HomeMy WebLinkAboutX2018-2946 - Permits"r City of Newport Beach - Building Division
6 100 Civic Center Drive, Newport Beach, CA 92660
E _ Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - SFP ELEC MECH PLUM
IIIIXIIIIIT0IIIIVIIIIIIIIIIIIII9IIIIIIDII II
COMB Permit: X2018-2946
Project No : 0925-2018
Issued Date: 10/0212018
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 Sunday's or Holidays
Job Address: 420 PROSPECT ST NB
Description: SFR ADD 18 SF ON 2ND STORY, INTERIOR ELEVATOR AND EXTEND DECK 525 SF
Legal Desc.: TR 772 LOT 13 BLK 20 SLY 20 FT THEREOF AND ALL (EXSLY 16 FT) LOT
Owner: FITZSIMONS SCOTT BROOKS
Contractor:
TODD CUSTOM HOMES INC
Architect:
•e
Address: 420 PROSPECT ST
Address:
23552 VIA PALOMA
Address:
o °
NEWPORT BEACH, CA 92663
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COTO DE CAZA CA 92679
Phone:
Phone:
949-279.7535
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Phone:
State Lic:
Applicant: DEMASCO CHERYL
Con State Lic:
635805
Engineer:
DAILEY TIMOTHY
Address: 9121 ATLANTA STE 826
Lic Expire:
04/30/2019
Address:
9332 WINTERWOOD CIR
HUNTINGTON BEACH, CA 92646
Bus Lic:
BT30060636
HUNTINGTON BEACH CA 92626
Phone: 714-473-6623
Lic Exp Date:
03131/2019
Phone:
714-962-6903 State Lic:C-039489
Code Edit: 2016
Worker's Compensation Insurance
Designer:
Type of Construction: V -B
Carrier:
EVERST NATIONAL CO
Address:
Occupancy Group: R3/U
Policy No:
7600014669181
Added /New sq.ft. Bldg: 0
Expire:
04/0112019
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 2
Building Setbacks
Rear: 5'
Special Conditions:
No of Units: 1
Front: 5'
Bldg Height: 0
Left: 3'
Bldg Sprinklers:
Right: 3'
Flood Zone:
Use Zone: Parking Spaces,
0
Fire Hazard Zone : N
Construction Valuation: $75.000.00
Building Permit Fee: $938.00
Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee: $0.00
Additional Fee :
$0.00
Plan check Fee:
$0.00 Fire Inspection:
Overtime Plan Ck: $0.00
Grading Bonds Fee:
$0.00
Fair Share :
$0.00 Fire Plan Rev
Investigation Fee: $0.00
Grading PC Consultant:
$0.00
SJH Trans :
$0.00 Demolition Fee
Record Management: $28.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee:
$0.00 Building Dept Adm
Energy Compliance: $0.00
Grading PC Fee:
$0.00
Public Works Department-
General Service
CA Seismic Safety: $9.75
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Refund Deposit
Disabled Access : $0.00
P/W Plan Check:
$0.00
Grading Bond:
Hazardous Mat $0.00
Electrical %:
$65.66
San Dist:
$0.00
Building Green Fee : $3.00
Mechanical %:
$37.52
NMUSD Fee:
$0.00
Plumbing %:
$84.42
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11 TOTAL FEE: $1,166.35 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $1,166.35
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) 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 3of the Bbsiness 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 (_) 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
improved 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
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 signatarg )?grow 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[)
sell a structure that ►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
Professions Cp4a,4s available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.govicalaw.htmi.
Si§nature of 1%ppitli Owner or Authorized Agent Date
410ENSED CQNTRACTOR'S DECLARATION
I Tlggety affirm u nge�r penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0) of Division 3 of the Business and Pr ' a and. - license is in full force
and effect. U ense Class License No Date Contractor Signature
;VQjKERS' COMP€NSATION DECLARATION
NARjJ((IG: FAILURE TOSURE WORKERS' COMPENSATION COVERAGE Is UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001, IN ADDITION TO THE
CCSi OG COMPENSAMON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I%feUy affirm un9er penalty of perjury one of the following declarations:
Z•.••
•I hie and.wiN rnntain 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 the
S rformance of the workfor which this permit is issued. Policy No.
.••• , ••
e and vril1Try30ain 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' compensatiol
nsurance carrier and policy number are:
is of Agent
certify that, in the p,
if I should become
Iature of Applicant _
Policy Number
Date
for which this permit is issued, I shall not employ any person in any manner so as to become subject to the
gempensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
treby affirm under ptnalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section
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 count ordinance nd state laws relating to building construction.
I authorize representatives of this city or county to pt!ove-id ntified property for inspection purposes. 14
nature of Prooertv Owner or Authorized ADent ////07��-P'nht Propertv Owner's or Authorized Agent's Na
ACTION
PERMIT EXPIRED
PERMITCANCELLED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCYISSUED
DATE BY /I REGULATIONS PPARTD61 O TITTLE 40AN AQMD RULECE WITH CODE OF RAL FOR OFFICE USE ONLY
I SUBMITTED ASBESTOS NOTIFICATION
IS NOT APPLICABLE TO
compensation laws of California, and
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