HomeMy WebLinkAboutX2015-0704 - Permits�Ir City of Newport Beach -Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
4r�r� Combination Type - SFP PLUM
Job Address:
1701 SKYLARK LN NB
Description:
SFR - BATH REMODEL
Legal Desc.:
N TR 3082 LOT 65
Owner:
PALMQUIST TIM
Address:
1701 SKYLARK LN
NEWPORT BEACH, CA 92660
Phone:
Applicant:
PALMQUIST TIM
Address:
1701 SKYLARK LN
NEWPORT BEACH, CA 92660
Phone
Code Edit:
2013
Type of Construction:
VB
Occupancy Group:
R3/U
Added /New sq.ft. Bldg:
0
Added /New sq. ft. Garage: 0
No of Stories:
1
No of Units :
1
Bldg Height:
0
Bldg Sprinklers:
Flood Zone:
Construction Valuation:
Building Permit Fee:
$144.00
Plan Check Fee:
$103.68
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$4.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access:
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FyIEE : $299.08
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
,
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COMB Permit: X2015-0704
Project No:
Issued Date : 03113/2015
Inspection Area : 3
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
INSTALL OR VERIFY SMOK&CARBON MONOXIDE DETECTORS /PLUMBING FIXTURES TO BE UPGRADED
Contractor: O W N E RI B LD R
Architect:
AAA --
Phone:
I
Phone:
State Lic:
Gen I
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Engineer:
o
Lic Expve
Address:
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Policy No:
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IdIr Setbae gM Re / r ` 13 V ice' Bo' ecia Conditions:
F ma
Right: /
Use Zone: Parking Spaces: 0 Fire Hazard Zone : N -
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000
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1
Ca
ee
$0.00 U
1 nin p
f g De a _ _l
i��-�6 �d-�mq l� F�ir�O
:
(work
started)
Plan check Fee :
Fair Share:
$3200 Fir
(no ''�4Rr' ici?-t
PC Consultant:
$0.00
SJH Trans:
$0.00 Demo
Permit Fee:
$0.00
In -lieu Housing Fee :
$0.00 Buil
RC Fee:
90.00
Public Works Denarrment - r:ar
%: $14.40
Plan Check Fee
Park Dedication : $0.00 Refund
PM Plan Check: $0.00 Bi �ti Ean.'E=rli.
$0.00
PUBLIC WORKS
PLAN CHECK B1
APPROVAL TO I:
Fee Due at Permit
0
Rev
i Fee
Dept Adm
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$0.00
$299.08
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
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
n 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,
usiness 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;perty, 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-BuilderiMfll auathe�b'Ifrd�'�f'o prow that it was not built or
improved for the purpose of sale).
❑ I, as owner of the property, am exclusively contracting with Iipensed.Ea - T e or ject (Secti �704 Bu JAess and Professio slCode: The Contractors Stag License Law does not
apply to an owner of property who builds or improves'the2oh� `a vti ntracts for th�r,, e, wit licensed C r�i, g�pUX;nt1, o" oj�i5•State License Law) -
LJ I am exempt from licensure under the Cc
By my signature below I acknowledge that,,,�ee
sell a structure Otif101Ve built as an owfierJ
ro ssipns Code,+e available upon request
ftlMie of Prgperty4wner or Authorized A
LLCENSED Cb"ACTOR'S DECLAR
hharebybaffrm u.nger penalty of perjury that I
and affect. Licepse Cass
NG: FAILURP TO SECURE WORKERS' COMPENSAI
OP COMPEN6A'MON, DAMAGES AS PROVIDED FOR
Eby affirm under penalty of perjury one of ff
sieve and Will maintain a certificate of cc
Tdance o?1*eavork for which this permit is
are and iW46maintain workers' compensa
fnee carror 2pc1policy number are:
ne of Agent
certify that, In the performance of the work for
if I should become subject to the workers' co
lature of Applicant
hereby affirm I
ender's Name
penalty of perjury. that there
my signature below, I certify to each of the folloN
I am the property owner or authorized to acton
I have read phis application and th��n
I agree to comply with cable
I authorize represent es a y or col
Owner or
s License a
NOgnal re
not been
ca su
nderi -ovisid
Icee No
WFU
E
F t E LABe'la Ions:
for
Date
issued by the
insurance, as required by Section 3700 of the Labor Code, for
this permit is
agency for the
relating to
person in any
r Code, I shall
of the work
one year
law, Section
of Division 3 of the Business and Proferssions Code, and m*' lic0[ise is in full force
Contractor Signature H
h
f�L
\LIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$ DOQ), IN ADDITION TO THE
6
of Industrial Relations as provided for by Section 3700 ofhe Labor Code, for th
pggforr' ail�e3o,( i am - ic�l th�� r � �I's ad. My'�vortjers' compensatioi
Expiration Date s �
Ptftiark vi. '`s 4- n
r
:r so as to become subject to the workers' compensation laws df California, and agree
ith comply with those provisions ,
Ig construction.
tion purposes.
Property Owner's or Authorized Agent's Na D
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■ f r,
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