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Home My WebLink AboutX2019-3376 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit: X2019-3376 ,. 100 Civic Center Drive, Newport. Beach CA 92660 X 2 0 1 9 3 3 7 6 Project No : 0804-2018 : Permit Counter Phone: (949)644-3288 - - ,. Inspection Requests Phone (949)644-3255 Combination Type - BLDG ELEC Issued Date 10123/2019 i Inspection Area : 7 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: 4301 BIRCH ST NIB Se Description: COMM-(1) LIGHT STANDARD (X2019-0751) Legal Desc.: N TR 5169 LOT 4 owner: 4321 BIRCH PTNRS LTD Contractor: D B A C INC Architect MARTIN RICHARD K �� Address: 26023 ACERO 9150 Address: 101 SHIPYARD WAY #A Address: 1400 QUAIL ST #120 MISSION VIEJO, CA 92691 NEWPORT BEACH CA 92663 NEWPORT BEACH CA 92660 Phone: Phone: 949-723.0147 Phone: 949-851=3044 State Lic:C014204 ° m - mmm°mm - Applicant MARTIN RICHARD K Con State Lia.' 637651 Engineer: ° MONTOYA HERNAN ° ^ Address. 1400 QUAIL ST#120 Lie Expire: 02129/2020 Address: 22421 GILBERTO, STEE -o NEWPORT BEACH CA 92660 Bus Lie: - BT00016282 RANCHO SANTA MARG CA 92688 .... o Phone: .949-851-3044 'Lie Exp Date: 10/31/2019 Phone: 9491713-7824 State Lic:S-002819Code Edit: 2016 Worker's Compensation Insurance Designer; Typeof Construction Carrier STATE COMP ' Address:. Occupancy Group: U Policy No. 9117372- Added /New soft. Bldg: 0 Expire: '. " 11111/2019 -Phone: m m o b Added /New sq. ft. Garage: 0 No of Stories:0 Building Setbacks Rear: / '. Special Conditions:. 00000m o I, o No of Units: 0 Front: / Bldg Height: 0 Left I ° Bldg Sprinklers:. Right. l ccoc Flood Zone: Use Zone: Parking Spaces: 0 - Fire Hazard Zone`. N 'Construction Valuation.` $1.200.00 Building Permit Fee: $104.00 Excise Tax: - $0.00 Planning Department - Fire Department Plan Check Fee: $90.48 ': Additional Feer $0.00 Plan check Fee ;. $40.00 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: .$0.00 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 Disabla ccess: $0.00 PAN Plan Check: $0.00. Grading Bond: $0.00 Hazardous Mata $0.00 Electrical %: $13.61 - San Dist: $0.00 Building Green Fee $1.00 Mechanical %:. _ - $0.00 NMUSD Fee: $0.00 $0.00:" Plumbing %i $0.00 - $0.00. TOTAL FEE : $249.09 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $249.09 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: 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) 1 have placed next to the applicable item(s) =coon 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 1 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 afessions 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 I 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 L) 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 provements 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 proved for the purpose of sale). I, as owner of the property, annexclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not ply 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). l 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 legal) II 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 Business and )fessions Code is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. ]nature of Propsrty.Qjiner or Authorized Agent D to CENSSED CONTRACTOR'S DECLARATION 150Sffirm upEolfr"palty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 v 'o o the Business and Profess) d a y f e e i J effect. License Class License No Date `contractor Signature DWRS' COMPENSATION DECLARATION KERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUND7dJA'iOUSAND DOLLARS ($700,000), IN ADDITION TO THE AS PROVIDED FOR IN SECTION 3703 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. affirm under penalty of perjury one of the following declarations: R and ;RI'Maintain a certificate of consent to self -insure for workers' compensation, Ince of thework for which this permit is issued. Policy No. issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for itave.'and wp,r9yig1tin 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' LWg carrier and policy number are: Policy Number Date ame of Agent "' • Phone # ]I certify that, in the pe orman f terfor which th' p it is iss d, 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre Iat, if I should become s to th compen lo provisio f Section 3700 o Labor Code, I shall forthwith comply with those provisions. _ ignature of Applicant Date�'� iECLARATION REGARD] G C STRUCTION L NDING AGENCY hereby affirm under pen ty of rjury 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 ymy signature below I c ify to each of the following: I am the propertylKner or authorized to act on the property owner'sZbehalf.I have read this applicationand the information ave vided is coagree to comply with all applicable city and c untyordin nces nd ti to building construction. 1 authorize representatives of this city or county ter a ve-id for inspection purposes. i nature of Property Owner or Authorized Agent int PropertOwner's or Authorized A ent's Na DatE 1CTION DATE BY A D LARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY GULATIONS PART 61 OF TITLE 40 AND AQMD RULE EXPIRED I I / / I U I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT EXTENDED I I L_KQMD PERMITFINAL ,. gN`4 � U ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF. PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: