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Home My WebLink AboutX2017-1954 - Permitswaa� City of Newport Beach - Building Division Ae 100 Civic Center Drive, Newport Beach, CA 92660 R, r^ Permit Counter Phone (949)644-3288 'y Inspection Requests Phone (949)644-3255 ray x> Combination Type - BLDG 111111111111111111111111111111111111111111111111111� jj PERMITS EXPIRE 180 DAYS R19SUANCE OR , Construction Hours: Monday -Friday 7:00 a.m j$;m6.SO .m, and Saturday from Job Address: 1201 SAND KEY NB�;�. wl" Description SFR MASONRY. BLOCK WALL 6 MAX HI R.c„ �48,2rt:W(THIN PIL "MARKERSOSI Legal Desc : N TR 6634 LOT 124 93 \j £ Owner SULLIVAN SHANE �i n rector BKRAR}5R0TH6F(S Address: 1201 SAND KEY s., c Address 12 A0 'O COVIr �" + CORONA DEL MAR, CA 2625 .n`v'T E NEWPd,RT �):AOH'C%1=926G3 Phone: Applicant: GOETZ ANDREW, Address: 2855 E COAST HWY #234 CORONA DEL MAR CA 926,6 •"" •. �� Phone: 949.673-3152 - `t COMB Permit: X2017-1954 Pr ' : 1338-2017 Issued Date IL03/2112 Inspection Ajea : 4 a.m. to 6:00�t r on Sundays, AWIit h GOETZANDREW Address: 2855 E COAST HWY #234 phone 71A350,;$692 Phone: i Vil. on Sjate Lic: 905510 z"c y s - gineer: LOic Ezprte: 10131(�419 r `�� l� dress: Bus Lic: a+�BF3b2$'B59 )' - r Code Edit: 2016 t°*rker's}eelnObnsiilF 3'f.�t,@.sVence Type of Construction: r ' `a Ca ' @r , G: SATE COMP Occupancy Group: U r 4 Poli 1 9041905 Added /New sq.ft. Bldg: 0 Expire: 02101/2019 Added /New sq. ft Garage: 0 } No of Stories: 0 Building gSSetback s ea s�-' No of Bldg Height: 0 j° 1, eft- 17 (t�'AN Bldg Sprinklers: Construction Valuation: $10.000.00 e, Fire Inspection: Public Works Department - Park Dedication : $0.00 PM Plan Check : Building Permit Fee: $386.00 xcise Tax: n,� OV -3 � Plan Check Fee: $342.50 djti+ ¢ `G $0.00 Overtime Plan Ck: $0.00 adj44biids Fee: $0. Investigation Fee: $0.00 G ding PC Consultan 0.00,,,m�="�''� Record Management: $0.00 G Ing Pe e: a::� $6.10 Energy Compliance: $0.00 Gra in PCFF $0.00 CA Seismic Safety: $0.00 WO -`Fee : $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Electrical %: $0.00 Building Green Fee : $1.00 Mechanical %: $0.00 Plumbing %: $0.00 TOTAL FEE : $767.00 Plan Check Fee PROCESSED BY: ZONING APPROVAL: Z GRADING APPROVAL: _. CORONA DEL MAR CA 92625 949-673-3152 State Lic: 4.� Phone: i Desi :C, fA Y) RK GREEN) �j �" dl �-£4 P one:t'if' ((h� Spedial Conditions: SJH Trans: Fire Department In -lieu Housing Fee Fire Inspection: Public Works Department - Park Dedication : $0.00 PM Plan Check : $0.00 San Dist: $0.00 NMUSD Fee: $0.00 m eeee • Su .+�"� 000eo e�� ✓aAy m • o 0 e 0 0 0 ° ti PS�� • o n e em • eemeeo e •Doom m e oemeoo OOOm-----'''''VVVVV•••••�� O E e Immo°-�q.homemme �em e•co° $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $342.50 Fee Due at Permit Issuance : $424.50 PUBLIC WORKS APPROVAL: PLAN CHECK BY: ORO APPROVAL TO ISSUE: 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: m eeee • Su .+�"� 000eo e�� ✓aAy m • o 0 e 0 0 0 ° ti PS�� • o n e em • eemeeo e •Doom m e oemeoo OOOm-----'''''VVVVV•••••�� O E e Immo°-�q.homemme �em e•co° $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $342.50 Fee Due at Permit Issuance : $424.50 PUBLIC WORKS APPROVAL: PLAN CHECK BY: ORO 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 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 not more than five hundred dollars ($500). 1 ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7 yJ44, Business 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 improvements 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 improved for the purpose of sale). ❑ 1, 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 IJapply to an gvgw 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 ehin *om licensure under the Contractors' State License Law for the following reason: By wy sign§ture 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 improvements covered by this permit, I cannot legall 91S?I � structure-tagPl 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 Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. $ignature of Prbptyrtyy Owner or Authorized Agent Date LTCENSED,CON&RACTOR'S DECLARATION I hef9by affimfdndef penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0 f Divi iogq3 of the Business and Professi s yJda, ani my license is in full force and -effect. LieertsE_Class License No Dat b Contractor Signature / �/( DECLARATION : FAILURE -1-0 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 COMPEN;ATIONr DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. affirnf t?nVef Penalty of perjury one of the following declarations: I tive and 41•rT�intain 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 'ermance oft0ework for which this permit is issued. Policy No. 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' carrier and policy number are: Policy Number Expiration Date of Agent ]I certify that, in the perform nc 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 pensation laws of California, and agre tat, if I should become s 1e to th rke ' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignature of Applicant /D, IECLARATION REG RDING (CONSTRUCTION LENDING AGENCY hereby affirm under enalty operjury 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 ly my signature below, I certify to each of the following: I am the property owner or authorized to act on the pr erty owner's behalf. I have read this application and the information I ha Proded is correct. I agree to comply with all applicable city and count or in nc and state laws relating to building construction. I authorize representatives of this city or county t ente a ove= entifl roperty for inspection purposes. //''/ ,....,+� ,.a Dr. 4. , n.... ..r e,.fk_A vA e..e.,r Dry„ r Drnnud,, n.,mer c nr A„f6nr;o=A AneM'a M„no / Y ii/ I Y V I d) I i ( n nwro 1403 PERMIT EMENDED PERMIT FINAL CERTIFICATE OF OCCUPANCY ISSUED OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY PART 61 OF TITLE 40 AND AQMD RULE ASBESTOS NOTIFICATION TO NOTAPPLICABLE TO o v � g G� m w N 'COO a 1 6 W S P -4g O U1 0> K U Q 0 0~ r �0 w 0— a p C c�4 0 zcr 3 4 0 Cj � o •� o s N c�V cC U 'C O2 O i4 O � •^ w G, cC 00 t � ONi C Vi r—� Q Cded -as 0003 N p p❑❑� "- p "" lcn is Oi. U N U O U N iK -40 O i •''" o�QU ow j Voo O to W vpi U O «S ice+' / cC •� O z U