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HomeMy WebLinkAboutX2017-3783 - Permits,rn City of Newport Beach - Building Division I IIIIII���IIIIII�IIIII�IIIIIIIIIIIIIIIIIIIIIII I� COMB Permit: X2017-3783 .100 Civic Newport Beach, CA 92660 °�'-`s. � `Permit X 2 0 1 7 3 7 8 3 �I Project No :.2649-2017 Counter hone, Counter Phone (949)644-3288 '.. Inspection Requests Phone (949)644-3255 �'ayp��u�,.= Combination Type - BLDG ELEC Issued Date : 12/06/2017 Inspection Area : 2 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: 1 BEACON BAY NB Description: MONUMENT SIGN "BEACON BAY" - Legal Desc.:.. R S 009-42 PAR 1 POR OF PAR .. �o. a - Owner. BEACON BAY COMMUNITY ASSOC Contractor: PALMER MASONRY Architect: LINSDAY BRANDON R Address: Address: ORLANDO RD 2672 NEWPORT BOULEVARD Address: 1571 ORANGE AVENUE'B' SAN SAN MARINO, CA 91108 COSTA MESA CA 92627 COSTA MESA, CA 92627 =• °moo ® - - -- . - Phone:. 949-642.6442 Phone: State Lic:6035799 o Applicant: DIANE/PALMER MASONRY Con State Lic: 679136 Engineer: MANSHADIFARHAD"�,j mom a°pO"r Address: 2672 NEWPORT BLVD- Lic Expire: 10/31/2019 Address: 1800 E 16TH ST UNIT B ` COSTA MESA CA 92627 Bus Lic: BT00002142 SANTA ANA CA 92701 Phone: 949-642-8442 Lic Exp Date: 12/31/2017 Phone: 714.835-2800 State Lic:C-036840 .:• :;!" ° ° m m - Code Edit.: 2016 Workers Compensation Insurance Designer. Type of Construction: Carrier: INSURANCE CO OF THE WEST Address: m E ° Occupancy Group: U Policy No: WSD603121102 o Added /New sq.ft. Bldg: 0 Expire: X10101/2018 Phone: 0 00 Added /New sq. ft. Garage: 0 - _ m ©° n mm°°mo No of Stories:.:. 0 Building Setbacks Rear: I Special Conditions: No of Units: 0 Front: / mm, o me0000 Bldg Height: 0... Left: / Bldg Sprinklers: _ Right:. / Flood Zone: 0.2 Use Zone: Parkin S aces: 0 Fire Hazard Zone : N Construction Valuation: $28.000.00 Building Permit Fee: $472.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $410.64. Additional Fee: $0.00 Plan check Fee : $37,50 - 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: $8.00 Grading Permit Fee: $0.00 In-lieu Housing Fee: $0.00 Building Dept Adm $0.00 Energy Compliance: $0.00 Grading PC Fee: $0.00 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 P/W Plan Check : $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %m: $61.78 San Dist: $0.00 Building Green Fee :: $2.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %m[. .$0.00 $0.00 TOTAL FEE : $991.92 Plan Check Fee: $448.14 Fee Due at Permit Issuance : $543.78 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: _- PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE:�SIC-N V' - OWNER -BUILDER DECLARATION 1 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 it!�gs) (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 the 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 Sof the Business•anrl Professions Code) or that he or she is exempt from licensure and the basis for thealleged 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 U 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 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 structpre 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 Professiows,88Qe° is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi, Signature of Propgrty Owner or Authorized Agent Date �aENSEJ5 CONTRACTOR'S DECLARATION I hereby affiM under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0) of Divisign 3 of the Business and Prof e,2nd m license is. in full force °• arld°effect. Litense Class License No Dat %2 Contractor Signatur WbRKERy°CYSMPENSATION DECLARATION •• kVAANING: FAIL Iir TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRI INAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE ° C019TOFCOMPBNaKM DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I°heP Eby aff1rcr under penalty of perjury one of the following declarations: • • 7 have and Gill 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 :Ottnance %ttjjp. yfprk for which this permit is issued. Policy No. have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, hldace carrjerand policy number are: der °' Policy Number for the performance of the work for which this permit is issued. My workers' Date me of Agent — certify that, in the pe oanance 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 becom subject tco ttheetwor rs' c pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applica t��AZE'/1� at/ CLARATION R ARDING CONSTRUCTION LENDING AGENCY areby affirm un r penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 30 7, Civil Code). lder'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 counIlfordinances and state laws relating to building construction. I authorize representatives of this city or countyyp tie tF h _above -identified property for inspection purposes. . /1. /)///, cp ���� ,Z7/mm/z"- signature of Property Owner or Authorized Agent L - U rrinr rropert owner s vi �nwm icau . U., . - - - ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMITEXPIRED I I�- y I U I SUBMITTED ASBESTOS NOTIFICATION TO FERMITFINAL CERFICATE OF ^7 S N O U DS N TIIFICATIO�N IS�LICABLE TO OCCUPANCY ISSUED I II i�