HomeMy WebLinkAboutX2020-0872 - PermitsCity of Newport Beach - Building Division
rry` 100 Civic Center Drive, Newport Beach, CA 92660 ,
N Permit Counter Phone (949)644-3286
�$ Inspection Requests Phone (949)644-3255
Combination Type - SFP MECH ELEC PLUM
COMB Permit: X2020-0872
IIIIIIIIIIIIIII�IIIIIII�IIIIIIIIIIIIIII II
Project No : 0604-2020
Issued Date: 0610912020
Inspection Area : 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0611012023 OR PERMIT WILL BE INVALID
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: 2529 VISTA BAYA NB
Description: SFR ADD 10 SF, REMODEL 1000 SF
Legal Desc.: TR 1159 LOT 3 NWLY 66 FT
PROCESSED BY:
ZONING APPROVAL:
PU86 10 NeORKS APPROVAL:
4 VG O 4p,> i V
PLAN CHECK BY:
GRADING APPROVAL: ,;"�. ��APPROVAL TO ISSUE:
Ooa uo X06 O O oua. 00�
U.
Owner: SMITH ALEXANDER & KATHRYN
Contractor:
PACIFIC WEST CONCRETE INC
Architect:
OLDHAM RYAN
Address: 2529 VISTA BAYA
Address:
3672 PROVINCETOWN AVE
Address:
2651 E. CHAPMAN AVE #110
NEWPORT BEACH, CA 92660
IRVINE CA 92606
FULLERTON, CA 92831
Phone:
Phone:
7141396-0088
Phone:
714.482-8296 State Lic:CO29715
Applicant: OLDHAM RYAN
Con State Lie: 639232
Engineer:
FORBES DALE L
' e '
Address: 2651 E. CHAPMAN AVE #110
Lie Expire:
05/31/2021
Address:
1800 E 16TH ST #B
� r ,
FULLERTON, CA 92831
Bus Lie:
BT30071085
SANTA ANA CA 92701
Phone: 714-482-8296
Lie Exp Date:
12/31/2020
Phone:
714-835-2800 State Lic:C-030407
a ,N
Code Edit : 2019
Worker's Compensation Insurance
Designer:
Type of Construction: VB
Carrier:
EXEMPT
Address:
Occupancy Group: R3
Policy No:
�^
Added /New sq.ft. Bldg: 10
Expire:
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 1
Building Setbacks
Rear: 10'
Special Conditions: VA0366
No of Units : 1
Front: 40'
COSTA MESA SANITATION
Bldg Height: 24
Left: 4'
Bldg Sprinklers: N
Right: 4'
Flood Zone: X
Use Zone: R-1
Parking Spaces:
2
Fire Hazard Zone : N
Construction Valuation: $120.000.00
Building Permit Fee: $1,288.00
Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee: $1,120.56
Additional Fee :
$0.00
Plan check Fee :
$0.00 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: $26.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee
:
$0.00 Building Dept Adm
$0.00
Energy Compliance: $84.00
Grading PC Fee:
$0.00
Public Works Department-
General Service
$0.00
CA Seismic Safety: $15.60
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Refund Deposit
$0.00
Disabled Access : $0.00
P/W Plan Check :
$165.00
Grading Bond:
$0.00
Hazardous Mat $0.00
Electrical W
$90.16
San Dist:
$0.00
Building Green Fee : $5.00
Mechanical %:
$51.52
NMUSD Fee:
$0.00
$0.00
Plumbing %:
$115.92
$0.00
TOTAL FEE : $2,961.76
Plan Check Fee:
$1,204.56
Fee
Due at Permit Issuance : $1,757.20
PROCESSED BY:
ZONING APPROVAL:
PU86 10 NeORKS APPROVAL:
4 VG O 4p,> i V
PLAN CHECK BY:
GRADING APPROVAL: ,;"�. ��APPROVAL TO ISSUE:
Ooa uo X06 O O oua. 00�
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason (a) indicated below by the checkmark(s) I have placed next to the applicable item (a)
(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 `) 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 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 legall,
sell a structure that 1 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.htmi.
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 700 ) of Division 3 of the Business and Pro a "ns G63 n y icense is in full force
and effect. License Class License No Date oq Contractor Signa
NORKERS' COMPENSATION DECLARATION
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUS ND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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
'ormance 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' compensa
Trance carrier and policy number are:
Policy Number Expiration Date
ne of Agent Phone #
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
if I should become subject to4heyVor c r§'-coMpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
of
DECLARATION REl'3AR"G 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
ender's Name Lender's Address
y 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 count to a ab en3ifieAJ' property for inspection purposes. i� f�-
icnature of Prooertv Owner or Authorized ADent V Y �!. G .: Print Prooertv Owners or Authorized Aoent's NameY -A vn�
DATEI I R OF
BY EGULAT ONS PART O61 OF ITTLE 40 AND ACMD RULE AL I FOR OFFICE USE ONLY
compensation laws of California, and
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Code).
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PERMIT EXPIRED
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