HomeMy WebLinkAboutX2019-0189 - PermitsCity Newport Beach BhcB Building Division I IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
IIIIIIIII
COMB Permit: X2019-0189
Civic Center aho
$1,390.00
Excise Tax:
Plan Check Fee: $1,209.30
Additional Fee
Overtime Plan Ck:
$0.00
Grading Bonds Fee:
Investigation Fee:
$0.00
' Grading PC Consultant
Permit Counter Phone (949)644-3288.
Project No : 0151-2019
Grading Permit Fee:
Inspection Requests Phone(949)644-3255
$95.90
Grading PC Fee:
.. r"�trecrc g Combination Type - SFP ELEC MECH PLUM -
Issued Date : 05/31/2019
WQ Insp. Fee:
Disabled Access:
Inspection Area: 1
$97.30
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
'. $0.00.
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
Building Green Fee :.
Job Address: 128 VIA YELLA NB
....
Description: SFR ADD 38 SF,REMODEL 1325 SF @ THE SECOND FLOOR AND YARD DRAINAGE
Plumbing %:
Legal Desc.: N TR 907 LOT 399
.
Owner PATRICK JAMES -
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BROYLES Contractor: GOLDEN EDGE CONSTRUCTION INC
Architect +'' t � °
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Address: 128 VIA YELLA Address' 15561 PRODUCT LN, C-14
NEWPORT BEACH, CA 82663
,
-Address: u , , 1 N "" '
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HUNTINGTON BEACH CA 92649
Phone:
P; ry
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Phone 714.897-0971
Phone: State Lie:°
Applicant GOLDEN EDGE CONSTRUCTION Con State Lie: 800077
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Engineer: REZAI FARHAD o ° ° ...
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Address:. 15581 PRODUCT LN Lie Expire: .10/31/2019
Address:. 16532 RHONE LN
° • • • "
HUNTINGTON BEACH CA 92649 Bus Lie - BT30062718
HUNTINGTON BEACH CA 92647
Phone 714.897.0971: Lie Exp Date: 04/3012020
Phone: 714/041-0337 State Lic:S-003970 . m •-m m ®m
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Code Edit : 2016 Worker's Compensation Insurance
Designer. LACY MATT m m m
ocor
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Type of Construction. V -B -SPR Carrier: STATE COMP
Address: 15581 PR PRODUCT LN
Occupancy Group: R3/U Policy No: 9083411
- HUNTINGTON BEACH, CA 92649
Added/New sq.ft. Bldg: 0 Expire: 01/01/2020
Phone: 714-897-0971
Added /New sq. ft. Garage:. 0
No of Stories: 2 Building Setbacks Rear: 10
Special Conditions: LIQUEFACTION
No of Units : 1 Front: 4
-
Bldg Height: 0 Left: 3
Bldg Sprinklers: Right: 3
Flood Zone: ' Use Zone: Parkina Snares: m
Pic. P. -A 7...,e - u
Construction. Valuation: $137.000.00
Planning Department -
.Building Permit Fee:
$1,390.00
Excise Tax:
Plan Check Fee: $1,209.30
Additional Fee
Overtime Plan Ck:
$0.00
Grading Bonds Fee:
Investigation Fee:
$0.00
' Grading PC Consultant
Record Management:
$50.00
Grading Permit Fee:
Energy Compliance:
$95.90
Grading PC Fee:
CA Seismic Safety:
$17.81
WQ Insp. Fee:
Disabled Access:
$0.00
$97.30
Hazardous Mat
'. $0.00.
Electrical %:
Building Green Fee :.
$6.00
Mechanical %:
Plumbing %:
11 TOTAL FEE: $3,794.76 -
PROCESSED BY: �^
ZONING APPROVAL:
GRADING APPROVAL:
$0.00
Planning Department -
Fire Inspection:
$0.00
Plan check Fee
$0.00
$0.00
Fair Share :.
$0.00
$0.00
SJH Trans':.
$0.00.
$312.00
In -lieu Housing Fee :
$0.00
$312.00
Public Works Department -
$0.00
$0.00
Park Dedication : $0.00
P/W Plan Check : - $123.75
$97.30
San Dist: $0.00
-$55.60
NMUSD Fee: $0.00
$125.10
Fire Department
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
Building Dept Adm
$0.00
General Service
$0.00
Refund Deposit
$0.00
Grading Bond:
$0.00 -
$0.00
$0.00
Plan Check Fee $2,020.00 Fee Due at Permit Issuance : $1,774.76
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 resson(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
:he 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
3rofessions 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 penally of
iot more than five hundred dollars ($500).
'❑ 1, 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
'mproved for the Purpose of sale).
0 I, as owner of ihe�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 "a an ownerot property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' Stale License Law).
E I am exampt.
t from licensure under the Contractors' State License Law for the following reason:
By nay 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
sAll a % fucture 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
Professi ons Code isavailable 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
LAGrENSED CONTRACTOR'S DECLARATION
I IJ9r8ly Affirm under peflalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0) of D' isi 3 of the Business and Profes Ions Code d my license is in full force
apq Vffgcl. License Class License No Date 5 3! Contractor Signature r
IIQORK�RS' COMBBJSATION DECLARATION
'NPIiFillr i FAILURE TO SECUNE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI AL PENALTIES AND CML FINES UP TO ONE HUNDR THOUSAND DOLLARS ($'I00,000(, IN ADDITION TO THE
COST OF COMPENSA11aN, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereny affirm undar{ snnalty 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 th
Iperformance of the work for which this permit is issued. Policy No.
Shave 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
nce carrier and policy number are:
Policy Number
Date
ne of Agent
certify that, in the performance of the work fA which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' C? mpensation laws of California, and agre
kers'
t, if I should becomes ject to the worompensation provisions >Section
3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant CJC�� a }'r Date
CLARATION REGA DING CONSTRUCT ENDI AGENCY
:reby affirm under nalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 309 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.
1 agree to comply with all applicable city and count ^ordinances and st a laws relating to building construction.
I authorize representatives of this city or county t,7,/yenter the abov� a tified properly or inspection purposes 1'14 � / `�
nature of PrODertv Owner or Authorized Agent ! /y✓'vc-� �i' �^ Print Property Owner's or Authorized Agent's Name r.� Date 7 7
ACTION DATE BY DECLARATION OF COMIILIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGU TIONSPART61 FTITLE 40 AND AQMD RULE
3
PERMITEXPIRED I Ll I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED / EPA
CERTIFICATE OF 47�E3 ��SIDNATUROSjU UTIONIONISN APPLICABLE TO
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