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HomeMy WebLinkAboutX2019-3803 - Permitswry City of Newport Beach - Building Division I IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit :X2019-3803 Per Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 3 8 0 3 Project No : 1334-2019 Permit Counter Phone (949)644-3288 .� Inspection Requests Phone (949)644-3255 r°r,�yrytm Combination Type - SFP Issued Date : 12/23/2019 Inspection Area : 2 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 6:00 a.m. to 6:00 p.m. No work on Sundays or Holidays Job Address: 1211 CLIFF DR NB Description: SFR -ADDITIONAL VALUATION -REBUILD SLAB UNDER BDRM 1,2&3, BATH, POWDER & FOYER (DELTA 2 & 3) Legal Desc.: N TR 1219 BLK B LOT 1 Am 6"m0 Owner: HILL II RUSH Contractor: PDC INC Architect: ®°, •e om.:�� Address: 115 22ND ST Address: 1010 S HATHAWAY ST UNIT C Address: • • • ` "' NEWPORT BEACH, CA 92663 SANTA ANA, CA 92705 Phone: Phone: (714) 664-0477 Phone: State Lic: •• • •"' • ° Applicant: ROLANDO/SMITH CRAIG Con State Lic: 988559 Engineer: JAMIL BASHAR S • e ` "",' °o Address: 1041 W 18TH STREET #A-208 Lic Expire: 11/30/2021 Address: 751 SHASTA DR COSTA MESA CA 92627 Bus Lic: BT30055261 CORONA CA 92881 Phone: 949-764-0010 Lic Exp Date: 06/30/2020 Phone: 714.883-4124 State Lic:C-083129 " OO•GO •mmmo-o Code Edit: 2016 Worker's Compensation Insurance Designer: m°••m• m ` Type of Construction: V-B Carrier: EVEREST PREMIER INS CO Address: Occupancy Group: R3/U Policy No: 7600020452191 Added /New sq.ft. Bldg: 0 Expire: 05/29/2020 Phone: �1 Added /New : H. Garage: 0 'A sp No of Stories: 2 Building Setbacks Rear: / Special Conditions: t�.dY" � No of Units : 1 Front: / Bldg Height: 0 Left: I Bldg Sprinklers: Right: / Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $40.000.00 Building Permit Fee: $636.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $553.32 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: $28.00 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 WO Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access : $0.00 PAN Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist: $0.00 Building Green Fee : $2.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 _ Plumbing %: $0.00 $0.00 TOTAL FEE: $1,259.32 Plan Check Fee: $593.32 Fee Due at Permit Issuance : $666.00 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 3 of the Business and 3rofessions 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 iot more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the mprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or 'mproved for the purpose of sale). ❑ I, as owner s1:t�%peoperty, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). a 1 am:exempt from 1i2Bnsure under the Contractors' State License Law for the following reason: BS my si§naturelbebw I.acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally se4 a strgcture thatJ have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code "is ayailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Date Sigpature of Property -Owner or Authorized Agent QCEpIStD COf1T RAR tTOR'S DECLARATION 7e�rgF�);affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) f Div' 'on of the Business and Profes ons Code and y license is in full force andel effect. LICe(I$e Clbss License No Date / Contractor Signature ..4-- W.0 CO`,M}i�ENSATION DECLARATION WARNING: d ILURE p.WJJFiIE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUND ED THOUSAND DOLLARS (8700,0061, IN ADDITION TO THE CAST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 111DId%'alfirm undel+penolty of perjury one of the following declarations: ...h + ❑I he and will"fiaiRtain 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 t have performance of the work for which this permit is issued., Policy No. 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' compensatioi insur ce carrier and policy number are: PoliNumber Expiration Date (`airiecr Y ,.,. .. Jame of Agent �I certify that, in the p/subj ce 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' mpensation Ia1 s of California, and agree hat, if I should becomo a workers ompe visions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.signature of Applicant Da )ECLARATION REGAONSTRUCTION LENDING AGENCYhereby affirm under pperjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3 7, Civil Code). .ender's Name Lender's Address 3y 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 hav provided is correct. I agree to comply with all applicable city and count ordinan s and sta laws relating building construction. I authorize representatives of this city or county t enter above-iden fi prop y or n purposes. Ztee signature of Propert Owner or Authorized Agent rty Owner's or Authorized Agent's Name e ACTION DATE BY DECLARATION OF CO„j`vIPLIA�F FEDERAL FOR OFFICE USE ONLY PERMIT PERMIT EXTENDED PERMIT FINAL c �] CERTIFICATEOF J r OCCUPANCYISSUED TO