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Home My WebLink AboutX2018-3091 - Permitst'o�i City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2018-3091 ^4 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 a 3 0 9 1 Project No: 2419-2018 E Permit Counter Phone (949)644-3288 - Inspection Requests Phone (949)644-3255 oarr9t1a�' `` Combination Type - SFP Issued Date 9 Inspection Area : 2 Applicant: PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Address: 145 W MAIN ST Record Management: 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 CA Seismic Safety: $0.00 Description: SFR DRYWALL REPAIR THROUGHOUT, RESTUCCO, REROOF W/CONCRETE TILE 5.7 PSF Hazardous Mat $0.00 Legal Desc.: N TR4003 LOT 38 t q�, n"`"n�,_!'1i ` $0.00 Owner: BOYD PATRICK Contractor: PMR CONSTRUCTION Architect: Address: 38 LINDA ISLE Address: 2061 FAIRWEATHER RD Address: s k w -g 'we NEWPORT BEACH, CA 92660 SANTA ANA, CA 92705 Phone: 949-633-6990 Phone: 714-231-7272 Phone: State Lic: Applicant: KELSAY DAN Address: 145 W MAIN ST Record Management: TUSTIN CA 92870 Phone: 949-375-6495 Code Edit : 2016 Type of Construction: Occupancy Group: Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 0 No of Units: 1 Bldg Height: 0 Bldg Sprinklers: Flood Zone: Building Permit Fee: $973.00 Plan Check Fee: $846.51 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 : $4.00 TOTAL FEE; $1,863.51 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Con State Lic: 716745 Lic Expire: 12131/2019 Bus Lic: 30053615 Lic Exp Date: 01/31/2019 Worker's Compensation Insurance Carrier: STATE COMP Policy No: 9024949 Expire: 09101/2019 Building Setbacks Excise Tax: Additional Fee: Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical W Mechanical %: Plumbing %: Rear: I Front: I Left: / Right: / $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Engineer: Address: Phone: Designer: KELSEY DANIEL Address: 145 W MAIN ST Fair Share TUSTIN CA 92780 Phone: 949.375.5495 Special Conditions Fire Hazard Zone : N Planning Department - Fire Department Plan check Fee Fire 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 Plan Check Fee : $846.51 State Lic: • m ommmmm 0 mmm• o ommo m e m °oomom 0 mom m • o •m o °o coomoo 0 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $1,017.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: o � omococ m • o • o c •o 0 0 m ° o c em o m000c m om000 °mocmc ° m c o m o°•000 __ o 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: • m ommmmm 0 mmm• o ommo m e m °oomom 0 mom m • o •m o °o coomoo 0 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $1,017.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: o � omococ m • o • o c •o 0 0 m ° o c em o m000c m om000 °mocmc ° m c o m o°•000 __ o 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 (_) 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). ❑ 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 LICENSEQ�aQORACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force apd effect. P lddhllp Class License No Date Contractor Signature TION DECLARATION NMIG: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUS.IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE T OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. ••.•• repy affirrh under•penalty of perjury one of the following declarations: t have arV WIti riSaintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for thi Crp7ance of -the work for which this permit is issued. Policy No. have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatior Irasice carriQapd$olicy number are: tier Policy Number Expiration Date he sf Agent ' . Phone # •• • •• certify that, in the performance 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 , if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. of Date CLARATION REGARDING 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, Civil Code). 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 to enter the above -identified property for inspection purposes. nature of Prooertv Owner or Authorized Aaent _ Print Property Owner's or Authorized Agent's Name Date ACTION DATEI BY I REGULATIONS PART DECLARATION OF O 1 OF IIT E 40 AN AQMD RULECE WITH CODE OF RAL I FOR OFFICE USE ONLY PERMIT EXPIRED NOTIFICATION TO PERMITFINAL / /�� /�///, y PROPOSED D NOTIFICATION IS NOTAPPLICABLE TO CERMIT RTEOF I( F f�'�/1/�/PROPOSED DEMOLITION OCCUPANCYISSUED J 74 - SIGNATURE: