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Home My WebLink AboutX2018-3217 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII) II COMB Permit: X2018-3217 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 8 3 2 1 7 Project No : 2509-2018 H 'S Permit Counter Phone (949)644-3288 Fire Inspection: Energy Compliance: $56.00 Inspection Requests Phone (949)644-3255 d Disabled Access; $0.00 Issued 1/1312018 Hazardous Mat $0.00 Combination Type - SFP ELEC.MECH A I, Inspecttionion Area : 8 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. In -lieu Housing Fee: 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 $0.00 Job Address: 1416 SEA RIDGE DR NB. $0.00 $0.00 Description:. SFR KITCHEN REMODEL 272 SF & ADDITION 184 SF General Service Legal Desc.: N.TR 15011 LOT 21 -. Park Dedication : Owner: KASSAB WALEED Contractor: OWNER/BLDR. Architect: BAILEY DAVID - Address:. 1416 SEA: RIDGE DR Address: KASSAB WALEED Address:. 23183 LA CADENA DR #101 P/W Plan Check: NEWPORT BEACH, CA 92660 LAGUNA HILLS CA 92653 Grading Bond: Phone: 949-290-1875 Phone: Phone: 949-573.1050 State Lic:CO27404 .San Dist: Applicant: BAILEY DAVID Con State Lit O/B Engineer: WILSON KALEN ' Address: 23183 LA CADENA DR #101 Lie Expire: Address: 1371 WARNER AVE #A NMUSD Fee: LAGUNA HILLS CA 92653 Bus Lica - TUSTIN CA 92780 Phone: 949,57.&1050 Lie Exp Date: Phone: 714-576-6524 State Lio:C-083753 •oo^ Cede Edi, : ° `2 2016 Worker's Compensation Insurance Designer. _ Trip°e of &onstructino.c V -B Carrier: Address: Ot;cu,.oancy Group? ` R31U Policy No: AQc?diF/N8w sq.ft. Bldg: 184 Expire: Phone: Addad1/fJ�yw sq. f6:Garage: 0 c Nmmk3tories: a ° ° 2 Building Setbacks Rear: I Special Conditions: No of UnFts :. 01 - .. Front: Bld'g.heiglit: Left: I .. Bldcg. SpSigklers: t Right ° Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: - Grading PC Fee: WQ Insp. Fee Electrical %: Mechanical %d. Plumbing %: ; TOTAL FEE : $2,630.07 PROCESSED BY:. ZONING APPROVAL: Yn�'tY GRADING APPROVAL: $0.00 c co°c° - $Gilding aermitFee: $°1,208.00 Plan Check Fee:° .976.88 Fire Department Overtime Plan Ck. $0.00 $0.00 Investigation Fee: $0.00 Record Management: $46.00 - Fire Inspection: Energy Compliance: $56.00 $0.00 CA Seismic Safety: $7.06 Disabled Access; $0.00 Fire Plan Rev Hazardous Mat $0.00 $0.00 Building Green Feed $3.00 Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: - Grading PC Fee: WQ Insp. Fee Electrical %: Mechanical %d. Plumbing %: ; TOTAL FEE : $2,630.07 PROCESSED BY:. ZONING APPROVAL: Yn�'tY GRADING APPROVAL: $0.00 Planning Department - Fire Department $0.00 Plan. check Fee: $160.00 Fire Inspection: $0.00 $0.00 Fair Share : $0.00 Fire Plan Rev .$0.00 $0.00 SJH Trans : $0.00 Demolition Fee $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $0.00 $0.00 Public Works Department - General Service $0.00 . $0.00 .. Park Dedication : $0.00 : Refund Deposit $0.00. P/W Plan Check: $41.25. Grading Bond: $0.00 $84.56 .San Dist: $0.00 $46.32 - NMUSD Fee: $0.00 $0.00 $0.00 _ $0.00 Plan Check Fee: $1,233.13 Fee Due at Permit Issuance : $1,396.94 PUBLIC WORKS. APPROVAL: _✓ PLAN CHECK BY: APPROVAL TO ISSUE: n 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) 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 penaltyAof not more than five hundred dollars ($500). S - ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, 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 thpy,, 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).. 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: pp o 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). exempt from licensure under the Contractors' State License Law for the fallowing reason: m 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 legal) sell structure that I have built as an owner -builder if it has not been constru din its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of t e Busin s 1 rofessions Code, is available upon request wh tis applicat}'h is submi or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Signature of Property Owner or Authorized Age t / A / Da I LICENSED CONTRACTOR'S DECLARATI� UV I 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 Code, and my license is in full force and effect. License Class License No Date Contractor Signature ORKERS' COMPENSATION DECLARATION .. WARNING: 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 ($108,6Vf WADDITION CIO SHE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty 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 Codc,f%9J performance of the work for which this permit is issued. Policy No. •. • Op°°° I 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 •vo?kejs' compemsstio insurance carrier and policy number are: . o ° o tier Policy Number Expiration Date :"': • `o ° ° e of Agent Phone # 00 • ° o I ertify that, in the performance of the work for which this permit is issu , I shall not employ any person in any manner so as to become subject to the workers' compensation la f p (jalifornia, end afire th , if I should become subject to the workers' compensation provisions o Section 3700 of the Labor Code, I shall forthwith comply with those provisions. • • ` ; ° ° Signature of Applicant X A/ \ s Datg� I ��..,� 9 - DECLARATION REGA�NG CONSTRUCTION L NG AGENCY {�(, - I 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). Lender's Name Lender's Address By my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owners 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 aws relating to building construction. /Ca; I authorize representatives of this city or cyl��tyto enter t/yrs\above-identi d property for. inspection. purposes. /� Y! Signature of Prooertv Owner or Authorized Ao dt \ �/ k n / Print Prooertv Owner's or AuthorizedADent's NamB / \ I \ i I t U Date ACTION DATE BY YDECLARATION OF REGULATIONS PART1 OFTITLE 40AN AQMD RULE COMPLIANCE RAL FOR OFFICE USE ONLY RV 1 PERMIT EXPIRED PERMITEXTENDED PERMITFINAL CERTIFICATE OF OCCUPANCYISSUED 10 r I SUBMITTED ASBESTOS NOTIFICATION TO UASBESTOS NOTIFICATION IS NOTA71CABLE TO PROPOSED DEMOL171AV It ,�