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Home My WebLink AboutX2019-2523 - Permits��,�t•„, City of Newport Beach - Building Division I11111111111111111111111111111111111111111111111111 11 COMB Permit: X2019-252 100 Civic Center Drive, Newport Beach, CA 92660 x 2 0 1 9 2 5 2 3 p Project No : 1798-2019 Permit Counter Phone 949 644 )644 FIRE SPRINKLERS h t ( ) � Inspection Requests Phone (949)644-3255 Combination Type - SFP ELEC GRAD MECH PLUM Issued Date : o19 REQUIREDInspection Arearea : 3 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: 1022 WEST WIND WAY NB Description: NEW SFR & GARAGE 4099/1229 SF A . Legal Desc.: N TR 4224 LOT 184 Owner: LEVINSON RONNI Contractor: LEWIS R W CONSTRUCTION Architect: LIGHT CHRISTIAN R Address: 1902 SUVA CIR Address: 1863 BAYPORT WAY Address: 1401 QUAIL ST #120 COSTA MESA CA 92626 NEWPORT BEACH CA 92660 NEWPORT BEACH CA 92660 , Phone: Phone: 714-321-4126 Phone: 949-851.8345 State Lic:CO22334 Applicant: SAMSAMI ALI Can State Lic: 597309 Engineer: SKUDLARSKI JASON Address: 1401 QUAIL ST#120 Lic Expire: 06/30/2020 Address: 9751 OLYMPIC DR NEWPORT BEACH CA 92660 Bus Lic: BT00021581 HUNTINGTON BEACH CA 92646 Phone: 949-851-8345 Lic Exp Date: 03/3112020 Phone: 949-752-1612 State Lic:C-067712 Code Edit : 2016 Worker's Compensation Insurance Designer: - Type of Construction: V-B-SPR Carrier: AU INSURANCE SERVICES Address: Occupancy Group: R3/U Policy No: 46-864922-01-07 ' Added /New sq.ft. Bldg: 4099 Expire: 12/11/2020 Phone: Added /New sq. ft. Garage: 1229 , No of Stories: 1 Building Setbacks Rear: 6' Special Conditions: 4 BEDRM TO 3 BEDRM No of Units : 1 Front: 10' Bldg Height: 0 Left: 6' Bldg Sprinklers: Y Right: 6' Flood Zone: Use Zone: R-1-6000 Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $1.600.000.00 Building Permit Fee: $5,494.00 Excise Tax: $1,118.88 Planning Department - Fire Department Plan Check Fee: $4,047.00 Additional Fee : $304.00 Plan check Fee : $417.00 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 : $580.56 SJH Trans : $0.00 Demolition Fee Record Management : $68.00 Grading Permit Fee: $1,144.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 Energy Compliance: $268.00 Grading PC Fee: $888.69 Public Works Department - General Service $0.00 CA Seismic Safety: $208.00 WQ Insp. Fee: $108.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access: $0.00 PAN Plan Check: $371.25 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $384.58 San Dist: $0.00 Building Green Fee : $64.00 Mechanical %: $219.76 NMUSD Fee: $1,560.32 $0.00 Plumbing %: $494.46 $0.00 TOTAL FEE : $17,740.50 Plan Check Fee : $63036.00 Fee Due at Permit Issuance : $12,704.50 PROCESSED BY: PUBLIC WORKS APPROVAL: C-1 ZONING APPROVAL: Lam✓ ` v PLAN CHECK BY: GRADING APPROVAL: /<:�� APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor is nse Law for trhe reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) coon 7031.5, Business and Professions Code: Any city or county that requi 5, e tf keiruVO""° olish, or repair any structure, prior to its issuance, also requires the applicant for permit to file a signed statement that he or she is licensed pursuant to the p owsl aLtoiig,42ON Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and fessions Code) or that he or she is exempt from licensure and the basis for the aIIe ,e3t!a p n of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, Iiness 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 rovements 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 roved 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' State License Law does not ply 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). J I am exempt trc+m!irensure under the Contractors' State License Law for the following reason: ly my siqnature 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 impro i s'r Icture thst I h37-e built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicat professions Code is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw. html. jiynature of Property Owner or Authorized Agent ICENSED CONTRACTOR'S DECLARATION horeb, affirm u,:iJcr penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 ) o Divis n 3 of the Business and Pro hd effect. License Class License No Date Contractor Signature PO!kKERS' COh7PENSATION DECLARATION X law, Section 7044 of the Business and is in full force 17J11'C: 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 )ST OF COMPENSATI6N, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. �er_�by ff rm under pe.,alty of perjury one of the following declarations: I- hava 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 ormance of the wnrk, 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' compensa trance carrier and policy number are: rier Policy Number Expiration Date is of Agent JI certify that, in the pe nce of th wo or 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 agre tat, if I should become subj o the ork compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /� signature of Applicant / Da Z IECLARATION REGARJBING CONSTRUCTION LENDING AGENCY hereby affirm under p alty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3,06, Civil Code) ender's Name It Lender's Address sy my signature below, I certify to each of the followin I am the property owner or authorized to act on thl I have read this application and the information I f I agree to comply with all applicable city and court I authorize representatives of this city or county to BY PERMIT EXPIRED PERMIT CANCELLED PERMITEXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCY ISSUED state laws relating to building construction. lentified property for inspection purposes. OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY PART 61 OF TITLE 40 AND AQM D RULE I SUBMITTED ASBESTOS NOTIFICATION TO SIGNATURE: TO