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Home My WebLink AboutX2017-3255 - Permits�1 KNIyj$ City of Newport Beach - Building Division Address: 100 Civic Center Drive, Newport Beach, CA 92660 Record Management: Permit Counter Phone (949)644-3288 . Inspection Requests Phone (949)644-3255 Applicant: Combination Type - SFP COMB Permit: X2017-3255 IIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIII II Project No: 1250-2016 Issued Date : 10/13/2017 Inspection Area : 5 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: 1653 BAYSIDE DR NB Description: SFR CANTALEVER DECK *ADDITIONAL SCOPE* 200 SF Legal Desc.: N TR 6927 LOT 2 Owner: PSC STRATEGIC INVESTMENTS Address: 27489 AGOURA RD Record Management: AGOURA HILLS, CA 91301 Phone: 818-435-7775 Applicant: KENNY/BDR Address: P.O. BOX 410 Bus Lie: AGOURA HILLS, CA 91376 Phone: 818-435-7775 Code Edit : Type of Construction: Occupancy Group: Added /New sq.ft. Bldg: Added /New sq. ft. Garage: No of Stories: 0 No of Units: 1 Bldg Height: 0 Bldg Sprinklers: Construction Contractor: B D R INC Address: 27489 AGOURA RD Record Management: AGOURA HILLS CA 91301 Phone: 818-435-7775 Con State Lic: 735996 Lie Expire: 0513112019 Bus Lie: BT30061626 Lie Exp Date: 07/31/2018 2016 Worker's Compensation Insurance Carrier: EVEREST NATIONAL Policy No: CA10002812161 0 Expire: 0 811 612 01 8 0 Building Setbacks Rear: / Front: / Left: I Right: I Building Permit Fee: $367.00 Plan Check Fee: $319.29 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $4.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $691.29 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Architect Address: Phone: State Lie Engineer: DEIHIMI DAMIR HOSSEIN Address: 23172 PLAZA POINTE DR STE 145 Additional Fee : LAGUNA HILLS CA 92653 Phone: 949-954-7244 State Lic:C-078194 Designer: $0.00 Address: General Service Phone: Special Conditions Excise Tax: $0.00 Planning Department - Fire Inspection: Additional Fee : $0.00 Plan check Fee: Demolition Fee Grading Bonds Fee: $0.00 Fair Share General Service Grading PC Consultant: $0.00 SJH Trans Grading Bond: Grading Permit Fee: $0.00 In -lieu Housing Fee Grading PC Fee: $0.00 Public Works Department - WQ Insp. Fee: $0.00 Park Dedication : $0.00 PAN Plan Check: $0.00 Electrical %: $0.00 San Dist: $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 Plumbing %: $0.00 Plan Check Fee Zone : N e e me••e• • e ooeoJ -� e o e P � O O O • • m� ynap� •m0 m emn �oo o m myaaas'Gat" o eoo ® �[yySgi� o o m o a •ec'rd�: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $282.00 Fee Due at Permit Issuance : $409.29 PUBLIC WORKS APPROVAL: PLAN CHECK BY: 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: e e me••e• • e ooeoJ -� e o e P � O O O • • m� ynap� •m0 m emn �oo o m myaaas'Gat" o eoo ® �[yySgi� o o m o a •ec'rd�: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $282.00 Fee Due at Permit Issuance : $409.29 PUBLIC WORKS APPROVAL: PLAN CHECK BY: 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) 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 L) portions of the work, and the structure is not intended or offered for sale (Section 7044, ,iness 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). 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 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 backnowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the in a structure MV161%ge built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the appl ifessions Code is available upon request when this application is submitted or at the following Web site:hftp://www.leginfo.ca.gov/calaw.htm]. 'n'atu're of PropeAy owner or Authorized Agent LENSED CONTRACTOR'S DECLARATION a2pyldffirm undOr penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0) Divi ion 3 of the Business and i effect. LicE:rl� gP Ass License No Dat d Contractor Signa )R,j !RS' COMPENSATION DECLARATION iyly : FAILURE:rO.SECtLRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE Huh CpMPENSA31064AAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. Rgr46y affirm under penalty of perjury one of the following declarations: vents covered by this permit, I cannot law, Section 7044 of the Business and Date in full force DOLLARS ($100,000), IN ADDITION TO THE and vdig"41tain 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 ce of the work -for which this permit is issued. Policy No. and wIM rgahAtlin 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' compensa carrier•Snd policy number are: Policy Number Date ne of Agent -vnone s certify that, in the perf9fmance 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 11Z2 'mpensation laws of California, and agre t, if I should become bject to the workers n provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applican .e1 CLARATION RE ARDIN CONSTRUCTI NDING AGENCY :reby affirm and penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3ode). Ider's Name Lender's 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 rdinances and state laws relating to building construction. I authorize representatives of this city or county t orente he above-identifi erty for inspection purposes. 1�e�Gc lTrt55� / /te nature of ProOertv Owner or Authorized Aqent Print Property Owner's or Authorized Agent's Name 'fes to �% �3 /• ACTION DATE BY / FIECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED EIEPA PERMIT EXTENDED QMD PERMITFINAL ASBESTOS 0011FICATION 15 NOT APPLIC TO CERTIFICATEOOCCUPANCYISF y c'�(1 , PR j7EM➢J TIO OCCUPANCVISSUED \ �! TLIOSE SIGNA7U �