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HomeMy WebLinkAboutX2017-3934 - PermitsSW1 City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2017-3934 $ �. 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 7 3 9 3 4 Project No: 2760-2017 $0.00 x Permit Counter Phone /9491n44.aona $0.00 Disabled Access : - $0.00. ' ?t Inspection Regl. $0.00 Building Green Fee a. $1.00 TOTAL FEE: $467.82 $0.00 Issued Date : $0.00 "�Lmnu xg " Combination Ty,.. -, oLDG PLUM PAN Plan Check : $0.00 $0.00 San Dist: $0.00 Inspection Area : 4 NMUSD Fee: $0.00 $19 53 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: 26 RUE GRAND VALLEE NB Description: SFR FIREPLACE MAX 6' Legal Desc.;. N TR 7384 LOT 21 Owner: MC GILVRAY MARKIJEAN Contractor. Architect: Address: 26 RUE GRAND VALLEE Address. Address: NEWPORT BEACH, CA 92660 ///``` Phone: 949.279.2071 .Phone: Phone: State Lia: .Applicant: MC GILVRAY MARK Con State Lice Engineer: LACHERTODD Address: 26 RUE GRAND VALLEE Lie Expire: Address: 1201 N TUSTIN AVE - NEWPORT BEACH, CA 92660 Bus Lie: ANAHEIM CA 92807 „ Zq Phone: 949-279-2071 Lie Exp Date: Phone: 714-630-6100 State Lic:C-067656 Code Edit: 2016 Worker's Compensation Insurance. Designer:. Type of Construction: Carrier: Address: Occupancy Group: U Policy No: Added /New sq.ft. Bldg: 0 Expire: .Phone:. Added /New sq. ft. Garage: 0 - No of Stories: 0 Building Setbacks Rear: I Special Conditions: No of Units: 0 Front: I Bldg Height: 0 Left: Bldg Sprinklers: ' - Right: Flood Zone: X Use Zone: Parkins Spaces: 0 Fire Hazard Zone: N Building Permit Fee: ' $217.00 Plan Check Fee: $188.79 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 a. $1.00 TOTAL FEE: $467.82 h -PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Excise Tax:. Additional Fee Grading Bonds Fee: Grading. PC Consultant: Grading Permit Fee:. Grading PC Fee:. WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: $0.00 Planning Department- .$0.00 Plan check Fee: $0.00 $0.00. Fair Share: $0.00 $0.00 SJH Trans : $0.00 In-lieu Housing Fee: $0.00 $0.00 Public Works Department - $0.00 Park Dedication : $0.00 $0.00 PAN Plan Check : $0.00 $0.00 San Dist: $0.00 $0.00 NMUSD Fee: $0.00 $19 53 Plan Check Fee: $0.00 Fee Due at Permit Issuance $467.82 PlyBLIC WORKGAPPROVAL: PLAN CHEbK 0 ' e o ° - ° APPROVALW T�OoISSUE Fire Department $37.50 Fire Inspection: $0.00 $0.00 Fire Plan Rev $0.00 $0.00 '. Demolition Fee $0.00 Building Dept Adm $0.00 General Service $0.00 Refund Deposit $0.00 Grading Bond: $0.00 $0.00 - $0.00.... Fee Due at Permit Issuance $467.82 PlyBLIC WORKGAPPROVAL: PLAN CHEbK 0 ' e o ° - ° APPROVALW T�OoISSUE 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,; rr'^ f- Itsissuance, 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 8c :1 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 sua,l-cts the applicant to a civil penalty of sot more than five hundred dollars ($500). _ :1 I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or (_) 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 ?VNvements 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 m)pro ed for the purpose of sale). V s 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 oan 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). m exempt from licensure under the Contractors' State License Law for the following reason: By my signature below I acknowledge that, except for my personal resideNe in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally ;ell a structure that I have built as an owner-builder if it has n t been coast ucted 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 wh thi ppJ'c f is su ml ed or at the following Web site:http://www.leginfo.ca.gov/calaw.html. signature of Property Owner or Authorized Agent '! I Dag LICENSED CONTRACTOR'S DECLARA ON hereby affirm under penalty of perjury that I am licensed underprovisions of Cha ter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No Date Contractor Signature NORKERS' COMPENSATION DECLARATION VARNING: 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 :OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. herebX affirm under penalty of perjury one of the following declarations: 1 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. :1I 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' compensatiol nsurance carrier and policy number are: :crier Policy Number Expiration Date Jame of Agent A Phone # certify that, in the performance of the wor fo 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 agree hat, if I should become s jec'�t t e rker' cc pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant D 1/ XCLARATION REGA ING CONSTRUCTION LENDI G AGENCY hereby affirm under penalty of perjury that there is a GO truction 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 krierty owner's behalf. I have read this application and the information I have provided is c0 ct. I agree to comply with all applicable city and county ordinances and at a laws relating to building construction. I authorize representatives of this city or cou t entAr bo a dent sed property for inspection purposes. Signature of PropertOwner or Authorized A ant Print Property Owner's or Authorized Agent's Name ACTION DATE BY DECLARATI0rOF-e5MPUANCI WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 610E TIT 40ANDAQMD RULE PERMITEXPIRED UISUBMITTEDASBESTOS OilfiCATIONiO ; i PERMIT CANCELLED DEPA PERMITEXTENDED 13AQMD PERMITFINAL CERTIFICATE OF G (A-(, `�-1 ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION OCCUPANCYISSUED / •• 0•• 0•• •:• SIGNATURE: ••i ••� •