HomeMy WebLinkAboutX2019-1180 - PermitsI:n City of Newport Beach - Building Division Illllllllllllllllll�llllllllilllllllllllllllllllu
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COMB Permit: X2019-1180
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100 Civic Center Drive, Newport Beach, CA 92660.
Type of Construction: VB
X 2 0 1 9
1 1 8 0
Record Management:
Project No
- [a
0
�"' Permit Counter Phone(949)644-3288
CA Seismic Safety:
$0.00 -
Disabled Access `..
c"j
Inspection Requests Phone (949)6443255
Phone:
....
.$1.00
P"d-acv`s Combination Type - SFP
San Dist:
$0.00
Issued Date :04115/2019
4 4
No of Stories: 0
Building Setbacks Rear: I.
Special Conditions:
Inspection Area : 3
°
4 e. ° .
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
- M
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 Holi aXs „
Job Address:
1727 CANDLESTICK LN NB.
3 !
Description:
SFR-ADD INSULATION @ATTIC (R30)+
r
Legal Desc.:
N TR 3763 LOT 45
Fire Hazard Zone : N
Owner:
WOOD ROBERT MC LANE Contractor:
SERVICE CHAMPIONS HTG
Architect:
s
Address:
1727 CANDLESTICK LN Address:
3150 E BIRCH
Address:
NEWPORT BEACH CA 92660
BREA CA 92821
Phone:
949-546-2878 Phone:
714-777-7777
Phone:
State Lie:
Applicant: -
SERVICE CHAMPIONS HTG Con State Lie:
799170
Engineer:
-
Address:
3150 E BIRCH Lie Expire:.
, 09/30/2019
Address:
BREA CA 92821 Bus Lie: -
BT01080105
Phone:
714.777-7777 Lie Exp Date:
07/31/2019
Phone:
State Lie:
Code Edit: 2016
Worker's Compensation Insurance
Designer:
Plan Check Fee: $0.00
Overtime Plan Ck:
Type of Construction: VB
Carrier: PACIFIC COMP
Address:
Record Management:
$0.00
Occupancy Group: R3/U
Policy No: WA000607
CA Seismic Safety:
$0.00 -
Disabled Access `..
Added /New sq.ft. Bldg:. 0
Expire: 03/22/2020
Phone:
....
.$1.00
Added /New sq. ft. Garage: 0
San Dist:
$0.00
E
4 4
No of Stories: 0
Building Setbacks Rear: I.
Special Conditions:
4
°
4 e. ° .
No of Units : 1
Front: I
Bldg Height: 0
Left: I
Bldg Sprinklers:
Right: I
Flood Zone:
Use Zone: Parkina Soaces 0
Fire Hazard Zone : N
Construction Valuation:. $7.906.00
Building Permit Fee:
$200.00
Plan Check Fee: $0.00
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$0.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00 -
Disabled Access `..
$0.00
Hazardous Mat
$0.00
Building Green Fee :
.$1.00
TOTAL FEE: $201.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. .Fee:
Electrical %:
Mechanical %:
Plumbing %:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee:
Planning Department -
Plan check Fee [
OEPLJ
$0.00
Fair Share :
° $OoQO
$0.00
SJH Trans :
4of4
$0.00
In -lieu Housing Fee:
$0.00
$0.00
Public Works Department
-
Park Dedication :.
$0.00
PM Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Fire Department
Fire Inspection:
Fire Plan Rev
Demolition Fee
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
$0.00 fee Due at Permit Issuance :
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
$0.00
$0.00
$201.00
OEPLJ
e •.may
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004400
4 4
4 4 4
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$0.00
$0.00
$0.00
$0.00
$0.00
$201.00
OWNER -BUILDER
I hereby affirm under penalty of perjury that 1 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).
❑ 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 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 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
im roved 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
apply 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).
❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason:
By 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 legall)
sell 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
Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. -
Signature of Property Owner or Authorized Agent
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 f bi ' 'o f the Business and Pro license is in full force
and effect. License Class License No Date Contractor nature
WORKERS' COMPENSATION DECLARATION
MARNING: 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 ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm udder penalty of perjury one of the following declarations:
'a I, rad and yvjll,glaintain 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
rmance of the Work for which this permit is issued. Policy No.
fth and will waintain 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
urdite carrier Arid pglicy number are:
.:fuer' _ "'= Policy Number Expiration Date
f Agent - rnone n
ify that, In the perfor nce of a work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compens tion law of California, and agre
should become s ject of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
L.�
of . Date J
wT,/1w, e�/� Nill T I+TI/1L11 C\IAI\12 11!]CNI�V
'%ejebl -affirm antler 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).
-enders 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 I have provided is correct.
I agree to comply with all applicable city and c rdinances and state laws relating to building construction.
I authorize representatives of this city o y to an e abov = ion purposes.
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name I
ACTION DATE BV TION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED
PERMITCANCELLED
PERMIT EMENDED
PERMITFINAL
CERTIFICATE OF I
OCCUPANCYISSUED
M
LJ I SUBMITTED ASBESTOS NOTIFICATION TO
IS NOTAPPLICABLE TO