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HomeMy WebLinkAboutX2019-3121 - Permitst= City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit: X2019-3121 100 Civic Center Drive, Newport Beach CA 92660 x 2 0 1 9 3 1 2 1 Project No: 2179-2019 O Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - MFP Issued Date : 10/28/2019 Inspection Area : 1 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Consmietion 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 Job Address: 3010 BALBOA BLVD NB Description: MFR REMOVE THE UMPERMITTED STAIRS (R2018-0768) - 610 Legal best.: Owner: MILAN] KASRA Contractor: , FLOORING KITCHEN& BATH DEPOT Architect: F� Address: 112 26TH STREET Address: 701 S RAYMOND AVE #1 Address: 1® NEWPORT BEACH CA 92663 - FULLERTON CA 92831 Phone: Phone: 714-870.1576 PhoneON State Lic: AJ Applicant: PULIDO ANDRES Con State Lic 965892 Engineer: VELASCO JOS!N tv1 Address: 3655 TORRANCE BLVD #300 Lic Expire: 0913012021 - Address: 8371 BENJAMIN DR TORRANCE CA 90503 Bus Lic: BT30053966 HUNTINGTON BEACH CA 9� pp�/ Phone 949-245-5641 Lic Exp Date: 0212812020.. : Phone: 877-821-1213 :State Lio:C-07 "® Code Edit: 2016 Worker's Compensation Insurance Designer Type of Construction. VB. Carrier STATE COMP. INS Address. Occupancy Group: `: R3/U 'Policy No. 9255163 Added /New sq.ft. Bldg: 0 Expire. 06/0412020 Phone Added /New sq ft. Garage. 0 No of Stories: 2 Building Setbacks Rear I Special Conditions: LIQUEFACTION AREA No of Units: 2 Front I HIGH DENSITY. Bldg. Height 0 Left I Bldg Sprinklers N = Right: I `. Flnnd 7nna- X'- Ilce 7nne- Parkinn :4naness n - Fva Ha arrl 7nnr'-N Construction Valuation: '-$37.000.00 Building Permit Fee $603.00 Excise Tax. - $0.00 Planning Department- Fire Department Plan Check Fee;. $524.61. ` Additional Fee : $0.00 Plan check Fee ` $40.00 Fire Inspection $0A0 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: x$12.00 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 PAN Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat -$0.00 Electrical %: - $0.00 San Dist: $0.00 Building Green Fee : $2.00 ' Mechanical %: $0.00 ' NMUSD Fee: - $0.00 $0.00 Plumbing %: ` $0.00 $0.00 TOTAL FEE : $1,181.61 <E�a Plan Check Fee : moo oe. $524.61 Fee Due at Permit Issuance : W� $657.00 PROCESSED BY: < �s � a �© � e �. sPUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: < m � W < < � < < �.�. 4 � � - 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 thecheckmark(s) I have placed next to the applicable item(s) + action 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 permit to file a signed statement that heor 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 Ifessions 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 more than five hundred dollars ($500): - - - 1, as owner hof 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 offered for sale (Section 7044, siness 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 novements 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 (roved for the purpose of sale). 1, as owner of the property,amexclusivelycontracting with licensed Contractors to construct the project (Section 7044, Business. and. Professions Code: The Contractors' State License Law does not )ly to an owner of property who builds or improves thereon, and who contracts for the projects with licensed Contractor pursuant to the Contractors' State License Law). I am exempt from licensure under the Contractors' State License Law for the following reason: 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 I 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 theBusiness and Ifessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. nature of Property Owner or Authorized Agent Date TENSED CONTRACTOR'S DECLARATION :reby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 00 of Division 3 of the Business and Pro srsio nsode, and my li==ce I effect. License Class License No Date Cs Contractor Signatur )RKERS' COMPENSATION DECLARATION 2NING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE I5 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (E700,000), IN ADDITION TO THE IT OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.: :reby affirm under penalty of perjury one of the following declarations: - 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 (Gfmance of the work for which this permit is issued. Policy No. have and Pi kpaintain 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' compensatio trance carri Eillpolicy numb e re: rier Lc Number Expiration Date - Tie of Agen Phone # certify that in the performance 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 become subject to_pe workers' compensatio Is' s of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. '�// ♦ s nature of Applicant Date's CLP}RATION REG DI G CONSTRUCTION LEN ING AGENCY et TT Ireoy affirm under lknalty of perjury that there is a constructionllending. 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: [ am the property owner or authorized to act on the property owners 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 thiscity or co o ent r above-identifi rd'perty for inspection purposes. nature of Property Owner or Authorb: d A a �` Print Property Owner's or Authorized Agent's - e ln-/� •> Gri vi �N ice TION DATE - BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY - REGULATIONS PART 63OF.TITLE 40 AND AQMD RULE'. 1403 •• u • ••• _•Yr ITEXPIREO - ITCANCELLED IT EXTENDED - ITFINAL �ICATE OF 0-1 FANCY ISSUED I SUBMITTED ASBESTOS NOTIFICATION TO •+ • • • • + OEPA:.. r• ••-•• • • • ••• QMD ASBESTOS NOTIFICATIO IS NOTAPPLICABLE TO .PRO OSEDE LITIO • ••' • • • ••• A • • �• SIGNATOR • •, toY �,c LU UUo��Q i fA _ a o OLLJ O cu [ CES OU o J i rn W L ¢ U Q F. ¢ IY CA v >, Q L v ro Zz M cc_ O'c ❑ (D 65 2E QG orn (g'., Q= 0 Mho pL �� Z 3a � 3: o� O C 0)N (DN / '+A N 0 �I m aAm� p Z ° o ��U ai o �� a� cu 0 1 ;rqA r c U. U) U o o 2 o� cLzu a - o �'��� C: U U 0 o L CO C6 U L G U LU 1— N:. N .. 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