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Home My WebLink AboutX2018-1752 - Permitswrvy City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2018-1 04 100 Civic Center Drive, Newport Beach, CA 92660 x 2 e 1 0 1 7 5 2 Project No: 1180-2018 Permit Counter Phone (949)644-3288 y iiG Inspection Requests Phone (949)644-3255 Issued Date: 0610712018 `acrrr�urs Combination Type - SFP ELEC Inspection Area : 5 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 Jab Address: 503 FERNLEAF AVE NB Description: MFR DELTA 1, INCREASE IN SCOPE FOR KITCHEN CABINETS & LIGHTING Legal Desc.: CORONA DEL MAR BLK 532 LOT 3 Owner: KOENIG KENNETH/CAROLYNN Contractor: OWNER/BLDR Architect: Address: 3045 4TH ST Address: KOENIG KENNETH Address: ST AUGUSTINE FL 32084 Phone: 904-962-2721 Phone: 904-962-2721 Phone: State Lic: %9 Applicant: MOSER RICK Con State Lic: O/B Engineer: ZASLAVSKY YURY J'-. Address: 21296 MONTERRA Lic Expire: Address: 4000 BIRCH ST #201-136�"`�" LAKE FOREST CA 92630 Bus Lic: NEWPORT BEACH CA 92660.. Phone: 949-633-7325 Lic Exp Date: Phone: 949-663-0853 State Lic:C-043622 Code Edit : 2016 Worker's Compensation Insurance Designer: dill Type of Construction: VB Carrier: Address: Occupancy Group: R3IU Policy No: Added /New sq.ft. Bldg: 0 Expire: Phone: Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear: / Special Conditions: REV18-1006 No of Units : 2 Front: I Bldg Height: 0 Left: I Bldg Sprinklers Right: I Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $9,000.00 Building Permit Fee: $202.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $175.74 Additional Fee : $0,00 Plan check Fee : $0.00 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: $0.00 Grading Permit Fee: $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $0.00 $0.00 Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department - General Service CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 $0.00 Disabled Access : $0.00 PAN Plan Check: $0.00 Grading Bond: Hazardous Mat $0.00 Electrical %: $14.14 San Dist: $0.00 $0.00 Building Green Fee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 TOTAL FEE : $392.88 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $392.88 PROCESSED BY: - , " _ PUBLIC WORKS APPROVAL: ZONING 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(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, priorto 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). 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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 p ements 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 nvovbq for the purpose of sale). , a wrier 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 pp_!y.m 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). am 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 legal[, 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 t_ hjs applic 'o ubmi or at the following Web site:http://w .leginfo.ca.gov/calaw.html. lignature of Property Owner or Authorized Agent o �t Date le- .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force nd effect. License Class License No Date Contractor Signature UORKERS' COMPENSATION DECLARATION 1ARNING: 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 ($100,0(10), IN ADDITION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S 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 erformance of the 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 if I should become; ubject to the orkers/c,oy,pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. / lature of Applican.'.�x,„��sG� D w/7/%,5 !I ARATInN RFr` R f.'�C NCTRI ICTIr1N 1 FNniN RFNCV' 7 lreby 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). 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 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 cou �ty�° enter t ove- Ified property for inspection purposes. nature of Prooertv Owner or Authorized ADent lC 0 _ _ I Print Prooertv Owner's or Authorized Anent's ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED I LJ I SUBMITTED ASBESTOS NOTIFICATION TO PERMITEXTENDED L IAQMD PERMITFINAL "'� S 1 a ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATEOF J 1\ PR POSED DEMOL%TION ' OCCUPANCY ISSUED SIGNATURE: \/ �7/�/ — It