HomeMy WebLinkAboutX2019-3323 - Permitsd+'1•�+P�, City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIII�III�IIIIIIIIIIIII�Illullll II
o{ 100 Civic Center Drive, Newport Beach, CA 92660 N y
v - Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255 `'rt�r,�n+`•' Combination Type- SFP ELEC MECH PLUM INSPECTOR
COMB Permit: X2019-3323
Project No : 2309-2019
Issued Date : 08124/2021)
Inspection Area : 2
PERMIT EXPIRES 160 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0812512023 OR PERMIT WILL BE 14VALID
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 Holidn ys
Job Address; 1611 KINGS RD NB
Description: SFR ADD 108 SF, REMODEL (E) LIVABLE. NEW ROOF STRUCTURE OVER ENTRY/STAIR. ALT BASEMENT STORAGE TO GYMIWINE STORAGE 6229 SF
Legal Desc.: N TR 1219 BLK E LOT 44
0000
Owner: STREIFF KIMBERLEE Contractor: GABAY DAVID JOHN JR Architect: TEALE MARK =
Address: 1611 KINGS RD Address: 31726 RANCHO VIEJO RD Address: 2900 BRISTOL ST BLDG A203 Colo'
NEWPORT BEACH CA 92663 SAN JUAN CAP CA 92675 COSTA MESA CA 92626
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Phone: Phone: 949-370-0478 Phone: 949-975-0123 State Lic:CO22162
Applicant: TEALE MARK
Address: 2900 BRISTOL ST BLDG A203
COSTA MESA CA 92626
Phone: 949-975-0123
Code Edit :
2016
Type of Construction:
V-B-SPR
Occupancy Group:
R3/U
Added /New sq.ft. Bldg:
108
Added /New sq. ft. Garage: 0
No of Stories:
2
No of Units :
1
Bldg Height:
29
Bldg Sprinklers:
Flood Zone:
Building Permit Fee: $5,775.00
Plan Check Fee: $5,009.93
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management :
$62.00
Energy Compliance:
$303.00
CA Seismic Safety :
$97.50
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$30.00
TOTAL FEE : $14,231.99
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Con State Lic:
529750
Lic Expire:
06130/2022
Bus Lic:
BT30033857
Lic Exp Date:
12131/2020
Worker's Compensation Insurance
Carrier: CALIFORNIA INSURANCE
Policy No: 468264410
Expire: 04101/2021
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: 10'
Front: 10'
Left: 4'
Right: 4'
Parking Spac
$0.00
($222.44)
$0.00
$0.00
$0.00
$0.00
$om
$404.25
$231.00
$519.75
2
0
Engineer:
HAKIM FADY
Address:
124 PEONY
=
IRVINE CA 92618
Phone:
310-422-1536 State Lic:C-075736
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Designer:
C
Address:
Phone:
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Special Conditions: LANDSLIDE AREA
Planning Department -
Plan check Fee
Fair Share
SJH Trans
In -lieu Housing Fee
Public Works Department -
Park Dedication : $0.00
PAN Plan Check : $473.00
San Dist: $0.00
NMUSD Fee: $0.00
Zone: N
Fire Department
$740.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
Plan Check Fee : $6,147.49 Fee Due at Permit Issuance :
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
$0.00
$0.00
$26.00
$219.00
$664.00
$0.00
$0.00
$0.00
$9,084.50
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OVtVNER-IBUIL!ER DECLARATION
1 hereby affirm ur der penalty of perjury that I am exempt from the Contractors' State License Law far the reason(s) indicated below by the chec kmark(s) I have placed next to the applicable item(s)
Section 7C31.5, But loess and Professions Code: Any city or county that requires a permit to construct, after, improve, demolish, or repair any structure, prior to its issuance, also mqu'aes the applicant for
he permit to file a s ,ned 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
'mfessfans Code) c 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
lot more than five h; rtdred dollars ($500).
1, as owner of th-. property, or my employees with wages as their sale compensation, will do ( ) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044.
3usiness and Pmfee ;ions 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
Tiprovertents are rc t 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
Ttproved for the put; ose of sale).
2 1, as owner of th property, am exclusively contracting with licensed Contractors to construct the project (Section 7044. Business and Professions Code: The Contractors' State License Law does not
rpply to an ovmer of Droperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License taw).
31 am exempt fro, licensure under the Contractors' State license Law for the following reason:
ly my signature be], w 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
all a structure that I nave 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
'mfessions Code, 1e available upon request when 8ris application is submitted or at the following Web site:hitp.,/lwww.lei imfo.ca.gov/cafaw.html.
Signature of Propen Owner or Authorized Agent Date
JCENSED CONT 1,ACTOR'5 DECLARATION
hereby affi0r uncle: penalty of perjury that 1 am licensed under provisions of Chapter 9 �cppImencing with Sectio 0 o Dlviston 3 of the Business and Pro Ions o e, and m license is in full force
Ind effect. License Class y License No_ 5 `A '1.SU __ Dat D Contractor Signature )
PORKERS' COM'ENSATtON DECLARATION
tARNNG: FA LURE TO:.=CUREwOR;ueUr COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUMIECTAN EMPLOYER To CRIMINAL PENALTES ANO CMt FRIES UP TO ONE HUNDRED THOUSAND OD"RS (3100,o00r, IN ADDMONT0 THE
�OSTOFCOMPENSATC DAMAGES AS PROVIDED FORIN SECTION 370E OFTHE LABOR CODE, INTEREST, AND ATTORNENS FEES.
hereby affirm under penalty of pejury one of the following declarations:
3 I have and will r rainta n 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 thi
--errfamiance of the v ork for which this permit is issued. Policy No.
have and will M.aintain 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' compensatior
Is ranee, carrier ant policy number are: 1!i!�" Q 1'
:arfer 1 Y C M a Policy Number -tw-(J.�1Q "iLi`'0'�-03 Fxpire6on Date
lame of Agent Le Inpd 1 jmsnC2 1Yl( 1�Q 2{n G.t Phone;# �JIS'�C3(c' tn?�nD
Lit certify that, In the pErfomtance of the work forwhfch this PITA is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agret
rat, if I should beco: i s Eject��to,, th�e,ycyyorkerre crom_pensatfon provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. (� �]' I
ignature ofApptica, t I'.Y!1 V F�tl Date v-✓'�f -yV lJ
rECLARATION REt. :AR G CONSTRUCTION LENDING AGENCY
hereby 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).
ender's Name Lender's Address
y my signature bekc .Y, I certify to each of the following:
I am the proper- owner or authorized to act on the property owner's behalf.
I have read this pplication and the information I have provided is correct.
I agree to comp), with all applicable city and county ordinances and state laws relating to building construction.
I authorize repre antatives of this city or coutVit, ektef the above; denWd property for inspection purposes.
DATE
TO
.1.11 IINAL b 23 9ESTO5 &TIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF OPOSEDDEMTON OCCUPANCY/SSUED
FOR OFFICE USE ONLY