoo
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Cn1-1 OO
Fire Hazard Zone : N
O O
m o m
0000
mmol ��
Planning Department -
Fire Department
Plan check Fee
$0.00
Fair Share
$0.00
SJH Trans
Fire Plan Rev
In -lieu Housing Fee:
$0.00
Public Works Department -
Park Dedication :
$0.00
PAN Plan Check,
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
$0.00 Fee Due at Permit Issuance : $221.32
PUBLIC WORKS APPROVAL:
PLAN CHECK BY: r
APPROVAL TO ISSUE:
Fire Department
$0.00
Fire Inspection:
$0.00
$0.00
Fire Plan Rev
$0.00
$0.00
Demolition Fee
$0.00
Building Dept Adm
$0.00
General Service
$0.00
Refund Deposit
$0.00
Grading Bond:
$0.00
$0.00
$0.00
$0.00 Fee Due at Permit Issuance : $221.32
PUBLIC WORKS APPROVAL:
PLAN CHECK BY: r
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 penMlty 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 (_) 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
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 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.htmi.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm uryfer penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 of ivi '0 3 of the Business and Pro s o e, an 1 iee / Yforee�
and effect. Licei4"011ss License No Date L Contractor Signa
V.g1J$�RS' CQMPQ,NSATION DECLARATION /
MARNING°FAILURLO TQS2CURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINER UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001,XINITIONTO THE
C44T OF COMPENSATION, 11AMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, ANO ATTORNEY'S FEES.
:1e?gjV%ffirm undgr penalty of perjury one of the following declarations:
....
I have and will.rrpplhtain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th,
ovrance of the work for which this permit is issued. Policy No.
`6% and HQlLfhaintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatiol
e rice carrier argd policy number are:
Iffi-pr._- Policy Number Expiration Date
'tame of•Agent .. f ' Phone #
�y .e.
wll certi�y that, indhrscttonthe
ork for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' mpensation laws of California, and agree
:h3t'f i should tie"orkers of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
SignatureofApplicaDat �,DECLARATION REONSTRUCTION LENDI G A NChereby affirm undeerjury that there is a construct nding agency for the performance of the work for which this permit is issued (Section 30 ,Civil Code).
Lender's Name Lender's Address
By my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owner's behalf.
I have read this application and the information I 'ded is correct.
I agree to comply with all applicable it y o antes and, laws relating to building construction.
I authorize representatives of this city or co my o enter t e abov -iderl ' ie p y for inspection purposes. Dr
Signature of Property Owner or Authorize an - ' t Property Owner's or Authorized Agent's NameAi�Q. LL'i..L$�t D e
ACTION DATE BY I DECLARATION OF COMPLI CE W CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 610E ITL OANDAQMD RULE
PERMITEXPIRED
I SUBMITTED ASBEST NOTIFICATION TO
PERMIT CANCELLED
EIEPA
PERMIT EXTENDED
-' QMD
PERMITFINAL
CERTIFICATE OF
OCCUPANCYISSUED
AAASIkSTOS NOTIFICATION IS NOT APPLICA LE TO
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