HomeMy WebLinkAboutX2019-0055 - PermitsI. City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II
w'T' 100 ic Cennter Drive, Newport Beach, CA 92660 X 2 0 1 9 0 0 5 5
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - MFP
No of Stories: 2
No of Units: 2
Bldg Height: 0
Bldg Sprinklers:
Building Permit Fee: $1,11.3.00
Plan Check Fee: $1,029.31
Overtime Plan Ck:
$0.00
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR i
$1,113.00
Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from
Job Address:
911 E BALBOA BLVD NB
$0.00
Description:
MFR STONE VENEER ON EXTERIOR OF HOUSE AND INTERIOR LATERAL SYSTEM REINFORCE
Legal Desc.:
BALBOA TR BLK 14 LOT 5
Hazardous Mat
' Owner:
TOLMAN TROY/TOLMAN BARBARA
Contractor: OWNER/BLDR
Address:
3214 OCEAN FRONT IN
Address: TOLMAN BARBARAITROY
NEWPORT BEACH, CA 92663
.Phone:
949.375-0019
Phone:
.Applicant:
TOLMAN BARBARA
Con State Lic: O1B
Address:
3214 OCEAN FRONT IN
Lie Expire:
NEWPORT BEACH, CA 92663
Bus Lie:
Phone:
949-375.0019
Lie Exp Date:
Code Edit:
2016
Worker's Compensation Insurance
Type of Construction:
V -B
Carrier:
Occupancy Group: R31U
Policy No:
Added /New sq.ft. Bldg: 0
Expire:
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units: 2
Bldg Height: 0
Bldg Sprinklers:
Building Permit Fee: $1,11.3.00
Plan Check Fee: $1,029.31
Overtime Plan Ck:
$0.00
Investigation Fee:
$1,113.00
Record Management:
$6.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access:
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$4.00
Building Setbacks
Use Zone:
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant:
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: /
Front: /
Left: I
Right: I
rking Space
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
0
COMB Permit X2019-0055
Project No : 0041-2019
Issued Date: 0 912012 01 9
Inspection Area : 1
VALID INSPECTION.
a.m. to 6:00 p.m. No work on Sundays or Holidays
r *117.2443*
Planning Department -
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
State
LARSON HAROLD EUGENI
1437 GLENNEYRE ST emma
LAGUNA BEACH CA 92651 s
`«,em
949-497-5203 State Lic:C-033222
m mm
m m m
Special Condition Vb V44
Plan check Fee:
Fire Department
Fair Share:
Fire Inspection:
SJH Trans : -
Fire Plan Rev
In -lieu Housing Fee
Demolition Fee
Public Works Department -
Park Dedication :
$0.00
P= Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
,
0 om
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
11 TOTAL FEE: $3,305.31 Plan Check Fee : $1,008.30 Fee Due at Permit Issuance : $2,297.01
PROCESSED BY: - PUBLIC WORKS APPROVAL:
ZONING APPROVAL: T u PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
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Fire Department
$40.00.
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
,
0 om
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
11 TOTAL FEE: $3,305.31 Plan Check Fee : $1,008.30 Fee Due at Permit Issuance : $2,297.01
PROCESSED BY: - PUBLIC WORKS APPROVAL:
ZONING APPROVAL: T u PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
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0 0
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OWNER -BUILDER DECLARATION e _2 ^
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 U 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
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
Im 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
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).
❑ 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 1 must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally
sell a structure that) have built as an owner -builder if it hay
t 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 li atiois submitted or a fgllowing Web site:http://www.leginfo.ca.gov/calaw.htmi.
Signature of Property Owner or Authorized Agent 7.v t. Date
LICENSED CONTRACTOR'S DECLARATIQff
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
and effect. LiciiiA? ° lass License No Date Contractor Signature
NORKERS' C6MNSATION DECLARATION
,MYARNING.FAILURS TO SECURE 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
COST 0f COMPENSAInVON}DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
•her �b -affirm under penalty of perjury one of the following declarations:
I have and All ea+ntain 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 thi
jerrJbjrVAnce of ttV. worlt for which this permit is issued. Policy No.
-1twe and mil 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 workers'
lrapce carrier ane policy number are:
00%• Policy Number Expiration Date
%1t:y that, i%We 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
tf1 should Dg %ome-subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
',ignature of Applicant Date_
IECLARATION REGARDING CONSTRUCTION LENDING AGENCY
hereby affirm under penalty 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).
Ender's Name Lender's Address
Iy 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. /m
I agree to comply with all applicable city and county ordinances and state laws relating to building construction.
I authorize representatives of this city or county t er Mhe above-iden/t1`fiedWroperty for inspection purposes.
ed
innature of Prooerty Owner or AuthorizADent W _u % w laic /l_.J Print Prooertv Owner's or Authorized ADent's Name �f/TMlIT/t11 c
ACTION DATE BY/ DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY `
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED I I I U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITFINAL p, ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATEOF -23- YR -1, POSEDE�(IOLITII A Q
OCCUPANCYISSUED SIGNATUR j /_�.Vy/lLii ♦ %/i(.ISLt