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Home My WebLink AboutX2019-1302 - Permitswt City of Newport Beach- Building Division III'��I�IB��u��l��lu II COMB Permit: X2019-1302 c+ 100 Civic Center Drive, Newport 60 Beach, CA 926II X 2 0 1 9 1 3 0 2 s Project No: 2465-2018 R Permit Counter Phone (949)644-3288 c"t.. Inspection Requests Phone (949)644-3255 'irarua�� Combination Type - SFP ELEC MECH. PLUM Issued Date : 0610612019 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 NI3 Description: DELTA - ADD'L SCOPE -REMODEL (3 BATHS, CHANGE ROOF CONFIGUATION @ FRONT, WINDOW CIO & NEW DOOR SYSTEM, REPLACE SKYLIGHT 1260 SF Legal Desc.: N TR 5130 LOT 7 Owner: MEYER HOLDINGS LLC Contractor: BLACK PETE CONSTRUCTION INC Architect: Address: 4320 VON KARMAN AVE Address: 1788 MONROVIA AVENUE - Address: •-0 • ' NEWPORT BEACH CA92660 COSTA MESA CA 92627 - ° ° ° Phone: Phone: 714-612-7678 Phone: State Lie: _x'•�#;� °�•ao Applicant: BUCHAN IAIN R bon State Lie: 692383 Engineer: BUCHAN IAIN R Address: 2340 S EL CAMINO REAL Lie Expire: 08/31/2020 Address: 2340 S EL CAMINO REAL • a ° ° SAN CLEMENTE CA .92672 Bus Lie: BT00003226 SAN CLEMENTE CA 92672 • ..... Phone: 949-489-9786 Lie Exp Date: 04/30/2020 Phone: 949-489-9786 State Lic:C-057147 , ° • °e ° ° Code Edit: 2016 Worker's Compensation Insurance Designer. ..... ®° • : ° ° ° ° ° °Q°°°o Type of Construction: V13 Carrier: EXEMPT Address: ° Occupancy Group: R3/U Policy No: Added /New sq.ft. Bldg: 0 Expire: Phone: Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear: I Special Conditions: FRANCHISED HAULER: No of Units : 1 Front: I ROBERTS WASTE Bldg Height: 0 Left: I Bldg Sprinklers: Right: I Flood Zone: _ Use Zone: Parkinq Spaces: 0 Fire Hazard Zone, N Building Permit Fee: $1,828.00 Excise Tax: $0.00 - Planning Department - Fire Department Plan Check Fee: $1 ,590.36 Additional Fee : $0.00 Plan check Fee : $40.00 Fire Inspection: $0.00 Overtime Plan Ck: $0.00 Grading Bonds Fee: $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: $34.00 Grading Permit Fee: $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $24.00 Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department - General Service $197.00 CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $564.00 Disabled Access: $0.00 PAN Plan Check : $41.25 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $127.96 San Dist: $0.00 BuildingGreen Fee: $9.00 Mechanical %i $73.12 NMUSD Fee: $0.00 $0.00 Plumbing %: $164.52 $0.00 TOTAL FEE: _$4,693.21 Plan Check Fee: $1,630.36 Fee Due at Permit Issuance : $3,062.85 PROCESSED BY:. PUBLIC WORKS APPROVAL: (�1 ' ZONING APPROVAL: 7JV PLAN CHECK BY: GRADING. APPROVAL: 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) Iction 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 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 Ifessions 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 more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, >iness 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 aovements 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 xoved 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 )ly 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: my signaW 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 Iegalll I a structuse-that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. 1 understand that a copy of the applicable law, Section 7044 of the Business and Aessions•(;pder is available upon request when this application is submitted or at the following Web site:http:/Aw .leginfo.ca.gov/calaw.html. nature oPPibperly Owner or Authorized Agent Date TENSED CQNTRACTOR'S DECLARATION leby affirm urlder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 I Sil the Business and Pro ode, and my license is in full force f effect. UcenseClass License No Date L� Contractor Signature �J?KERS' COJIDPENSATION DECLARATION QNING: FAILUREnOl�5tCURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE YQF COMPIRJSXM N, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. Roby affirm urltler penalty of perjury one of the following declarations: I hJve and "l•Rlljintain 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 fonnance of the work for which this permit is issued. Policy No. I.4�JE and will I%rTtain 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' compensatioi urance carrier and policy number are: Policy Number of Agent Date certify that, in the pe ormance of th t�rk for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers ompensat'on laws of California, and agre tiff I should become ubje, t to th ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. c� /� Da J nature of Applicant CLARATION RE RDING CONSTRUCTION LENDING AGENCY Ireby affirm under enalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 30 , 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 cor act I agree to comply with all applicable city and co my ordinances a state laws relating to building construction. ' I authorize representatives of this city or count to enter the a = 'Ted property for inspection purposes. nature of Prooerty Owner or Authorized Acent Print Property Owner's or Authorized Agent's Na ' !"r n'le (�+ F ate _ ACTION I DATE I BY DECLARKION OF I REGULATIONS PART0MPLIANCE WITH CODE OF 61 OF IIT E 40 AND AQMD RU ESL FOR OFFICE USE ONLY PERMITEXPIRED (SUBMITTED ASBESTOS PERMITCANCELLED EPA PERMIT EXTENDED OMD PERMIT FINAL BEST CERTIFICATE OF ,�V III I� �( I'P' OSEDEMOLITT�T IS NOTAPPLI BLE TO OCCUPANCYISSUED Inn �j' TTSIGNATUR t�