HomeMy WebLinkAboutX2019-3384 - Permitsi11p City of Newport Beach`- Building Division
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COMB Permit: X2019-3384
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�+4 ' 100 Civic Center Drive, Newport. Beach CA 92660
h' Permit Counter Phone (949)644-3288
X 2 0 1 9 3 3 8 4
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Project No: 2340-2019
Inspection. Requests Phone (949)644-3255
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NFexx Combination Type - NIFP ELEC MECH PLUM
Issued Date 10/25/2019
Inspection Area : 3
PERMITS EXPIRE 480 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: 7SWIFT
Description: MFR- 1611 SF SFA ALT KITCHEN &POWDER RM
-
' ���(.^T��
Legal Desc : TR 7817 LOT 3 UNIT 210 OF PROJECT LOCATED ON AP 424-041-01 TOGETHER
_
Owner: LUCERO JOHN & JEANETTE Contractor:
SOUTH COAST DEVELOPERS ' Architect: SANTILLAN MICHAEL
Address: - 7 SWIFT CT Address:
- 417 ASSOCIATED RD #114 Address: 27 ORCHARDm. •.• m
NEWPORT BEACH, CA 92663
BREA CA 92821
LAKE FOREST CA 92630
Phone: Phone:
714-716-4376
Phone: 949.716-9990 State Lic CO23337 o e o ° °:• •
°
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°•ss•
Applicant: BLACKMORE JASON Con State Lie:
1006431
Engineer:
'• °°•
•
Address: 2735 DE SOTO`AV Lic€xpire:
c 08131/2021
- Address:
° °
°
COSTA MESA CA 92626 Bus tic.
ST30069488
<° s • • +
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Phone: 949-274-6585 Lie Exp Date:
; 10/3112020.
Phone:,
State Lie: °` °••i
Code Edit : 2018 Workers Compensation Insurance '.
: Designer:
°•o` ® m'
Type of Construction V -B Carrier:
ACE AMERICAN
Address:
mmeo<
Occupancy Group:. R2" Policy No:
C66370823
Added/New sq.ft. Bldg: '" 0 .Expire
` 10/01/2020.:
Phone
Added/New sq. ft. Garage: 0
° 'm••�°°<'
No of Stories. 2 Building Setbacks
Rear: /
Special Conditions:
No of Units: 3
Front: /
••flO- -
Bldg Height: 0
Left: /
Bldg Sprinklers: N
.'Right I
Flood Zone: X :-: Use Zone:` Parkin `S aces::
0 Fire Hazard Zone N
Construction Valuation: $15.000.00
Building Permit Fee: $312.00 Excise Tax:
$0.00
Planning Department-
Fire Department
Plan Check Fees $271.44 " .Additional Fee ;.
$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 : .$8.00 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
III
Disabled Access : > $0.00 1 ,
PAN Plan Check: $0.00
Grading. Bond. $0.00
'.
Hazardous Mat $0.00 Electrical %:
$21.84
San Dist: $0.00
'. Building Green: Fee $1.00 Mechanical %: -
$12.48 -
NMUSD Fee: $0.00
$0.00
Plumbing %:
:'$28.06
'$0.00
TOTAL FEE $$694.84 Plan Check Fee :
$311.44 Fee Due at Permit Issuance : $383.40
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PROCESSED BY: -
' PUBLIC WORKS APPRO AL:
ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
APPROVAL TO ISSUE: -'
I
i
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)
ction 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 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
,fessions 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).
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,
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
)rovements 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, am exclusively contracting 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 a 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.) 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,.
a structurelMl n'pve 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
Ifas4ons Code. p.available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
natdfe of Pro arty Owner or Authorized Agent Date
,EtJSED CsAtlkACTOR'S DECLARATION
rreby affirm un'fer penalt perjury that I am licensed under provisions of Ch�Pt�gr (c mmencing with Section 00 of I ' f the Business and Prof ss' ns`Dod and my license is in full force
I effect. Lipdnsprnass t) License No l��)(rr`f A Date I t Contractor Signature
)RKERS' MMPENSATION DECLARATION
MING: FAILU6E't0 ftURE 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
VP COMPENSATOON, DAMAGES AS PROVIDED FOR IN SECTION 3106 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
by affirm under penalty of perjury one of the following declarations:
I live anO%wa Plaintain 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
fWance of the work for which this permit is issued. Policy No.
ave and.willmintain 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' compensatioi
ance carri9rdIRJgToollcv number are:
Policy Number
Date
is of Agent rnone n
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
if I should become su ' the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with those provisions.
Iature of ApplicDate
,eby affirm under pJnatty 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).
Jer's Name Lender's Address
ny 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 countyordinances and state laws relating to building construction.
I authorize representatives of this city or county to ente above -identified property for inspection purposes.
Iature of Prooertv Owner or Authorized Apent NC t Print Property Owners or Authorized Agent's Name
BY IDECLARATION OF COMPLIANCE WITH CODE OF FEDERAL �` FOR OFFICE USE ONLY
REGULATIONS PART 610E TITLE 40 AND AOMD RULE
1403
I SUBMITTED ASBESTOS NOTIFICATION TO
ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO
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