HomeMy WebLinkAboutX2018-2811 - Permits�rh e B Char of Newport Beach -Building Division
IIY
COMB Permit : X2018-2811
' 00
IV wig Ce�deg D6iye, N.Owport Beach, CA 92660
X 2 0 1 8 2 8 1 1
Project No: 2251-2018
Aa
Eo P•ergiit•Coynl:+zr hone (909)644-3288
s • Inspection Reques1s°Rh4e7949)644-3255
Combination Type - SFP
Issued Date: 018
Inspection Area : 6
o e . o
e° e°e oo ee
��•
o a • • e .. • s° .0. PERMITS EXPIRE
780 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
.. ° CQ4Vrg4;6on mss' iWonday - 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: 7 GREENS BLUFF NB
Description: SFR REPLACE PATIO DOORS WITH SLIDER DOORS
Legal Desc.: N TR 15818 LOT 33
Owner: DICKLER Contractor:
P COLBURN CONSTRUCTION INC Architect:
FRANK SILKE
Address: 1 GREENS BLUFF Address:
9881 LAPWORTH CIR Address:
2026 BAYPOINT DR
NEWPORT COAST, CA 92657
HUNTINGTON
BCH CA 92646
NEWPORT BEACH CA 92660
Phone: Phone:
714-235-2535
Phone:
949-280.3793 State Lic:CO28991
Applicant: FRANK SILKE Con State Lie:
667625
Engineer:
MOKHTAR TAREK
Address: 2026 BAYPOINT DR Lie Expire:
0212912020
Address:
31645 S COAST HWY
NEWPORT BEACH CA 92660 Bus Lie:
BT30056270
LAGUNA BEACH CA 92651
Phone: 949-280-3793 Lie Exp Date:
08131/2019
Phone:
949-499-6254 State Lic:8-004189
Code Edit: 2016 Worker's Compensation Insurance
Designer:
14
Type of Construction: VB Carrier
STATE COMP.
INS Address:;
-
Occupancy Group: R31U Policy No:
9164709
Added /New sq.ft. Bldg: 0 Expire:
08/17/2019
Phone:
� � n
CZ®Q
Added /New sq. ft. Garage: 0
s
q
No of Stories: 1 Building Setbacks
Rear: 1
Special. Conditions:
No of Units : 1
Front: I
-
Bldg Height: 0
Left: I
Bldg Sprinklers:
Right: I
Flood Zone: Use Zone: Parking Spaces:
0 Fire Hazard Zone : N
Construction Valuation: $20.000.00
Building Permit Fee: $367.00 Excise Tax:
$0.00
Planning Department-
Fire Department
Plan Check Fee: $319.29 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: $14.00 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
PMN Plan Check: $0.00
Grading Bond: $0.00
Hazardous Mat $0.00 Electrical %:
$0.00
San Dist: $0.00
Building Green Fee: $1.00 Mechanical %:
$0.00
NMUSD Fee: $0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE : $738.79 Plan
Check Fee
: $356.79 Fee Due at Permit Issuance : $382.00
PROCESSED BY:
PUBLIC WORKS APPROVAL:
,,
ZONING APPROVAL: 1�
PLAN CHECK BY:
GAO
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) 16! played- exit tpthe 111plicatge 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, prior2o $s issua4m;also Requires the applicant far
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 SEetidhl M00rof DiSsion 3 of iletusiness and
Irofessions 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
lot more than five hundred dollars ($500). ,
I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offePrelfor idle jS*tipn :0,C4,3usiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, bui(dtpr iroproves.t4e pr arty, p#widetl tliat the
mprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will havB Jft 4LNen of'p�Ovirif�}L1at it ha notbuilt or
m 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' State License Law does not
Ipply 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).
7 1 am exempt from licensure under the Contractors' State License Law for the following reason:
3y 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 legalh
yell 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
Irofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
-ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions oa�fQQha ter 9 (commencing with Section 7000 f Di isilor�.3 of the Business and Profs si de, and m R .se-r^IrtT01f force
effect. License Class License No (C(c - D @ fS Contractor Signatu
VORKERS' COMPENSATION DECLARATION
IARNING: 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 0706 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
rformance of the work for"which this,permit is issued. Policy No.
Iave 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
nce carrier and policy number are:
7e of Agent
certify that, in the performance
, if I should become subject to I
Policy Number
Date
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
rkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. t
Dat
IECLARATION REGARDING CONSTRUCTION LENDING AGENCY
hereby 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).
ender's Name Lender's Address
ly 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 county to enter the above -identified property for inspection purposes.
ionature of Prooerty Owner or Authorized Anent \/ . Print Prooertv Owner's or Authorized ADenfs Namev
ACTION DATE BY DECLARATION OF 1403 LAT ONS PART61 OF IITLE 40 AND ACMD RULE CE WITH CODE OF RAL FOR OFFICE USE ONLY
REGUPERMIT EXPIRED I U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT EXTENDED
I
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PERMITFINAL
CERTIF104TE OF
7 _ASBESTOS
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NOT ATIO NOT APPLICABLE TO
PROPOSED DEM I ION
OCCUPANCYISSUED
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