HomeMy WebLinkAboutX2015-1751 - PermitsCity of Newport Beach - Building. Division IIIIIIIIIIIIIIPIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII j� COMB Permit: X2015-1751
100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 5 1 7 5 1 Project No : 3040-2013
`i nn Permit Counter Phone (949)644-3288
y m Inspection Requests Phone (949)644-3255
Kgi4 Combination Type - MFP ELEC MECH PLUM Issued Date : 06123/2015
0
Inspection Area : 5
Applicant: CARLSON JIM
Con State Lic: O/B
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
Engineer:
ABARQUEZ JOSE M
INSTALL OR VERIFY SMOKE/�Ag§ON MONOXIDE DETECTORS 1PLUMBING FIXTURES TO BE UPGRADED
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Job Address:
314 DAHLIA PL NB
Lic Expire:
Description:
NEW DETACHED UNIT -1920 SF W1480 SF GARAGE UNIT B
Legal Desc.:
N TR 15935 LOT 69
NEWPORT BEACH CA 92663
u �v
00,
Owner:
NSC ENTERPRISES, INC
Contractor: OWNERIBLDR Architect: CARLSON JAMES
Address:
PO BOX 982
Address: SHEILA KAVIANI Address: 2300 CLIFF DR
Phone: 949-645-3051
CORONA DEL MAR CA 92625
NEWPORT BEACH CA 92663
Phone:
Phone:
Phone: Phone: 714-632-3210 State Lic:C013773
Applicant: CARLSON JIM
Con State Lic: O/B
Engineer:
ABARQUEZ JOSE M
Address: 2300 CLIFF DR
Lic Expire:
Address:
18 EL CORZO
NEWPORT BEACH CA 92663
Bus Lic:
RSM CA 92688
Phone: 949-645-3051
Lic Exp Date:
Phone:
714-277-9895 State Lic:C-051994
o®oo
Code Edit: - 2010
Worker's Compensation Insurance
Designer:
"°°°°®
Type of Construction: V-BSPR
Carrier:
Address:
Occupancy Group: R3/U
Policy No:
Added /New sq.ft. Bldg: 1920
Expire:
Phone:
Added /New sq. ft. Garage: 480
No of Stories: _--3- -
Building Setbacks
Rear:
10
Special Conditions: O/B AUTH ATT
No of Units : 1
Front:
20
GRADING ON X2013-3597
Bldg Height: 29
Left:
3
ARTICLES VERIF
Bldg Sprinklers: Y
Right:
3
Flood Zone: X
Use Zone: RM
Parking
Spaces:
4 Fire Hazard Zone : N
Construction Valuation: $582.757.50
Building Permit Fee: $3,818.00
Excise Tax:
$504.00
Planning Department -
Fire Department
Plan Check Fee: $2,803.96
Additional Fee :
$0.00
Plan check Fee :
$0.00 Fire Inspection:
° o$ay,
Overtime Plan Ck: $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 : $110.00
Grading Permit Fee:
$34.80
In -lieu Housing Fee:
$0.00 Building Dept Adm
$0.00
Energy Compliance: $264.00
Grading PC Fee:
$0.00
Public Works Department -
General Service
$0.00
CA Seismic Safety : $75.76
WQ Insp. Fee:
$23.20
Park Dedication : $0.00
Refund Deposit
$0.00
Disabled Access: $0.00
P/W Plan Check: $0.00
Hazardous Mat $0.00
Electrical %:
$534.52
San Dist: $0.00
Building Green Fee : $24.00
Mechanical %:
$458.16
NMUSD Fee: $3,155.60
$0.00
Plumbing %:
$381.80
- .
$0.00
TOTAL FEE : $12,187.80
A 11
Plan Check Fee
: $0.00 Fee
Due at Permit Issuance :
$12,187.80
PROCESSED BY:
PUBLIC WORKS APPROVAL:
ZONING APPROVAL:
m
PLAN CHECK BY:
+`
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GRADING APPROVAL: (Jl/'
Y
\l`l f ` � \ 1
APPROVAL TO ISSUE:
1
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OWNER -BUILDER DECLARATION
(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)
>ection 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, priorto its issuance, also requires the applicant for
ie '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
rofessions 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
of more than five hundred dollars ($500).
4 I, as owner of the property, or my employees with wages as their sole compensation, will do a I of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
uslness and Professions Code: The Contractors' State License Law does not apply to an own r of property who, through employees' or personal effort, builds or improves the property, provided that the
nprovements 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
nproved 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
pply town 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:
y my signature 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 legally
all 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
rofessions Code, is available upon reques hen Is applic io is s�bmittefi or at the following Web site:hltp://www.leginfo.ca.gov/calaw.html. Da r
ig nature of Property Owner or Authorized Ag t nO i /� ����z✓/�i p �5
ICENSED CONTRACTOR'S DECLARAT N
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cod , and my license is in full force
nd effect. License Class License No Date Contractor Signature
/ORKERS' (;MPENSATION DECLARATION
ARNING, FAILURE"rSSECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($700,000), IN ADDITION TO THE
BiAORCOMPENSAiION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
iereby"affirm *Aar.penalty of perjury one of the following declarations:
5.1"11d6e 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 the
Yrform ance o the VbrM for which this permit is issued. Policy No.
ii Cave and wilmaintain 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' compensatior
SUrrlce camir NJdWlicy number are:
BV�c • " '" Policy Number Expiration Date
Agent
ttRirformance 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' compensation laws of California, and
come subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant Date_
CLARATION REGARDING CONSTRUCTION LENDING AGENCY
:reby 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).
ider's Name Lender's Address
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.
I agree to comply with all applicable city and county ordinances and state laws relating to building construction.
I authorize representatives of this city or c°�f ty toe r abo de%n'fi d property for inspection purposes. /
nah„m of PrnncHv (3wnar nr Authnri7ed AarAAr /' /�ilit�- Print Property Owners or Authorized Agent's Na,� S!'/ ✓�f���C(�'(IQN/ Da �/
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