HomeMy WebLinkAboutX2017-1952 - PermitsCity of Newport Beach - Building Division I�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
C+° ' 100 Civic Center Drive, Newport Beach, CA 92660 x 2 0 1 7
a� Permit Counter Phone (949)644-3288
v. Inspection Requests Phone (949)644-3255
Combinatien Type - SFP ELEC MECH PLUM
COMB Permit: X2017-1952
1 9 5 2 Project No : 1338-2017
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Issued Date: 2018
Inspection Arearea : 4
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
$0.00
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: 1201 SAND KEY NB
Plan Check Fee: $1,290.00
Description: SFR ADD TO REAR OF HOUSE (NEW MASTER BEDROOM AND BATH) 797 SF
• • •
Plan check Fee :
Legal Desc.: N TR 6634 LOT 124
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• • • •
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Overtime Plan Ck:
$0.00
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Owner: SULLIVAN SHANE Contractor: BURKHART BROTHERS CONSTR
Architect: GOETZANDREW •e,'e;F'f,"eY�
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Address: 1201 SAND KEY Address: 12 BALBOA COVES
Address: 2855 E COAST HWY #234
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CORONA DEL MAR, CA 92625 NEWPORT BEACH CA 92663
CORONA DEL MAR CA 92625
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Phone: Phone: 714.350-3892
Phone: 949.673-3152 State Lia:C018499
Demolition Fee
Record Management:
&t'r• o
Applicant: GOETZ ANDREW Con State Lic: 905510
Engineer:
In -lieu Housing Fee :
Address: 2855 E COAST HWY #234 Lie Expire: 10/31/2019
Address:
$0.00
CORONA DEL MAR CA 92625 Bus Lie: BT30026869
$68.54
Grading PC Fee:
Phone: 949.673-3152 Lie Exp Date: 03/31/2018
Phone: State Lie:
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Code Edit: 2016 Worker's Compensation Insurance
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Designer: •
-'s-gay °
Type of Construction: V -B Carrier: STATE COMP
Address: • ° •sa-."�4se
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Occupancy Group: R31U Policy No: 9041905
• ° •
Refund Deposit
Added /New sq.ft. Bldg: 797 Expire: 02101/2019
Phone:
,?
Added /New sq. ft. Garage: 0
PM Plan Check : $228.00
No of Stories: 1 Building Setbacks Rear: 6
Special Conditions:
$0.00
No of Units : 1 Front: 15 (sand key)
$0.00
Electrical %:
Bldg Height: 0 Left: 17 (park green)
San Dist: $731.00
Bldg Sprinklers: Right: 6
Building Green Fee :
Flood Zone: X Use Zone: Parkins Spaces: 0
Fire Hazard Zone: N
$70.64
Construction Valuation: $97.920.00
Building Permit Fee:
$1,766.00
Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee: $1,290.00
Additional Fee :
$0.00
Plan check Fee :
$0.00
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 :
$0.00
SJH Trans : -.
$0.00
Demolition Fee
Record Management:
$18.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee :
$0.00
Building Dept Adm
$0.00
Energy Compliance:
$68.54
Grading PC Fee:
$0.00
Public Works Department -
General Service
$0.00
CA Seismic Safety:
$12.73
WQ Insp. Fee:
$0.00
Park Dedication : $0.00
Refund Deposit
$0.00
Disabled Access :
$0.00
PM Plan Check : $228.00
Grading Bond:
$0.00
Hazardous Mat
$0.00
Electrical %:
$123.62
San Dist: $731.00
Building Green Fee :
$4.00
Mechanical %:
$70.64
NMUSD Fee: $1,466.48
$0.00
Plumbing %:
$158.94
$0.00
TOTAL FEE : $6,087.95
Plan Check Fee
: $1,301.54 Fee
Due at Permit Issuance :
$4,766.41
PROCESSED BY:
PUBLIC WORKS APPROVAL:
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ZONING APPROVAL:
9 - ��
PLAN CHECK BY:
GRADING APPROVAL:
APPROVAL TO ISSUE:
1
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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)
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
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
fessions 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 toe civil penalty of
more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 744,
;iness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
rovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
roved for the purpose of sale).
*0**
I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
It to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
I am exemptrfrovn licensure under the Contractors' State License Law for the following reason:
my signature oalo?Nl acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legal
9 g({dcture thatt have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
jessions Code, -is available upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.htmi.
rmture of Property Owner or Authorized Agent Date
:EFI$ED CONTRACTOR'S DECLARATION
itt; Tffirm ufiM"Dalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 Divis'on of the Business and Profes ' n de, an my license is in full force
13ffdct. Licensg Class License No Date Contractor Signature
) MRS' COJNPENSATION DECLARATION
:NING:kAILURE*rb*sW E WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THO AND DOLLARS ($100,000), IN ADDITION TO THI
"ROOMPENSATION, D MAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
reby affirm udw peaalty of perjury one of the following declarations:
. ..
I 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 tl
'ormance of the work for which this permit is issued. Policy No.
*Jwve 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' compensatiol
nsurance carrier and policy number are:
'arrier Policy Number Expiration Date
Jame of Agent Phone #
—1I certify that, in the pe or anc 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' co7ensation laws of California, and agre
hat, if I should become ubj ct t the r rs' co sation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant Da
3ECLARATION RE RDIN CONSTRUCTION LENDING AGENCY
hereby affirm under 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 Code).
_ender's Name Lender's Address
3y 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 1 have provided is correct. YV U (q (�
I agree to comply with all applicable city and cou y o in, nces and state laws relating to building construction. J
I authorize representatives of this city or county ant r e o e-ide prope y for inspection purposes. i/_ -�(
3i nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name D e '/
ACTION DATEBY DE R TION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REG lAT10N5 PART fit OF TITLE 40 AND AQMD RULE
PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED DEPA
PERMIT EXTENDED OMD
CERTIFICATE
EL 1 `p /n A 5705 TIFIC I�S N BLE TO
OCCUPCATEOF �/ 1� D NSA PROPOSED M ITI
OCCUPANCY ISSUED IL- (/VV --' SIGNATOR
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