HomeMy WebLinkAboutX2020-2599 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIII�III�IIII II COMB Permit: X2020-2599
100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 0 2 5 9 9
w `t Permit Counter Phone (949)644-3288 Project No: 2088-2019
tt.: Inspection Requests Phone (949)644-3255
"�zrre + Combination Type - MFP MECH ELEC PLUM Issued Date : 11/05/2020
9
Inspection Area : 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 11/06/2023 OR PERMIT WILL BE INVALID
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: 14 BIG DIPPER CT NB
Description: MFR REMODEL KITCHEN 110
SF, CHANGE OUT (E) WATER HEATER & 100 AMP SERVICE PANEL
Legal Desc.: TR 8835 LOT 6 UNIT 11 P-11 G-11 CP -11 OF PROJECTLOCATED ON AP
Z!
Owner: WHEELERIHOLDEN
Address: 9104 HIGH OAK CT
Contractor:
Address:
PYXIS WATER SYSTEMS INC
9121 ATLANTA AVE
Architect:
Address:
V�
FAIR OAKS, CA 95628
HUNTINGTON BEACH CA 92646
2;
_Tj,
Phone:
Phone:
714.504-1860
Phone:
State Lic:
-
MApplicant:
HOLDEN KELLY
Con State Lic:
896753
Engineer:
HOLDEN KELLY
Address: 9104 HIGH OAK CT
Lic Expire:
0613112021
Address:
9104 HIGH OAK CT `
FAIR OAKS, CA 95628
Bus Lic:
BT30069113
FAIR OAKS CA 95628
` J
Phone: 9165794707
Lic Exp Date:
0913012021
Phone:
State Lic:C-042268
�` 7
Code Edit : 2019
Worker's Compensation Insurance
Designer:
Type of Construction: VB
Carrier:
SECURITY NATIONAL INS CO
Address:
Occupancy Group: R21U
Policy No:
SWC1148349
DO
Added /New sq.ft. Bldg: 0
Expire:
06104/2021
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 0
Building Setbacks
Rear: I
Special Conditions: LANDSLIDE AREA
No of Units : 0
Front: I
REV20.1707
Bldg Height: 0
Left: /
Bldg Sprinklers:
Right: /
Flood Zone: X
Use Zone: Parking Spaces: 0
Fire Hazard Zone : N
Construction Valuation: $14.000.00
Building Permit Fee: $314.00
Excise Tax:
$0.00 Planning Department -
Fire Department
Plan Check Fee: $273.18
Additional Fee :
$0.00 Plan check Fee :
$46.25 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: $6.00
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
WQ Insp. Fee:
$0.00 Park Dedication :
$0.00
Refund Deposit
$0.00
Disabled Access : $0.00
PM Plan Check:
$0.00
Grading Bond:
$0.00
Hazardous Mat $0.00
Electrical %:
$21.98 San Dist:
$0.00
Building Green Fee : $1.00
Mechanical W
$12.56 NMUSD Fee:
$0.00
$0.00
Plumbing %:
$28.26
$0.00
TOTAL FEE: $703.23
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Plan Check Fee
$0.00 Fee Due at Permit Issuance : $703.23
<' RUBLI�,WOj2K,"a APPROVAL:
"PLAN CHECK BY:
APPROVAL TO ISSUE:
c • ca•
4
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)
lection 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
to 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 qnd
'rofessions 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
of more than five hundred dollars ($500).
7 1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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
nprovements 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
nproved 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' Slate License Law does not
pply 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).
3 1 am exempt from licensure under the Contractors' State License Law for the following reason:
ly 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
ell 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
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http:l/www. leginfo.ca.gov/calaw.html.
signature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Cha ter 9commencing with Section 70 0) of Division 3 of the Business and Prof ns��,,00��e,, and m I nsP, Is in full force
nd effect. License Class License No r7i�P67 7i Date -0 Contractor Signatureizot
YORKERS' COMPENSATION DECLARATION
'ARNING: 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
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penally of perjury one of the following declarations:
id 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
of the work for which this permit is issued. Policy No.
have and waintain 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'
rance carrier n olicy num0%are:
Date
Of
1 —
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
if I should become su ect to the 'comp I a ' n provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
lature of Applicant
we/i�� - z t�
hereby affirm under nalty 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 Lenders 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 county tReor tIdentif' pe y Inspection purposes. I/ 1
ignature of Property Owner or Authorized Agent ;?� Print Property Owners or Authorized Agent's Nam 6 lC-7
%CTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY C v
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION 0• •"•
PERMIT CANCELLED UEPA • • + � e •
PERMIT EXTENDED QMD +
PERMITFINALq3 Q��% ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF �1 �t7' PR SED EMO
OCCUPANCYISSUED SIGNATURE: • ••• •�• •'•
s • •