The URL can be used to link to this page

Home My WebLink AboutX2019-2960 - Permitswh City of Newport Beach - Building Division II COMB Permit: X2019-2960 Building Permit Fee: $548.00 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII� ' Plan Check Fee: $476.76 Excise Tax: Overtime Plan Ck: $0.00 Investigation Fee: $548.00 Record Management: $12.00 Plan check Fee: Energy Compliance: 100 Civic Center Drive, Newport Beach, CA 92660 Fire Inspection: X 2 0 1 9 2 9 6 69 Project No: 2073-2019 ) Disabled Access: it Permit Counter Phone (949)644-3288 $0.00 Hazardous Mat $0.00 Grading PC Consultant: s' -Inspection Requests Phone (949)644-3255 $2.00 $0.00 Demolition Fee Utz q,'d Combination Type.- SFP Grading Permit fee: - Issued Date: 09/2312019 FriYt Building Dept Adm $0.00 Inspection Area : 8 $0.00 Public Works Department - General Service $0.00 WO Insp. Fee: PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. $0.00 Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m, and Saturday from 6:00 a.m. to 6:00 p.m. No work on Sundays or Holidays Refund Deposit Job Address: 95 OLD COURSE DR NB PAN Plan Check: $0.00 Description: SFR -INSTALL SHAFT & PERSONAL LIFT - 119.2516 Grading Bond: $0.00 ' - Electrical %: Legal Desc.;- N TR 16391 LOT 72 San Dist: $0.00 Owner: FISHER CORDELL S Contractor: - ACCESS TO FREEDOM Architect: $0.00 Address: 95 OLD COURSE DR Address: 9272 JERONIMA RD #111 Address: $0.00 NEWPORT BEACH, CA 92660 IRVINE, CA 92618 $0.00 Phone:. 949-721.1331 Phone: 949-472-4900 Phone: State Lie: .... ...... Applicant: BENJAMIN AMGAD SAMWEL Con State Lica 786659 °°° Engineer: BENJAMIN AMGAD SAMWEL Address:.. 24310 MOULTON PKWY #0-105 Lie Expire: 10/3112020 Address: 24310 MOULTON PKWY #0-105 . .... %.° ° ° LAGUNA HILLS CA 92637 Bus Lic: BT30067117 LAGUNA HILLS CA 92637 •... ° Phone: 949.446-1417. Lie Exp Date: 04/3012020 Phone: 949-446-1417 State Lic:S-064449 ° o • °.°° Code Edit: 2016 Worker's Compensation Insurance Designer: o °° °� Type of Construction: V-BR31 AM INSURANCE CO Address: ^I® ° Occupancy Group: R31U PolicyCarrier: Policy No:. 00541 ACWC05413T INS f"'+ 1 /V' E 0.01 Added /New sq.ft. Bldg: - 0 Expire: 03101/2020 Phone: °O°Op Added /New sq. ft. Garage: 0 ° 00000 No of Stories: 2 , Building Setbacks Rear: I Special Conditions: No of Units : 1 Front: I o ..... ° o Bldg Height: ' 0 Left: / Bldg Sprinklers Right: I ° ° o ° ° ° 0... o ° Flnnd 7nne- Use Zone: Parkina Soares: 0 Fire Hazard Zone : N PROCESSED BY: w_uu Construction Valuation: $31 Building Permit Fee: $548.00 ' Plan Check Fee: $476.76 Excise Tax: Overtime Plan Ck: $0.00 Investigation Fee: $548.00 Record Management: $12.00 Plan check Fee: Energy Compliance: $0.00 Fire Inspection: CA Seismic Safety: $0.00 $0.00 Disabled Access: $0.00 $0.00 Hazardous Mat $0.00 Grading PC Consultant: Building Green Fee : $2.00 PROCESSED BY: w_uu Excise Tax: $0.00 Planning Department - Fire Department Additional Fee : $0.00 Plan check Fee: $40.00 Fire Inspection: $0.00 Grading Bonds Fee: $0.00 Fair Share :. $0.00 Fire Plan Rev $0.00 Grading PC Consultant: $0.00 SJH Trans: $0.00 Demolition Fee Grading Permit fee: $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $0.00 Grading PC Fee: $0.00 Public Works Department - General Service $0.00 WO Insp. Fee: $0.00 Park Dedication: $0.00 Refund Deposit $0.00 PAN Plan Check: $0.00 Grading Bond: $0.00 ' - Electrical %: $0.00 - San Dist: $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE: $1,626.76 Plan Check Fee $526.33 Fee Due at Permit Issuance : $1,100.43 PUBLIC WORKS APPROVAL: ZONING APPROVAL: �/��1 PLAN CHECK BY: GRADING APPROVAL:. APPROVAL TO ISSUE: C C 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, 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 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 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 (_) 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 im roved 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). ❑ I 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 legall) sell 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.. Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Signature of Property Owner or Authorized Agent Date LICENSED'GQMTRACTOR'S DECLARATION . I hersby affirm lyndecpenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 71) ) of Divisign 3 of the Business and Prof ode, and my license is in full force and'eifect. NijopClass License No Date/ H Contractor Signature ORKERS' COMPENSATION DECLARATION WARNING: FAILUR€ TO$ICURE 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 COST •OF COMPrr'ISAWONI DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 11h1 fir, by affirm 'under penalty of perjuryone of the following declarations: W 1have and NAILJWsaintain 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 �ruance o the work for which this permit is issued. Policy No. have and wyl 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 ns ance carritPArVaolicy number are: Policy Number Expiration Date ererof Agent* Phone # certify that, in the performa ce 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' c pensation laws of California, and agre I, if I should become subje o h orkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ((��-49 nature of Applicant Dat �I 2 3 CLARATION REGARD G CONSTRUCTION LENDING AGENCY areby affirm under pen Ity of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 309 , 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 county r 'nar ces and state laws relating to building construction. I authorize representatives of this city or cou y the above -identified property for inspection purposes. (. '�� t I y SZ�i,-�� nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name 1 Date ACTION DATE BY, (I DEGqb�fECLARA ONS OF CO 1 OF TITCE E 40TH DE OF FEDERAL FOR OFFICE USE ONLY / PERMITEXPIRED I I A LJ I SUBMITTED ASBESTOS NOTIFICATION TO I PERMITEXTENDED LkQMD PERMITFINAL CERTIFICATE OF OCCUPANCY ISSUED 9ASBESTOS �'m�ell N TIFICATION IS NOT APPLICABLE TO PRO OSED DE T StURE: