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Home My WebLink Aboutx2017-2052 - Permitst r City of Newport Beach - Building Division ' ` IIIIIIIII�IIIIIIII�IIIIIIII�IIIIIIIIIIIIIIIIIII COMB Permit: X2017-2052 "p 1 7 2 0 5 2 100 Civic Center Drive, Newport Beach, CA 92660 x 2 0 "�'j' ' Permit Counter Phone (949)644-3288 Project No : 1432-2017 ' Inspection Requests Phone (949)644-3255 'c"� rs,�a `" " Combination Type - SFP ELEC MECH PLUM Issued Date, 08/07/2017 0 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 No work on Sundays Holidays Job Address: 2415 FRANCISCO DR NB p.m. or .... Description: SFR -ADD BDRM &BATH 296 SF &REMODEL 300 SF, RELOCATE GARAGE DOOR Legal Desc.: N TR 3282 LOT 12 Owner: SUN DONALD Contractor: NEW WEST BUILDERS INC Architect: ° r`0 ,,,, • ° °°•° Address: 2415 FRANCISCO DR Address: 12082 WOODBINE DR Address: ° • • , NEWPORT BEACH CA 92660 SANTA ANA CA 92705 :.wf. Phone: 714-335-5200 Phone: 714-412-5263 Phone: State Lie' -B,po °, • •°°,,,• Applicant: DORN ROBERT Con State Lie: 469416 Engineer: STANGER CRAIG Address: 4561 PALOMA LN Lie Expire: 01/31/2019 Address: 2014 E WESTPORT DR#A YORBA LINDA CA 92886�. Bus Lie: BT30058264 ANAHEIM CA 92806 ; Phone: 714-400-2569 Lie Exp Date: • 0313112018 Phone: 714-778-6691 State Lic:S-003893 „o - #••®+• Code Edit: 2016 Worker's Compensation Insurance Designer: DORN ROBERT o Type of Construction: VB Carrier: WIC EXEMPT Address: 4561 PALOMA LN Occupancy Group: R3IU Policy No: (NO EMPLOYEES) YORBA LINDA CA 92886 - Added /New sq.ft. Bldg: 296 Expire: Phone: 714-400-2569 Added /New sq. ft. Garage: 0 No of Stories: 1 - Building Setbacks Rear: 10' Special Conditions: SD17-0366 No of Units : 1 Front: 15' Bldg Height: 0 Left: 10' Bldg Sprinklers: Right: 10' Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $100,000.00 Building Permit Fee: $1,669.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $1,282.04 Additional Fee : $0.00 Plan check Fee: $187.50 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: $50.00 Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 Energy Compliance: $70.00 Grading PC Fee: $0.00 Public Works Department - General Service $0.00 CA Seismic Safety: $13.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access : $0.00 P/W Plan Check: $76.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $116.83 San Dist: $0.00 Building Green Fee : $4.00 Mechanical %: $66.76 NMUSD Fee: $0.00 $0.00 Plumbing %: $150.21 $0.00 TOTAL FEE : $3,685.34 Plan Check Fee: $1,352.04 Fee Due at Permit Issuance : $2,333.30 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: n PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: �� ) OWNER -BUILDER 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 is 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 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 ($500). 7 I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, usiness and Pr4fe$yons 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 nprove4l for the purpose of sale). l�saownersf lfie�xoperty, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not �ly tp an owner o{property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). arri exempt from licensure under the Contractors' State License Law for the following reason: �Ymysignaturq, elo'w Lacknowladga 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. ells stItrcture thaPMlPave 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, S tion 7044 of the Business and I. Irofessions Code, 17avB lable upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.htmi. 111 Jre of Prcipe ty Owner or Authorzed Agent Date IIISO?SED CONTRACTOR'S DECLARATION ' h emb7 Affirm ungler penalty of perjurythat I am licensed under provisions of Chapter 9 (commencing with Section 7 o� Division 3 of the Business and Prof sio od ,arrtlTtly4ic@0 is in full force 6d effest. License E,VS License No Date j - - Contractor Signatur fOR"WS' CPMQ, bISATION DECLARATION 'AIIMNQ. FAILURERQSECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUWECT AN EMPLOYER TO CRIMI AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm under penalty of perjury one of the following declarations: ] 1 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 th erformance 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' rance carrier and policy number are: Policy Number Date `ne of Agent I rnone a cemfythat, in the perforplance 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' C nsati laws of California, and agre, t, if I should become s ject' o he workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. i nature of Applicant �— te— CLARATION REG RDING'60NSTRUCTION LENDING AGENCY ereby affirm unde 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 Co a). rder'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 pro rty owner's behalf. I have read this application and the information I have ovided is correct. 1 agree to comply with all applicable city and count ances and state laws relating to building construction. //(( I authorize representatives of this city or county t enttA a ove-identified property for inspection purposes. (,L,� mature of Pronertv Owner or Authorized ADent Print Property Owner's or Authorized Agent's Nam EI; D ACTION I DATE DECLARATION 01 CMPLIANCE WITH CODE OF I BY / REGULATIONS PART061 OF TITLE 40 AND QMD RULE �L FOR OFFICE USE ONLY PERMIT EXPIRED LJ I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED EPA P PERMIT EXTENDED QMD PERMITFINAL n/.qq ASBESTOS NOTIF ION IS NOT APPLICABLE TO CERTIFICATE OF S'?j�'✓$/ PROPOSED DEM IT.d OCCUPANCY ISSUED SIGNATURE: � f