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HomeMy WebLinkAboutX2018-2860 - PermitsgW1 City of Newport Beach - Building Division Illlllllllllllll�llllllllllllllllllllllllllu COMB Permit: X2018-2860 s °°. °° . a Per Civic Center Drive, 9Newp49)6 t Beach, GA 92G60e o o° X 2 9 1 8 2 8 6 9 Project No : 2290-2018 e Permit Counter Phone (949)61-3288. °. ° ° ° a m c,. Inspection Requests Phone(P}J)6d4-9265. Combination Type - SFP ELEC MECH PLUM Issued Date : 09/2512018 Inspection Area : 5 m m ® ° PERM179S EXPJ?E 180.DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Construction Hours; Mg;njay - Frriday X00 a. y. to ¢!30 p.m, and Saturday from 8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays Job Address: 4606 WAYNE RD NB Description: SFR - RE-FRAME ROOF, BI-FOLD DOORS, FIREPLACE, ALT POWDER, KITCHEN, MASTER BED/BATH, STORAGE IN GAR, R/R WINDOWS, NEW ROOF 923 SF Legal Desc.: N TR 3519 LOT 100 Owner: SCHWARTZ KELLI Contractor: SPAIN DANIEL P Architect: EXEMPT Address: 4606 WAYNE RD Address: 46 COLORIDO Address: Added /New sq.ft. Bldg: 0 Expire: CORONA DEL MAR, CA 92625 Phone: 949-422-9191 RANCHO SANTA MARGARITA CA $0.00 Grading Bonds Fee: Phone: No of Stories: 1 Phone: Rear: / Phone: State Lie: Applicant: RICHART JASON Con State Lic: 659781 Engineer: GHAZLANI ANDY Address: 1041 W 18TH ST STE Al 06 Lie Expire: 0 713112 01 9 Address: 4202 ATLANTIC AVE #204 Use Zone: COSTA MESA CA 92627 Bus Lie: BT30064716 $0.00 LONG BEACH CA 90807 Phone: 949-422-9191 Lie Exp Date: 10/3112019 Phone: 562-253-2385 State Lic:C-060867 Code Edit : 2016 Worker's Compensation Insurance Designer: RICHART JASON Type of Construction: V -B Carrier: EXEMPT Address: 1041 W 18TH ST STE A106 Occupancy Group: R3/U Policy No: Additional Fee : COSTA MESA CA 92627 Added /New sq.ft. Bldg: 0 Expire: Fire Inspection: Phone: 949-422-9191 Added /New sq. ft. Garage: 0 $0.00 Grading Bonds Fee: $0.00 No of Stories: 1 Building Setbacks Rear: / Special Conditions: No of Units : 1 $0.00 Front: / $0.00 Bldg Height: 0 $0.00 Left: / Bldg Sprinklers: $30.00 Right: I $0.00 Flood Zone: Use Zone: Parkina Snaresn Fire Hazard 7nne - N Building Permit Fee: $1,570.00 Excise Tax: $0.00 Planning Department- Fire Department Plan Check Fee: $1,365.90 Additional Fee : $0.00 Plan check Fee: $40.00 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 : $30.00 Grading Permit Fee: $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $24.00 Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department - General Service $197.00 CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $564.00 Disabled Access: $0.00 P/W Plan Check : $41.25 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $109.90 San Dist: $0.00 Building Green Fee : $7.00 Mechanical %: $62.80 NMUSD Fee: $0.00 $0.00 Plumbing %: $141.30 $0.00 TOTAL FEE : $4,153.15 Plan Check Fee: $1,405.90 Fee Due at Permit [as ante: $2,747.25 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 belor•rr ey the clleckn rk(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, den%li1h, or Pepnir:In2 stfuQurv, prj)3r to its issuance, also requires the applicant for 1e permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License LAW (Cnbpter 9 (corhmending witlrSection 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). 7 1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions o0 awrnk and 41i stsucture isnot 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 otpersdlvI eftorC bJ1Ids3)r improves the property, provided that the nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of con%dtiop:Ule Ovjn&Byl'IgcVr wiihllave J1 burden of proving that it was not built or n roved for the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale License Law does not pply 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). ] I 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 legally 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 this application is submitted or at the following Web site:http://w .leginfo.ca.govicalaw.htmi. signature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 of Divisio of the Business and Profs si s ode a nse is in full force nd effect. License Class License No Dat Contractor Signatur YORKERS' COMPENSATION DECLARATION DARNING: 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 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 7 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. ]I 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' compensatior Liutrance.carrier and policy number are: Policy Number Date ceAi that, in the perFdrme of the ork r w ch 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 t, if I hould becomTt t the/y6y/rIp{e o ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �� �� nature of Applicah �N'6� .>!i/i^ Dat CLARATION REGARD G CONSTkU15TIOA LENDING AGENCY :reby 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: 1 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 or ' a ces and Steil tet lating to building construction. I authorize representatives of this city or county to n r th ab( v a if roperty for inspection purposes. nature of Propertv Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name X"/� I ` y� Date r l h ACTION DATE BY J DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMITEXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED LIEPA PERMIT EXTENDED qMD PERMIT FINAL ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATEOF 'O q PROPOSED DEMOLITION OCCUPANCYISSUED 1 SIGNATURE: