HomeMy WebLinkAboutX2019-2222 - Permitst City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
e"�s,rnxss' Combination Type - MFP ELEC MECH PLUM
*X20192222* COMB Permit: X2019-2222
Project No: 1434-2019
Issued Date : I, 11('/ 1 f
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: 1728 BEDFORD LN NB
Description: MFR -(UNITS 12 - 18) APPLICANCE AND LIGHT FIXTURE UPGRADE, ADD WASHER/DRYER
Legal Desc.: N TR 1893 LOT 13
Owner:
CHRISTIAN PHIL
Address:
130 NEWPORT CENTER DR
Record Management:
NEWPORT BEACH CA 92660
Phone:
$0.00
Applicant:
NGUYEN GIANO
Address:
3621 W MACARTHUR BLVD
Hazardous Mat
SANTA ANA CA 92704
Phone:
714-617-5035
Code Edit: 2016
Type of Construction: V -B
Occupancy Group: R21U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units: 6
Bldg Height: 0
Bldg Sprinklers:
Construction
Building Permit Fee: $833.00
Plan Check Fee: $724.71
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$56.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :.
$3.00
TOTAL FEE`. $1,968.25
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Contractor
Address:
Phone:
Con State Lie:
Lie Expire:
Bus Lie:
Lie Exp Date:
Worker's Compensation Insurance
Carrier:
Policy No:
Expire:
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: /
Right: I
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$109.04
$62.31
$140.19
Architect: NEVILLE, SCOTT EDWARD
Address: 3621 W MACARTHUR BLVD
SANTA ANA CA 92704
Fire Department
Phone: 714.617.5035 State Lic:C031228
$40.00
Fair Share
ay
Engineer:
Fire Plan Rev
Address:
$0.00
Public Works Department -
V1-17 Eli
Phone: State Lic:
P/W Plan Check:
$0.00
San Dist:
Designer:„
NMUSD Fee:
Address:
Refund Deposit
Phone:
::>ms•_
Special Conditions:e�-P
rv'
Planning Department -
Fire Department
Plan check Fee
$40.00
Fair Share
$0.00
SJH Trans
Fire Plan Rev
In -lieu Housing Fee
$0.00
Public Works Department -
Park Dedication :
$0.00
P/W Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Plan Check Fee : $0.00 r 6 a Fee Due at Permit Issuance : $1,968.25
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PLAN CHECK BY:
APPROVALIP01ISSUE:
ao v
Fire Department
$40.00
Fire Inspection:
$0.00
$0.00
Fire Plan Rev
$0.00
$0.00
Demolition Fee
$0.00
Building Dept Adm
$0.00
General Service
$0.00
Refund Deposit
$0.00
Grading Bond:
$0.00
$0.00
$0.00
Plan Check Fee : $0.00 r 6 a Fee Due at Permit Issuance : $1,968.25
a
PLAN CHECK BY:
APPROVALIP01ISSUE:
ao v
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).
❑ 1, 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,
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).
❑ 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, I cannot legal)
sell a structure that I 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 Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
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 70 0) of ivis'on 3 of the Business and Profs;sions Code n, n �»�J+aPnse is in full force
and effect. License Class License No Date OY ) Contractor Signature `�
WORKERS' COMPENSATION DECLARATION
WARNING: 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 ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 9706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
I have 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 Code, for IN
pe9rmance of the work for which this permit is issued. Policy No.
I have 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 workers' compensatio
insurance carrier and policy number are: N
Carrier . /l IQ (/ /(4 d n Policy Number Expiration Date
Nameof AgentQv-k "J",10VA Phone#
I 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 agre
that, if I should become subject to the workers' mpensat' n provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant Date X 07/twirI
DECLARATION REGARDING CONSTRU NDING AGENCY
I 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).
Lender'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 ordinances and state laws relating to building construction.
I authorize representatives of this city or county to enter the abov = ' ' d property for inspection purposes. �pp(,- /
Signature of Property Owner or Authorized Agent Print Property Owners or Authorized Agent's Name R J4� ""' t'Q_ Date elf
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE
1403 .• •., . •.• .
PERMIT EXPIRED I SUBMITTED ASBEST®9 NOTlrNCATIO i TO
PERMIT CANCELLED EPA • • • • ^ • • • ', •
PERMIT EXTENDED AQMD
PERMITFINAL �/� 'A ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO
CERTIFICATE OF Y, PROPOSED DEMOLITION . . .'. •°,. �:•
OCCUPANCYISSUED SIGNATURE: '