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Home My WebLink AboutX2019-2415 - Permitst. , City of Newport Beach - Building Division pWIIIIIIIIIIIII�IIIIIIIIIIIIIIIIII�IIIIIIIIIIIIII COMB Permit: X2019-2415 100 Civic Center. Drive, Newport Beach, CA 92660 Ilf X 2 0 1 9 2 4 1 5 Project No: 0792-2019 Ew : ra Permit Counter Phone (949)644-3285 " - InspSttion 4equests Phone (949)644-3255 "r4s rn a Combination Type- SFP. ELEC MECH PLUM Issued Date: 08/06/2019 0 Inspection Area : 4 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Construction Hours: Monday - Friday 7.00 a.m. to 6:30p.m. and Saturday from 8:00 a.m. to. 6:00 p.m. No work on Sundays or Holidays Job Address: 123 JASMINE CREEK DR NB Description: SFR *CHANGE OF CONTRACTOR` CONV 44 SF OF GAR TO LIVABLE, REMODEL (E) 1,600 SF A A/V`�� Legal Desc.: N TR 7967 LOT 72 V` Owner: BENTROTT BRYAN Address: 123 JASMINE CREEK DR CDM CA 92625 Phone: Applicant: BISHOP ALEX Address:. 23183LA CADENA DR STE 101 LAGUNA HILLS CA 92653 Phone: 949-677-2484 Code Edit 2016 Type of Construction: We 23153 LA CADENA DR STE 101 Occupancy Group: R31U Added /New sq.ft. Bldg: 44 Added/New sq. ft.Garage: 0. No of Stories: 1 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Flood Zone: X Construction Valuation: Building Permit Fee: $0.00 Plan Check Fee: $0.00 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 $0.0� Building Green Fee : 00 FEE: $35.00 PROCESSED BY: ZONING APPROVAL: Contractor: PREMIUM BUILDERS Architect: Address: 1701 E EDINGER AVE #C-9 Address: SANTA ANA CA 92705 Phone: 714-569-1255 Phone: State Lic: Con State Lie: 492049 Engineer: WILSON KALEN •°°°•• Lie Expire: 05/31/2020 Address: 1371 WARNER AVE #A Bus Lie: BT30068364 TUSTIN CA 92780 • Lie Exp Date: 08/31/2020 Phone: 714-576-6524 State Lic:C-083753. ° ° ° Worker's Compensation Insurance Designer: COYLE ROBERT Carrier: STATE COMPENSATION INSURANCE F Address: °°B••• Policy No: 9150924 LAGUNA HILLS CA 92653 Expire: 0111412020 Phone: 949-677-2484 ° Building Setbacks Rear:. 15 Special Conditions: CR & R TO ° 0 Front: 15 HAUL DEBRIS ... ° Left: 5 REPLACE X2019-1116 ° Right: 5 °0000° Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Excise Tax: $0.00 Planning Department -. Fire Department Additional Fee: $35.00 Plan check Fee : $0.00 Fire Inspection:. $0.00 Grading Bonds Fee: $0.00 Fair Share: $0.00 Fire Plan Rev $0.00 Grading PC Consultant: $0.00 SJH Trans : $0.00 Demolition Fee Grading Permit Fee: $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $0.00 Grading PC Fee: $0.00 Public Works Department- General Service $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 PM Plan Check: : $0.00 Grading Bond: $0.00 Electrical %:. $0.00 San Dist: $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 .Plan Check Fee: $35.00 PUBLIC WORKS Fee Due at Permit Issuance : $0.00 PLAN CHECK BY: I GRADING APPROVAL: I \ APPROVAL TO ooea• 000°. ®0000• e ° ° ° 0000 a 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 jfv sign 3 of the Business and Professions Code) or that he or she is exempt from Iicensure 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). ❑ 1, 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, 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). 111, 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 Iicensure 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 LICENSED COFAVACTOR'S DECLARATION I.herebyaffirm unt9i'13enalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 7000 - ivi on 3 of the Business and Profess' qs Code, and @n'se is in full force V%ftLt. LiceirItt"iss License No Date Contractor Signatu WQRKERS' COMPENSATION DECLARATION ORRIagj:111FAILURE TONSECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSA LL RS ($100,000), IN ADDITION TO THE COST OF COMPENW1011,0AMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. - I bersbyy affirm under penalty of perjury one of the following declarations: 2I.;�ve and )yRI"gigtain 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 p ace of the wtxk for which this permit is issued. Policy No. ba 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 compensatioi uf2 carriet4rl" icy number are: 1Bf _ Policy Number Expiration Date V' moJAgent ." ' Phone # :1I certify that, in the performance of the work for wh' h 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 agre hat, if I should become subject to the workers' c nation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant Date�X. J 3ECLARATION REG DING CONS T LENDING AGENCY hereby affirm under olpInalty of per" that there is a construction lending agency for the performance of the work forwhich this permit is issued (Section 3097, Civil Code). _ender's Name Lender's Address 3y 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 law Ling to building construction. I authorize representatives of this city or county to enter the above-i i operty for inspection purposes. [/ Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name tzoDatei ACTION DATE BY DECLARATION 0 O LIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATION ART 61 OF TITLE 40ANDAQMD RULE PERMIT EXPIRED I I I LIISUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED EPA PERMITFINAL .f DA'ti LIASBESTOS NOTIFICATION IS NOTAPPLICABLE TO CERTIFICATE OF F''ari PROPOSED DEMOLITION OCCUPANCYISSUED I SIGNATURE: