HomeMy WebLinkAboutX2018-1654 - PermitsI� City of Newport Beach - Building Division iiiiiiiiiiilll COMB Permit: X2018-1654
100 Civic Center Drive, Newport Beach, CA 92660 Project No: 1278-2018
v ,Perrnit Counter Phone (949)644-3288
'y Inspection Requests Phone (949)644-3255 Issued Date : 0513112018
°'�uxlr4e`a Combination Type - BLDG Inspection Area : 4
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: 3 ROCKY POINT RD NB
Description: DEMO POOL "METHOD B"
Legal Desc.: P BK 95 PG 30 PAR 1
Owner: FIRST ROCKY PROP LLC
Address: 2530 S BIRCH ST
SANTA ANA, CA 92707
Phone:
Applicant:
CHAMBRONE RICHARD
Address:
335 E BLUERIDGE
ORANGE CA 92865
Phone:
9449-391-8200
Code Edit : 2016
Type of Construction:
Occupancy Group: U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 0
No of Units : 0
Bldg Height: 0
Bldg Sprinklers:
Valuation:
Building Permit Fee: $112.00
Plan Check Fee: $0.00
overtime Plan Ck:
$0.00
Investigation Fee:
$0.0c
Record Management:
$0.0c
Energy Compliance:
$0.0c
CA Seismic Safety:
$0.0c
Disabled Access :
$0.0(
Hazardous Mat
$0.0c
Building Green Fee :
$1.01
TOTAL FEE : $113.00
PROCESSED BY:
ZONING APPROVAL:
Contractor: OWNER/BLDR Architect:
Address: AUTH AGNT:CHAMBRONE, RICHARDAddress:
Phone
Con State Lie: O/B
Lie Expire:
Bus Lie:
Lie Exp Date:
Workers Compensation Insurance
Carrier:
Policy No:
Expire:
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical W
Mechanical %:
Plumbing %:
Rear: I
Front: I
Left: /
Right: I
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Phone: State Lie
Engineer:
BACH GEORGE
Address:
2961 MCINTOSH DR
LONGMONT CO 80503
Phone:
215-313-6525 State Lic:C-011092
Designer:
Address:
Phone:
Special Conditions
Planning Department -
Plan check Fee
Fair Shane :
SJH Trans
In -lieu Housing Fee
Public Works Department -
Park Dedication :
$0.00
PAN Plan Check :
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Fire Department
$0.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee : $0.00 Fee Due at Permit Issuance : $113.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
GRADING APPROVAL:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indict ted below by the checkmaric(s) I have placed next to the applicable items)
ction 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
Zrmit 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
sions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Sectiqn 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
more than five hundred dollars ($500). I
LJ I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U portions of tl
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through E
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of comp
improved for the purpose of sale).
❑ I; as owner of the property, am excrusively contracting with licensed Contractors to construct the project (Section 7044,
apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor
❑ I am exempt from licensure under the. Contractors' St se the (lowing reason:
By rtiy signaturd below I acknowledge that, except for y perso I r sidence n ich I must have resided for at least one y
sell a structure that I have built as an owner-buil it h be constr t In its entirety by licensed contractors. I unr
Professions Code, is available upon qua this ap cation su 1tt EI or at the following Web site:http://www.leginf
Signature of Property Owner or Autho ' d A nt
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm 1 coder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of
and ef.-ect. License Class License No Date _
NORKERS"COMPENSATION DECLARATION
NPRN,NG: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALT
30ET OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
heeby affirm urdet penalty of perjury one of the following declarations:
J i nave and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of
,( r!3.mance cf J.E vcrk for which this permit is issued. Policy No.
:11 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the pal
n,urd.Ice carrier and oolicy number are:
;arriel Policy Number
Agent _ _
y that,5n tYJ
if I
work, and the structure is not intended or offered for sale (Section 7044,
oloyees' or personal effort, builds or improves the property, provided that the
on, the Owner -Builder will have the burden of proving that it was not built or
and Professions Code: The Contractors' State License Law does not
to the Contractors' State License Law),
to completion of the improvemen
that a copy of the applicable law,
3 of the Business and Professions
Contractor Signature
ad by this permit, I cannot
7044 oyy��he B�iness and
Sl2,)/fs1
and my license is in full force
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001, IN ADDITION TO THE
Relations as provided for by Section 3700 of the Labor Code, for
of the work for which this permit is issued. My workers'
Date
work f r whi thi permit is issued, I shall not employ any person in any manner s as to become subject to the
'kers' c mp satNprovisions of Section 3700 of the Labor Code, I shall forthwith omply with those provisions.
(nature of p' aht
CLARATIO REGARDING C STRUCT LENDING AGENCY
areby affirm under penalty of rju there is a construction lending agency for the performance of the work for which
ider's Name Lender's Address
my signature below, I certify to each of the fallowing:
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 y or manc t ws relating to building construction.
I authorize re entatives off Is ity or unty o e er the bove= t' ed property foJr'nspection purposes.
nature of Pro a Owner or A h ADent / Print Pronertv owner's nr A.01
ACTION DATE �LARAF COMPLIANCE WITH CODE OF FEDERAL
ART 61 OF TITLE 40 AND AQMD RULE
PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO
ft� ( ( Q LJ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF Z__1 PROPOSED DEMOLITION
OCCUPANCY ISSUED eir-A, Ar, me.
compensation laws of California, and
S k1h"p,-
permit is issued (Section 3097, Civil Code).
FOR OFFICE USE ONLY