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HomeMy WebLinkAboutX2017-3959 - Permits1bt City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 z Permit Counter Phone (949)644-3288 '... Inspection Requests Phone (949)644-3255 "vs sous Combination Type - MFP GRAD MECH ELEC PLUM *X20173959' COMB Permit: X2017-3959 Project No: 2776-2017 Issued Date : 04/0212018 Inspection Area : 1 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: 1046W BALBOA BLVD NB IN la�� R Description: NEW DUPLEX WIATT/GARAGE 3,4671643 SF FO "LegalDesc.: NTR234BLK10LOT12 Owner: PACK INVESTMENT GROUP LLC Contractor: BURKHART BROTHERS CONSTR Architect: LIN JUINTOW Address: 1041 BALBOA BLVD W Address: 12 BALBOA COVES Address: 392 CAMINO DE ESTRELLA NEWPORT BEACH, CA 92661 NEWPORT BEACH CA 92663 SAN CLEMENTE CA 92672 Phone: Phone: 714.350.3892 Phone: 949.325-3001 State Lic:C033054 Applicant: FOX MICHAEL Address: 392 CAMINO DE ESTRELLA SAN CLEMENTE CA 92672 Phone: 949-325-3001 Code Edit : 2016 Type of Construction: V -B -SPR Occupancy Group: R3/U Added /New sq.ft. Bldg: 3467 Added /New sq. ft. Garage: 643 No of Stories: 3 No of Units: 2 Bldg Height: 29 Bldg Sprinklers: Y Flood Zone: 0.2 Construction Building Permit Fee: $4,563.00 Plan Check Fee: $2,846.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $150.00 Energy Compliance: $268.00 CA Seismic Safety: $87.82 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $28.00 Con State Lic: 905510 Engineer: Lic Expire: 10/31/2019 Address: Bus Lic: BT30026859 $0.00 Lic Exp Date: 03/31/2019 Phone: Worker's Compensation Insurance Designer: Carrier: STATE COMP Address: Policy No: 9041905 Expire: 0210112019 Phone: Building Setbacks Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical W Mechanical %: Plumbing %: Rear: 0 Front: 10 Left: 3 Right: 3 $863.10 $0.00 $0.00 $870.84 $820.00 $191.16 $108.00 $638.82 $501.93 $410.67 ROHRER PAUL DUANE 1527 E. AUTUMRIDGE CT ORANGE CA 92866 714.272-9579 State Lic:S-004340 Special Conditions: LIQUEFACTION AREA Planning Department - Plan check Fee Fair Share SJH Trans In -lieu Housing Fee Public Works Department - Park Dedication : $0.00 PAN Plan Check: $304.00 San Dist: $0.00 NMUSD Fee: $2,082.88 comm m 0oomo moon 0 0000 °oocco co 0 © 0 0 c om $0900 o.�DA➢m 40.06m SDUO $0.00 $0.00 $0.00 $0.00 0 0 com000 o a oomoo °mmecc com000 om mmmmm< m oo®° II TOTAL FEE: $15,125.22 Plan Check Fee : $3,822.00 Fee Due at Permit Issuance : $11,303.22 II PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: PUBLIC WORKS APPROVAL: PLAN CHECK BY: n APPROVAL TO ISSUE: /- Fire Department $0.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: comm m 0oomo moon 0 0000 °oocco co 0 © 0 0 c om $0900 o.�DA➢m 40.06m SDUO $0.00 $0.00 $0.00 $0.00 0 0 com000 o a oomoo °mmecc com000 om mmmmm< m oo®° II TOTAL FEE: $15,125.22 Plan Check Fee : $3,822.00 Fee Due at Permit Issuance : $11,303.22 II PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: PUBLIC WORKS APPROVAL: PLAN CHECK BY: n 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) 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 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 Section 7000) of Division 3 of the Business and 'rofessions 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 iot 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 U portions of the work, and the structure is not intended or offered for sale (Section 7044, Nsiness 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 nprovements 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 n roves) forthe purpose of sale). !r 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 pply 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). J am exempt from licensure undertthe Contractors' State License Law for the following reason: ly 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, ell 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://v w .leginfo.ca.gov/calaw.html. lignature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section POO) of Division 3 of the Busin d Professions Code, and my license is in full force nd effect. License Class License No D Contractor S. n fire UORKERS' COMPENSATION DECLARATION DARNING: 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 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: ] 1 have and 01•1iairtain 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 erformance of thew"k for which this permit is issued. Policy No. and vA rrhDintain 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' carrier and policy number are: ne Of Agent Policy Number Date Ice 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 worke}s' compensation laws of California, and to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. -\ :rebyaffirm ender 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). rler's Name Lender's Address ow slgnaturg, 6gl5*.l certify to each of the following: I am the prooerVowner 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 a !cable city and county ordinances and state laws relating to building construction. I authorize represent�tiWhis city or county to enter the above -identified property for inspection purposes. ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE v 1403 PERMITEXPIREDI SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED EPA PERMITFINAL `Q^/Gy� &� UASBESTOS NOTIFICATION IS NOTAPPLICABLE TO CERTIFICATEOF PROPOSED DEMOLITION OCCUPANCYISSL SIGNATURE: