HomeMy WebLinkAboutX2022-0417 - Permitsi £rf City of Newport Beach - Building Division *X2022-0417*
5 A� 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - BLDG PLUM
COMB Permit: X2022-0417
Project No : 0369-2022
Issued Date : 02/11/2022
Inspection Area : 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 02/11/2025 OR PERMIT WILL BE INV)
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: 1459 GALAXY DR NB
Description: SFR DEMO (E) 4-BEDROOM HOUSE 2635 SF
Legal Desc.: N TR 4224 LOT 257
Owner:
VON DER AHE DANIELLE & GEOFF
Address:
1459 GALAXY DR
NEWPORT BEACH, CA 92660
Phone:
949-235-4382
Applicant:
MILO CONSTRUCTION
Address:
101 VIA MONTE PICAYO
SAN CLEMENTE CA 92673
Phone:
949-290-6429
Code Edit :
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 1
No of Units : 1
Bldg Height: 0
Bldg Sprinklers:
Contractor:
MILO CONSTRUCTION
Address:
101 VIA MONTE PICAYO
SAN CLEMENTE CA 92673
Phone:
949-290-6429
Con State Lic:
871429
Lic Expire:
03/31/2022
Bus Lic:
BT30038762
Lic Exp Date:
03/31/2022
2019 Worker's Compensation Insurance
Carrier:
NO EMPLOYEES
R3/U Policy No:
0 Expire:
0
Building Setbacks
Rear: /
Front: /
Left: /
Right: /
X Use Zone:
Parkinq Spaces: 0
Construction Valuation: $20
Building Permit Fee:
$122.00
Plan Check Fee: $223.00
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$4.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
IITOTAL FEE: $2,448.98
PROCESSED BY: 55
ZONING APPROVAL: M 5 W
Architect:
Address:
Phone: State Lic: ,
Engineer:
Address:
Phone: State Lic:
Designer: FORKERT ENGINEERING & SURVEYING ING
Address: 22311 BROOKHURST ST #203 .. '
HUNTINGTON BEACH, CA 92646
Phone: 714-963-6793
Special Conditions
Zone:
Excise Tax:
$0.00
Planning Department-
Fire Department
Additional Fee :
$0.00
Plan check Fee :
$104.00
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 I
Demolition Fee
Grading Permit Fee:
$0.00
In -lieu Housing Fee :
$0.00
Building Dept Adm
$27.00
Grading PC Fee:
$0.00
Public Works Department-
General Service
$265.00
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Refund Deposit
$1,692.00
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 %:
$10.98
$0.00
Plan Check Fee
: $0.00
Fee Due at Permit Issuance :
$2,448.98
PUBLIC WORKS APPROVAL:
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(g)
;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
:he 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
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).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) 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).
❑ 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 ow,1�I cf oroperty 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 LQm licensure under the Contractors' State License Law for the following reason:
9y m•, 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 legallt
sell astructure teat I Save 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
Prcfdssions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi,
Sigiature of Property Owner or Authorized Agent Date
'_ICENSED =N7PACTOR'S DECLARATION
I nemby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) qt Diwson 3 of the Business and Profess Code, nd my licen In full force
Rnd effect. ❑cenre Class License No Date '/1 'k1T3EontractorSignature X�.2�
'IVOP.KERS' COMPENSATION DECLARATION
NPPN'N ;: 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
CCST C. COMPENSAT16d`.bAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm cider penalty of perjury one of the following declarations:
D 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 thi
performance of me 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'
rance carrier and policy number are:
Policy Number
of Agent
Date
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 laws of California, and agre
t, if I should become subject
to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant /�. �(tiGw+'aC--%L —rol � Date ' /' 202Z
)ECLARATION REGARDING CONSTRUCTION LENDINGAGENCY
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
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 laws relating to building construction.
I authorize representatives of this city or county t enter the above -identified prop y for inspection purposes.
signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name %C JG/,F /SL �• LetG+G Date
ACTION DATE BY DECLARATION OF COMPLIANCE WA CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERMIT EXPIRED Y_FI SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED UEPA
PERMITEXTENDED _11 119AQMD
NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF ( ( C_ Y w/ PROPOSEDDEMO ON
OCCUPANCYISSUED lv` C"4S I SIGNATURE: X,