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HomeMy WebLinkAboutX2018-2914 - PermitsIc Ty,pfiiyeevpoxt•F,f��ch -Building Division ��Illlllllllllllll�lllllllllllllllllllllllllu�� COMB Permit: X2018-2914 a� 4� 1010 ci�ic�entaw Dliv �avpoft Bsach, CA 92660 X 2 9 1 8 2 9 1 4 Project No: 1604-2018 '., Ranrn Goun4Gr1'hbge (9149)649-3288 i Inspection Requests Phone (949)644-3255 * tvnu�"s Cojnbination Type - CIP ELEC Issued Date :0912X2018 n . Inspection Area : 7 c ° ° • ; m PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. •••• Construction HourSmMond"ay -Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. No work an Sundays or Holidays Job Address: 1100 QUAIL ST NB St: 1 FI: 1 Unit: 105 Description: COMM - TI 550 SF "BIEBER LLC" Legal Desc.: P BK 48 PG 11 PAR 1 Owner: ARNAUD ANCENAY Contractor: HARRISON BUILDING Architect: Address: 1100 VENEZIA AISLE Address: 23 DEERWOOD Address: IRVINE CA 92606 IRVINE CA 92604 Phone: Phone: 949-278-1727 Phone: State Lie: Applicant: AUDENIS PATRICK Con State Lie: 951412 Engineer: KHAEF ESMAIL Address: 20932 CRESTVIEW LN Lie Expire: 03/31/2019 Address: 2825 LAGUNA CANYON RD BLDG A HUNTINGTON BEACH CA 92646 Bus Lie: BT30049801 LAGUNA BEACH CA 92651 Phone: 949-278-1727 Lie Exp Date: 01/31/2019 Phone: 949.497.6810 State Lic:C-045870 Code Edit: 2016 Worker's Compensation Insurance Designer: Type of Construction: V -B Carrier: WC EXEMPT Address: Occupancy Group: B Policy No: (NO EMPLOYEES) Added /New sq.ft. Bldg: 550 Expire: Phone: Added /New sq. ft. Garage: 0 No of Stories: 1 Building Setbacks Rear: I Special Conditions: No of Units: 0 Bldg Height: 0 Front: I Left: I Bldg Sprinklers: Right: / f: { Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N g ` Construction Valuation: $10.000.00 IB- v Building Permit Fee: $232.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $0.00 Additional Fee: $304.00 Plan check Fee: $0.00 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: $16.00 Grading Permit Fee: $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $0.00 Energy Compliance: $56.00 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 : $87.00 P/W Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $32.48 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 : $728.48 Plan Check Fee; $0.00 Fee Due at Permit Issuance : $728.48 PROCESSED BY: :1 PUBLIC WORKS APPROVAL: ly- V\ ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION e o 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 checkmar%(s; I have placgd reyt to the afflicable 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' gr'tor4cJs issuance, alsd•requlres 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 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 appliclnt to g 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 L) all of or U portions of the work, and the structure is mot intended orbfJa a for saTr(Sa 111 i 7044, 3usiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort *ild%or improvP�a fjre�roperty,.provided that 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 have'tAd burden of proving that it was not built or mproved 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 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). 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 legally :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 rrofessions 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 -ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 7000) of ivisio 3 of the Business and FjTgfyssiCod g, and my li ense is in full f ce Ind effect. License Class License No D e Contractor Signat l _�__�t�,d�_ 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 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby 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 thr erformance of the work for which this permit is issued. Policy No. have 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' rance carrier and policy number are: Policy Number Date Ti of Agent ' Phone # l c�rtify that, int 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 agrea tfit. 1 1 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. n� ature of Applicank /X A< L / DV ,09 ZIZ- CLARATION REG RMG CONSTRUCTION LENDING AGENCY � '�` Ireby 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). Ider's Name Lenders 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 ordinances and state laws relating to building construction. I authorize representatives of this city or coud'�,i,('to enter the bova� e ffied pr party for inspection purposes. r �q nature of PrODertv Owner or Authorized Aaent A //t1de '%ir�dl�fl �'�+�/, Print Prooertv Owner's or Authorized Aaent's Name I Y,a1MDate[_ ACTIONDECLARATION OF COMPLIANCE WITH CODE OF FEDE I DATE BY rREGULAT ONS PART61 OF TITLE 40 ANDAQMD RU ERAL I FOR OFFICE USE ONLY PERMIT EXPIRED L_I I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED 0EPA PERMITEXTENDED UAQMD PERMITFINAL CERTIFICATE OF OCCUPANCY ISSUED t\•}Lj.\�L1 ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION SIGNATURE: