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X2018-3166 - Permits
gwa• City of Newport Beach Building Division IIIIIIIIIIIIIIIIIIIIIIIIaIIIIIIdIIIllll COMB Permit: X2018-3166 a 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 8 3 1 6 6 a Project No: 2465-2018 - F '• 'E. Permit Counter Whorie t349)644-3208 - r"`s : 3t Inspection Requests Phone (949)644-3255 - xkrrra;� Combination Type - SFP ELEC MECH PLUM Issued Date: 0110912019 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: 1027 DOLPHIN TER NB Description: SFR ADD 790 SF (ENCLOSE BREEZEWAY), REMODEL KITCHEN MSTR BATH 8. POWDER RM (940 SF) Legal Desc.: N TR 5130 LOT 7 Owner MEYER HOLDINGS LLC Address: 4320 VON KARMAN AVE NEWPORT BEACH CA92660 Phone: Applicant: BUCHAN IAIN R Address: 2340 S EL CAMINO REAL SAN CLEMENTE CA 92672 Phone: 949-489-9786 Code Edit, 2016 Type of Construction: VB Occupancy Group: R31U Added /New sq.ft. Bldg: 790 Added /New sq. ft. Garage: 0 No of Stories: 1 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Flood Zone: X 0U�©pp Building Eermit F�eP.L , ,$4,593.00 Pla cChe@k Fee: $3,672`70 Overtime Plan Ck: • $0.00 Investigation Fee:.". $0.00 Reco°rd4Nanageriigr„t": m $46.00 EDer,g;i`gprnpliange... $268.00 CA•Seiamic Safe:_ _ , $65.00 Disabled Access: $0.00 Haeardsus Mat ® $0.00 Building Green $20.00 ...... ® o TOrf"AL FEE: $10,528.30 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Contractor. BLACK'PETE CONSTRUCTION INC Address: 1788 MONROVIA AVENUE COSTA MESA CA 92627 Phone: 714-612-7678 Con State Lic: 692383 Lic Expire: 0813112020 Bus Lic: BT00003226 Lic Exp Date: 0413012019 .. Worker's Compensation Insurance Carrier: STATE COMP. INS Policy No: 9042053 Expire: 02/11/2019 Building Setbacks Rear: 1 ib Front: / L; Left: / Right: / Use Zone: Parkin Snar' sr n Architect: Address: Phone: State Lic: Engineer: BUCHAN LAIN R Address: 2340 S EL CAMINO REAL SAN CLEMENTE CA 92672 Phone: 949-489-9786 State LiaC-057147 Designer: _ Address: Phone: Special Conditions: TIGHT QUARTERS TO HAUL DEBRIS Fire Hazard Excise Tax: $0.00 Planning Department - Additional Fee : $0.00 Plan check Fee Grading Bonds Fee: $0.00 Fair Share: Grading PC Consultant : $0.00 SJH Trans : Grading Permit Fee: $0.00 - In -lieu Housing Fee: - Grading PC Fee: $0.00 Public Works Department - WQ Insp. Fee: $0.00 Park Dedication : $0.00 PM Plan Check: $0.00 Electrical %: $321.61 San Dist: $0.00 Mechanical %:. $183.72 NMUSD Fee: $0.00 Plumbing %: $413.37. Fire Department $160.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit. Grading Bond: $0.00 $0.00 $24.00 $197.00 $564.00 $0.00 $0.00 $0.00 Plan Check Fee : $4,100.70 Fee Due at Permit Issuance : $6,427.60 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 reasons) indicated below by the checkmark(s) I have p)aced. 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 IS 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 'rofessions 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 of more than five hundred dollars ($500). 7 I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, iusiness 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 nprovements 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 nproved for the purpose of sale). 1 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 pply 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). lam exempt from licensure under the Contractors' State License Law for the following reason: ly 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 ell 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 'rofessions Code, is available upon request when this application is submitted or at the following Web she:hftp://www.leginfo.ca.gov/calaw.htmi. signature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70.0) of D isio 3 of the Business and Professions CgJeI, and my license is in full force nd effect. License Class License No Datf' Contractor Signature ), � VORKERS' COMPENSATION DECLARATION rARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES 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 e%ormance of the work for which this permit is issued. Policy No. 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' carrier and policy number are: Policy Number Date me of Agent t'none s I 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 IallA pfCVliforma, gqd ggre t, if I should become subject to t workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. O nature of Applicant X !' — Date",L� // :..••. CLARATION REG NG ONSTRUCTION LENDING AGENCY r./I ,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). • ,,,,, lder'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. 1 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 ove-identified property for inspection purposes. mature of Pronertv Owner or Authorized ADentrJL Print Property Owner's or Authorized Agent's Name./ PERMITEXPIRED PERMIT EXTENDED DATE BY V XPECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY /y REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE 1403 ASBESTOS NOTIFICATION TO PERMITFINAL ASBESTOS CERTIFICATEOC UPANCYIOSSUED �I -7I L L U 4 ��ONATURErXMOLITIONI S`NAPPLICABLE TO