HomeMy WebLinkAboutX2019-1056 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIg
100 Civic Center Drive, Newport Beach, CA 92660 X 2 9 1 9
.td Permit Counter Phone (949)644-3288
} Inspection Requests Phone (949)644-3255
.''ax'��' ' Combination Type - BLDG PLUM
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1 6 5 6
COMB Permit: X2019-1056
Project No : 0733-2019
Issued Date: 04/03/2019
Inspection Area : 2
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: 436 SAN BERNARDINO AVE NEI
Description: SFR EXTERIOR FIREPLACE (6'H MAX)
- Legal Desc.; FIRST ADD TO NEWPORT HEIGHTS ELK 13 LOT 15
Owner: ROGER PALLEY Contractor:
SAILHOUSE HOMES INC
Architect
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Address: 121 VIA FIRENZE Address:
170 NEWPORT CENTER DR #260
Address:
'+s. H 4A
NEWPORT BEACH, CA 92663
NEWPORT BEACH CA 92660
Phone: Phone:
949-281-6045
Phone:
State Lie: ......
Applicant: SAILHOUSE HOMES INC Con State Lie:
1007531
Engineer:
BIEDENBACH CHRISTOPHER mee. cme.
Address: 170 NEWPORT CENTER DR #260 Lie Expire:
09/30/2019
Address:
1201 N TUSTIN ....
NEWPORT BEACH CA 92660 Bus Lie:
BT30036603
ANAHEIM CA 92807• °
Phone: 949-281-6045 Lie Exp Date:
08/31/2019
Phone:
e e o °
714-630-6100 State Li¢C-074003 • • °
poem
Code -Edit : 2016 Workers Compensation Insurance
, Designer:
....
Type of Construction: Carrier:
STATE COMP. INS
.Address:
mo °
m •
Occupancy Group: U Policy No:
9213113
Added /New sq.ft. Bldg: 0 Expire:
1 212 912 01 9
Phone:
Added /New sq. ft. Garage: 0°
......
No of Stories: 0 Building Setbacks
Rear: /
Special Conditions: e m m m o
No of Units: 0
Front: /
° mmommm
Bldg Height: 0
Left: /
°B6o `omen°
Bldg Sprinklers:
Right: /
....
Flood Zone: Use Zone: Parking Spaces: 0
Fire Hazard Zone: N
Construction Valuation: $2.000.00 .
Building Permit Fee: $104.00 Excise Tax:
$0.00 Planning Department -
Fire Department
Plan Check Fee: $90.48 Additional Fee :
$0.00 Plan check Fee :
$40.00 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: $4.00 Grading Permit Fee:
$0.00 In -lieu Housing Fee:
$0.00 Building Dept Adm $0.00
Energy Compliance: $0.00 Grading PC Fee:
$0.00 Public Works Department-
General Service $0.00 -
CA Seismic Safety: $0.00 WQ Insp. Fee:
$0.00 Park Dedication :
$0.00
Refund Deposit $0.00
Disabled Access : $0.00
PIN Plan Check:
$0.00
Grading Bond: $0.00
Hazardous Mat $0.00 Electrical %:
$0.00 San Dist:
$0.00
'.
Building Green Fee : $1.00 Mechanical %:
$0.00 NMUSD Fee:
$0.00
$0.00
Plumbing %:
$9.36
$0.00
TOTAL FEE: $248.84
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Plan Check Fee:
$0.00 Fee Due at Permit Issuance : $248.84
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO, ISSUE: ���
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) 1 have placed next to the applicable item(s)
Iction 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 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 U all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
siness 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).
1, asowner 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
)ly 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 exempt from licensure under the Contractors' State License Law for the following reason:
my signature below I acknowledge that, except for my personal residence in which 1 must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot Iegall)
I a structure that I 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
Ifessions Code,•!% available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
nature of Pro0q*QMner or Authorized Agent Date
;RWPFD C0JJJjACTOR'S DECLARATION
sreby affirm underpenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sept] 7000 of Division 3 of the B iness and Professyyjns Code, and my license is in full force
I effect. License Rss License No a3.a_ to 44 ractor Signatures < ,�.►�--
AK£RSr CON;PENSATION DECLARATION 1
fNINP. FAILUREfO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FI Ea UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
nVAMPENSAIM&R,, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
1rg4y;afFrm ullder per)alty of perjury one of the following declarations:
rl•have and wile 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 th
Eor"gice of the Eaork for which this permit is issued. Policy No.
IPe•and wiNmailftoin 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
omnee carrier and porcy number are:
rIL1 • • • • • • Policy Number Expiration Date
ne of Agent Phone #
certify that, in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the worke 'compensation laws of California, and ogre
I, i 1 =should sub/j/�,Ct to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
na Iicant // / --- ate /g
herebyaffirmunifier 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
y 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 I have provided is correct. T
1 agree to comply with all applicable city and county ordinances and state laws relating to building construction. 2:4
I authorize representatives o r county to nter the abo identified property for inspection purposes. y /'
innature of Prnnerty Owner n utht h.rizatl-Aaent ,Lr�+ Print Prooertv Owner's or horized AGent's Name ate
ACTION DATE BY [-DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL-1—FOR:OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE
1403
PERMIT EXPIRED I U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT EXTENDED
PERMITFINAL I PROPOSED D NOTIFICATION IS NOT APPLICABLE TO
CERMITFINAL G PROPOSED DEMOLITION
OCCUPANCY155UED 1 SIGNATURE: