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Home My WebLink AboutX2017-3756 - Permitsh City of Newport Beach - Building Division I IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII IICOMB Permit: X2017-3756 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 7 3 7 5 6 Project No: 1241-2016 N * ermit Counter Phone (949)644-3288 cr Inspection Requests Phone (949)644-3255 _ °ay�F7 ,a Combination Type - MFP GRAD ELEC MEC F}+��y1ffiI%F1R'NK,LERS Issued Date (1G v ED Inspection Area : 1 PERMITS EXPIRE w 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: 407 38TH ST NB Description: MFR -ADD 933 SF, REMODEL 116 SG 8: ADD 294 SF TO GAR, DECKS 400 SF *CHANGE OF CONTRACTOR* Legal Desc.: CANAL SECTION BLK 438 LOT 15 Owner: LI HONG GUO FAMILY TR Contractor: M S CUSTOM HOMES INC Architect: Address: 1817 VISTALOMITAS DR Address: 15333 CULVER DRIVE STE 968 Address: FULLERTON CA 92831 IRVINE, CA 92604"-'-oJO.''• Phone: 909-319-6668 Phone: (949) 279.1841 Phone: State Lie: Applicant: PATROSKE WALT Con State Lie: 997076 Engineer: EVANGELISTA GIL Address: 2132 S GROVE AVE #F Lie Expire: 09/30/2018 Address: 20505 E VALLEY BLVD #110 °r`" �;• ° ° ONTARIO CA 91761 Phone: 951-756.1109Lie Bus Lie: Exp Date: BT30061337 11/3012018 Phone: ° WALNUT CA 91769 aV y:' ° • r 909.598-5045 State Lic:S-002422 : ° • o ° ° Code Edit: 2013 Type of Construction: V -B -SPR Worker's Compensation Insurance Carrier: EXEMPT Designer: Address: PATROSKE WALT 2132 S GROVE AVE #F o ° • • • y-=^ •• ° Occupancy Group: R-3/1.1 Policy No: ONTARIO CA 91761�"'`,;;+,. Added /New sq.ft. Bldg: 933 Expire: Phone: 951-756-1109 ° ° ° Added /New sq. ft. Garage: 294 0 ° ° ° ° ° 0 • ° No of Stories: 2 Building Setbacks Rear: / Special Conditions: ° ° ° ° ° • ° ° ° ° No of Units:. 2 Front: I Bldg Height: 0 Left: I Bldg Sprinklers: Y Right: I Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone: N Construction Valuation: $0.00 Building Permit Fee: $0.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $0.00 Additional Fee: $33.00 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 : $459.61 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 Energy Compliance: $0.00 Grading PC Fee: $100.90 Public Works Department - General Service $0.00 CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access : $0.00 PAN Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist: $0.00 Building Green Fee : $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $33.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $33.00 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: 5 GRADING APPROVAL: APPROVAL TO ISSUE: 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,Agnstruct, alter, improve, demolish, or repair any structure, prior to its issuance, also require the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions oftpe ctDYs'FStatp,.Ucpps Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and 11 Professions Code) or that he or she is exempt from licensure and the basis for the alleged ex p tsr{�Fv11y ulp(a;lgnip Seoi oo 03,,1s,,^.5 y any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). �.y ❑ I, as owner of the property, or my employees with wages as their sole compensation; will do (_) SII nF,d 4o-0 t(¢ 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, tf � Ug 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 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). ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason: By 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 sell a structuredhaW 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 Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. $LvT4jre of Proe%V.Owner or Authorized Agent Date LICENSED 6UNTRACTOR'S DECLARATION Pger84y affirm ur6fer penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 01 ap' isi D 3 of the Business a d Pro ns C de my license is in full force and•effect. License.Glass License No Dat f' Contractor Sig WQRKERS' W APENSATION DECLARATION NARNMG: FAILUFJE TO W6URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT Al EMPLOYER TO C INAL PENALTIES AND CIVIL FINES UP TO ONE NDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE C85j QF COMPEIISAI[ON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. keret'% affirm under penalty of perjury one of the following declarations: Z].I+liajre 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 Serformence oftREu48rt for which this permit is issued. Policy No. �1-M& and will meiMain 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 carriel iRd policy number are: Policy Number Expiration Date of Agent ceub that, in the pert rmance of the for which this It is issued, shall not employ any person in any manner so as to become subject to the workers' co ensation laws of California, and ogre I, if I should become bject to tkers pensati n. p v 'ons of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant D CLARATION RE RDING CONSTRUOTION LENDING AGENCY :reby affirm uncle 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 op rdinances and state ws relating to building construction. I authorize representatives of this city o co y e eerrJtne o d n property for inspection purposes. / /�1 q_ r nature of Prooertv Owner or Authorized A��l�,//�WA Print Property Owner's or Authorized Agent's Na Doe ACTIONOF I . DATE L — eREGULATIONS PPART 61 O TIIT E 40 A DbffCLARATION OF COMPLIANCE WITH COAQMD RULE DE AL FOR OFFICE USE ONLY PERMIT EXPIRED PERMIT CANCELLED PERMIT FINAL /C- l'rrf res ESTOS OTIFI IS NOT APPLICABLE TO CERTIFICATE OF PROPOSED M ION OCCUPANCYISSUED SIGNAT6