HomeMy WebLinkAboutX2019-0455 - Permits44 wtro City of Newport Beach -Building Division II IIIIII IIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIII I II COMB Permit: X2019-0455
' 100 Civic Center Drive, Newport Beach, CA 92660 x 2 0 1 9 0 4 5 5 PfOJECt No: 0334-2019
R Permit Counter Phone (949)644-3288
z"t Inspection Requests Phone (949)644-3255
Combination Type - SFP ELEC. MECH PLUM
$0.00
Issued Date : 04/03/2019 -
$0.00
Building`FGamit Fee:
$1,624.00
Inspection Area : 3
-
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: 18CAPE ANDOVER NB
$0.00
$0.00
Record Management:
Description: SFR INTERIOR REMODEL 2200 SF
$24.00
Energy Compliance:
$123.20.
Legal Desc.: N TR 15012 LOT 118
CA Seismic Safety:
$0.00
$564.00
Owner: SCHULZE STEPHEN J
Contractor:
SHORELINE DEVELOPERS
Architect: ROCHELEAU MITCHELL SCOTT
Address: 18 CAPE ANDOVER
Address:
P O BOX 551
Address: 23291 DOWNLAND RD
NEWPORT BEACH, CA 92660.
NEWPORT BEACH CA 92651
LAKE. FOREST CA 92630
Phone: .949.466-8010
Phone:
949-697-3993
Phone: 210-771-1615 State Lic:C036977
Applicant: ROCHELEAU MITCHELL
Con State Lie:
890871
Engineer: WONG ARIV NATHANIEL
Address: 9891 IRVINE CENTER DR STE 190
Lie Expire:
01/31/2021
Address: 180 S PROSPECT AVE#110
.0.°. IRKINf CA 92618
Bus Lie:
BT30041079
TUSTIN CA 92780
phone: 21P-,T71A615
Lie Exp Date:
10/31/2019
Phone: 714-838-9898 State Lic:C-055045
.Qgde edit: s 2016
Worker's Compensation Insurance
Designer.
°
Q.fype df Construction:V-B
Carrier:
STATE COMP
Address:
Occ`lgancy Group: R3/1.1
Policy. No:
9038773
bd/New Gq. . Idg: ` : 0
Expire:
01/01/2020
Phone:
°
(+Wed /New�aq°ft..Garage:.. 0
-
e Noro�f Storiesb ° o0 2
Building. Setbacks
Rear: I
Special Conditions: COUSYNS TO HAUL
Nabf Units °. 1
°`O °
mBWA
Front: I
DEBRIS
Height: 0
Left:
BIprinklers: N
Right:
° ° `F'
one.
Use Zone: Parking Spaces: 0
Fire Hazard Zone : N
TOTAL FEE:
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Excise Tax:
$0.00
Additional Fee :
$0.00
Building`FGamit Fee:
$1,624.00
Grading PC Consultant :
Plan Check Fee: $1,412.88
Grading Permit Fee:
- Overtime Plan Ck:
$0.00
$0.00
Investigation Fee:
$0.00
$0.00
Record Management:
$46.00
$24.00
Energy Compliance:
$123.20.
$197.00
CA Seismic Safety:
$0.00
$564.00
Disabled Access :
$0.00
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$8.00
TOTAL FEE:
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Excise Tax:
$0.00
Additional Fee :
$0.00
Grading Bonds Fee:
$0.00
Grading PC Consultant :
$0.00
Grading Permit Fee:
$0.00
Grading PC Fee:
$0.00
WQ Insp. Fee:
$0.00
Electrical %:
Mechanical %:
Plumbing %:
$113.66
$64.96
$146.16
Planning Department -
Plan check Fee:
Fair Share :
SJH Trans:
In -lieu Housing Fee
Fire Inspection, yi-)1d
Public Works Department -
Park Dedication :
$0.00
PAN Plan Check:
$82.50
San Dist:
$0.00
NMUSD Fee:
$0.00
Plan Check Fee : $1,617.33
Fee Due at Permit Issuance :
PUBLIC WORKS APPROVAL:
.PLAN CHECK BY:
APPROVAL TO ISSUE:
$0.00
$0.00
$2,831.05
w ,..
Fire Departrleiit
$40.00.
Fire Inspection, yi-)1d
$0.00
$0.00
Fire Plan Rev
$0.00
$0.00
Demolition Fee
$0.00
Building Dept Adm
$24.00
General Service
$197.00
Refund Deposit
$564.00
Grading Bond:
$0.00
Fee Due at Permit Issuance :
PUBLIC WORKS APPROVAL:
.PLAN CHECK BY:
APPROVAL TO ISSUE:
$0.00
$0.00
$2,831.05
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 (_) all of or.0 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).
1, 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).
❑ 1 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, 1 cannot legall
sell a structure that Ihave 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 CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) f D' ' iot 3 Df the Business and Professiy���e, and my license is in full force
and effect. License Class License No Da I Contractor Signature
•••s• o
WORKERS'COMPENSATIONDECLARATION
NARNING: 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 ($10000), IN ADDITION;0 THE o
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. •„ :• u
hereby affirm under penalty of perjury one of the following declarations: -
• o00
❑ I h 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,C+ode, fer°tb
3e o ance of the work for which this permit is issued. Policy No. ,• • • 00
h ve 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 work e*rj,,qpm pens6tio `
nsura ce carrier and policy number are: - •,,,. °
yam Policy Number Expiration Date
�7�ffie of Agent .Phone #
❑1 certify that, in the perform a 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 CaliforBiB!And agre
:hat, if I should become lect to thew rkers' on prowslons o ection 3700 of the Labor Code, I shall forthwith comply with those provisions. D � I �'(� ,. • • °
Signature of Applica t
DECLARATION RE INSTRUCTION LENDING AGENCY
hereby affirm under enalty of perjury that there is a construction lending agency for theperformance of the work for which this permit is issued (Section 3097, Civil Code).
ender's Name Lender's Address
By 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 o state laws relating to. building construction.
I authorize representatives of this city Or county t. enter the above-i ' ' d property for ins action purposes. r J [
Signature of PropertOwner or Authorized A ent Print Pro ertOwner's or Authorized Agent's Name We ` ' 11
,Date
ACTION DATE BY WECLARATF15N OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMITEXP/RED I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED EPA
PERMIT EXTENDED MAQMD
PERMITFINAL SNOTIFIC OM" LICABLE TO
CERTIFICATEOF PROPOSED DEM 'ION
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