HomeMy WebLinkAboutX2019-3576 - Permitswho City of Newport Beach - Building Division
-* 100 Civic Center Drive, Newport Beach, CA 92660
F, Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - SFP MECH ELEC PLUM
IIIII�IIIIIIIIIIIIIIIIilllllllllll II COMB Permit: X2019-3576
Project No : 2453-2019
Issued Date : 0111012020
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: 1414 DOVER DR NB ^^
Description: SFR - CONV BDRM TO MASTER BATH, REM KITCHEN & BATHROOMS, RMV WALL IN LIVING RMIDINING RM, WINDOW CIO 1,500 SF '�A ^��TOP
Y
Legal Desc.: N TR 1645 LOT 37 INSPEG
Owner: MONTGOMERY RICHARD Contractor: HAWKER CONSTRUCTION Architect: SHINDELUS BRUCE
Address: 603 IVY LN Address: 1531 LOWER LAKE CT Address: 2623 ANTONIO DR #206
SAN ANTONIC TX 78209 CARDIFF BY THE SEA, CA 92007 CAMARILLO CA 93010
Phone: Phone: 714-743.7110 Phone: 805-404-8216 State Lic:C015918
Applicant:
MARSH CHRIS
Address:
1531 LOWER LAKE CT
Occupancy Group:
CARDIFF CA 92007
Phone:
949.283-0500
Code Edit :
2016
Type of Construction:
VB
Occupancy Group:
R3/U
Added /New sq.ft. Bldg:
1500
Added/New sq. ft. Garage: 0
No of Stories:
2
No of Units :
1
Bldg Height:
0
Bldg Sprinklers:
N
Flood Zone:
X
Building Permit Fee: $1,438.00
Plan Check Fee: $1,251.06
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$20.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$6.00
TOTALFEE:
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Con State Lic:
930312
Engineer:
Lic Expire:
0113112021
Address:
Bus Lic:
BT30063937
Plan check Fee :
Lic Exp Date:
07/3112020
Phone:
Worker's Compensation Insurance
Designer:
Carrier:
STATE FUND
Address:
Policy No:
9123340
$0.00
Expire:
01127/2020
Phone:
Building Setbacks
Rear: /
Front: /
Left: /
Right: /
FORBES DALE L
1800E16TH ST #13 mom.
SANTA ANA CA 92701
714-835-2800 State Lic:C-030407
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Special Conditions:
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Damm
Excise Tax:
$0.00
Planning Department-
Fire Department
Additional Fee :
$0.00
Plan check Fee :
$40.00
Fire Inspection:
$0.00
Grading Bonds Fee:
$0.00
Fair Share:
$0.00
Fire Plan Rev
$0.00
Grading PC Consultant:
$0.00
SJH Trans :
$0.00
Demolition Fee
Grading Permit Fee:
$0.00 -
In -lieu Housing Fee :
$0.00
Building Dept Adm
$0.00
Grading PC Fee:
$0.00
Public Works Department -
General Service
$0.00
WQ Insp. Fee:
$0.00
Park Dedication : $0.00
Refund Deposit
$0.00
PNV Plan Check : $41.25
Grading Bond:
$0.00
Electrical %:
$100.66
San Dist: $0.00
Mechanical %:
$57.52
NMUSD Fee: $0.00
$0.00
Plumbing %:
$129.42
$0.00
3.91
Plan Check Fee
: $1,186.66 Fee Due at Permit Issuance : $1,897.25
'
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PUBLIC WORKS APPROV
PLAN CHECK BY:
APPROVAL TO ISSUE:
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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 U 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
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
im roved for the purpose of sale). I, as owner of the pro perty,'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 legally
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 at
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm un(jgrenalty of perjury that I am licensed under provisions of Chapter -9 (commencing with Section 700 ) of ivis'on 3 of the Business and Profs io o e, and my li seis4n-full-force
and effect. License cTaes License No 8 9365(7- Date 0 Contractor Signature
dDOFKeRS' COMPENSATION DECLARATION
AARNINVIFAILURE•10•SE6URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINA PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
:OST ORCOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
ilereby affirm under penalty of perjury one of the following declarations:
L h2 a wXl•meintain 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, forth(
W111nce of the work for which this permit is issued. Policy No.
and v,tINVUi Ifain 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' compensatior
carrier and policy number are:
Policy Number
Date
me oPAgent • ° • Phone #
...•
1 certify that, irstil6 perform ce of 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 ogre
I, ifi should 6ergMd'subj t to orkers' compen'o pro ' i s f Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
mature of Applican Daft
CLARATION REG R ONSTRUCTION L ING AGENCY /
areby 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).
lder'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 prrpvidefl is correct.
I agree to comply with all applicable city and county Win as and state laws relating to building construction.
I authorize representatives of this city or county to ter ov�e-idsentifi erty for inspection purposes. e
ature of Prooertv Owner or Authorized Aaent /- Print Prooertv Owner's or Authorized Aaent's Name 1�Y..- 6-1' MCA
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ACTION DATE
BY K DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND ACIMD RULE
1403
PERMITEXPIRED
U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED
EPA
PERMIT EXTENDED
MD
PERMITFINALII n
ASBESTOS NOT,I ION 15 NOTAPPLICABLE TO
CERTIFICATE OF +1
PROPOSED DE ON
OCCUPANCYISSUED
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