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HomeMy WebLinkAboutX2015-2787 - Permitse��ne4 City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIII�lljlllll 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 5 Permit y Inspection u Requests Phone (949)644-3265 ComBination Type - BLDG F 2 7 7 II COMB Permit: X2015-2787 Project No Issued Date: 09/24/2015 Inspection Area : 3 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Planning Department - Fire Department Job Address: 2412 UNIVERSITY DR NB Plan Check Fee: $71.28 Additional Fee : Description: SFR BLOCK WALL 5'X 6LF (INSIDE P/L, HOA AGREEMENT ATTACHED TO PERMIT) CITY STD PLAN Plan check Fee : $32.00 Fire Inspection: _ $0.00 Legal Desc.: TR 4444 LOT 17 TOGETHER WITH AN UND 1/33 INT IN LOT 34 $0.00 Owner: MASUNAKA IRENE Contractor: THE CONSTRUCTION GUYZ Architect: - $0.00 Investigation Fee: Address: 2412 UNIVERSITY DR Address: 8321 MAGIC CIRCLE Address: $0.00 SJH Trans : $0.00 NEWPORT BEACH, CA 92660 HUNTINGTON BEACH CA 92646 Record Management : $2.00 Phone: Phone: 714.261-9922 Phone: State Lia, Building Dept Adm Applicant: THE CONSTRUCTION GUYZ Con State Lic: 811992 Engineer: $0.00 Grading PC Fee: Address: 8321 MAGIC CIRCLE Lie Expire: 03/31/2016 Address: General Service $0.00 HUNTINGTON BEACH CA 92646 Bus Lie: BT30049983 $0.00 WO Insp. Fee: $0.00 Phone: 714.261-9922 Lic Exp Date: 02/29/2016 Phone: State Lie: Disabled Access: Code Edit: 2013 Worker's Compensation Insurance Designer: P/W Plan Check : $0.00 Type of Construction: Carrier: STATE COMP Address: Hazardous Mat $0.00 Occupancy Group: U Policy No: 9096074 $0.00 San Dist : $0.00 Added /New sq ft. Bldg: 0 Expire: 04/12/2016 Phone: $1.00 Mechanical %: Added /New sq. ft. Garage: 0 NMUSD Fee: $0.00 $0.00 No of Stories: 0 Building Setbacks Rear: / Special Conditions: Plumbing %: $0.00 No of Units : 0 Front: / $0.00 TOTAL FEE : $205.28 Bldg Height: 0 Left: / Plan Check Fee : $0.00 Fee Due at Permit Issuance : $205.28 Bldg Sprinklers: Right: / ° ° Flood Zone: Use Zone: Parkinq Spaces: 0 Fire Hazard Zone : N ZONING APPROVAL: Building Permit Fee: $99.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $71.28 Additional Fee : $0.00 Plan check Fee : $32.00 Fire Inspection: _ $0.00 Overtime Plan Ck: $0.00 Fair Share : $0.00 Fire Plan Rev - $0.00 Investigation Fee: $0.00 Grading PC Consultant : $0.00 SJH Trans : $0.00 Demolition Fee Record Management : $2.00 Grading Permit Fee: $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $0.00 Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department - General Service $0.00 CA Seismic Safety: $0.00 WO Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access: $0.00 P/W Plan Check : $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist : $0.00 Building Green Fee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $205.28 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $205.28 PROCESSED BY: ° ° °o °o Ptbi&iC WOIRKSeAPPROVAL: ZONING APPROVAL: ` t °° PLAN CHELk Bl,.,,,, GRADING APPROVAL: ,. _. APPROVAL TO ISSUE: ° o coo c o c( 0 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Divi$ion 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). 111, 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). 0 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), ❑ I 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 Iegallt 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 D#TSAND te LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 ) o Islo 3 0 the Business and Pe, my li as is in full force and effect. License Class License No Date - Z r Contractor SignatuWORKERS'COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 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 th pert rmance 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' compensatiol insurance carne d.policy number ar Carrier \\ P i y mber Expiration Date Name of Agent I Phone # ❑I certify that, in the perform nce of he work forwhich thi er It is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation lawsofCalifornia, and agre that, if I should become su bje t to the workers' co pensati n ovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. DatCy�/ J Signature of Applicant :reby affirm under penalty of Jury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil o e). 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 hav vided is corre t. I agree to comply with all applicable city and count ordin nces and st to a relating to building construction. I authorize representatives of this city or coun t nter t abov id ntproperty for inspection purposes. nature of of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name 1 arrxrly r sFf v DECLARATION QFCOMPJUAAICE WITNCODEOF KNEta�rcar rrnrd Aj vrr4H ATN MQ VAAT:AY' nF Td TI FJrr@ dAJ1} PFRdurIT fXPdRfla • e • �'tlDitP R'U7+r. 4403. • • • PFRUT T WPIRFtCtd' . • s : © qf ffnivrfi:+�:fif�(:S� & Mwfrit'4TdONTO. 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