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HomeMy WebLinkAboutX2017-3728 - Permits (2)�4wno�� City of Newport Beach - Building DivisionIIII�IIIIIII�III�IIIIIIIIIIIIIIIIIIIII II COMB Permit: X2017-3728 �7 100 Civic Center Drive, Newport Beach, CA 9260 m ° ° ®° ° o e ° ° o ° X 2 0 1 7 3 7 2 8 Project No: 2604-2017 F Permit Counter Phone (949)644-3288 m ° ° • ® 0 a m ° 4.* Inspection Requests Phone (949)644-3255 m • • e ° ° ° m eme e e e Combination Type - MFP ELEC PLUM MECH _ Issued Date: 11/27/2017 - Inspection Area : 2 e o eoe o00 VER -M7% EXPI E•180AAWS A6TER i SUANCE OR LAST VALID INSPECTION. Construction Hours: Monday - Friaay 7:00 a.ru oto 4:30 p.m. end Saturday from 8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays Job Address: 1026 E BAYSIDE COVE NB mmm ... m m m m e m m e Description: MFR- REMODEL (2) BATHS 300 SF& REPIPING Legal Desc.: TR 8073 LOT 2 UNIT 511 P.B G OF PROJECT LOCATEDON AP 50-383-09 Owner: JACK MELINDA Contractor: Address: 1026 BAYSIDE COVE E Address: Energy Compliance: NEWPORT BEACH, CA 92660 CA Seismic Safety: Phone: 949433.1533 Phone: Applicant: JACK MELINDA Con State Lie: Address: 1026 BAYSIDE COVE E - Lie Expire: $0.00 NEWPORT BEACH, CA 92660 Bus Lie: Phone: 949433-1533 Lie Exp Date: Code Edit : 2016 Type of Construction: VB Occupancy Group: R311.1 Added /New sq.ft. Bldg: - 0 Added /New sq. ft. Garage: 0 No of Stories: 2 - No of Units : 3 Bldg Height: 0 Bldg Sprinklers: Construction Building Permit Fee: $542.00 Plan Check Fee: $471.54 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 : $2.00 TOTAL FEE: $1.161.44 PROCESSED BY: ZONING APPROVAL: OWNER/BLDR Ole Worker's Compensation Insurance Carrier: Policy No: Expire: Building Setbacks Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: / Front: / Left: / Right: / 'arkina Spaces $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $37.94 $21.68 $48.78 Plan Check Fee Architect: EVERSON DAVID Address: 345 THIRD ST .f - LAGUNA BEACH CA 92651 Phone: 949-376-3076 --. State Lic:C033163 J Engineer:' Address: Phone: State Lie: Designer: Address: - Phone: Special Conditions: - Fire Planning Department - Fire Department Plan check Fee $37.50 Fair Share $0.00 SJH Trans Fire Plan Rev In -lieu Housing Fee: $0.00 Public Works Department - Park Dedication : $0.00 PNV Plan Check : $0.00 San Dist: $0.00 NMUSD Fee: $0.00 .® $471.54 Fee Due at Permit Issuance : $689.90 PUBLIC WORKS APPROVAL: f� PLAN CHECK BY: 1 ' GRADING APPROVAL: APPROVAL TO ISSUE: Fire Department $37.50 Fire Inspection: $0.00 $0.00 Fire Plan Rev $0.00 $0.00 Demolition Fee $0.00 Building. Dept Adm $0.00 General Service $0.00 Refund Deposit $0.00 Grading Bond: $0.00 $0.00 $0.00 $471.54 Fee Due at Permit Issuance : $689.90 PUBLIC WORKS APPROVAL: f� PLAN CHECK BY: 1 ' GRADING APPROVAL: APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION .. ... . . ..• .. ... I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for tle Eeasoq(slinaicat¢S below byihe 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, a:e ;improve; d4mglisr or rppaioany structure, prior to its issuance, also requires thelapplicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the ContractorsbState•LicenSe Law (Chapter9(commencing with Section 7000) of Division 3 of the BusiPass 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 peI ,alty 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 otos L) portions:oiihe work, andhe so'ucture 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 prop ft whp, thfough,prilNoyeEs' o= 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 ore ygjr of complel . 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 I pp 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 Jim exempt from licensure under the Contractors' State License Law for the following reason: 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) se7l 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 o the Bu iness and Professions Code, is available upon request when t 's pl anon' sub 'tted or he following Web site:http://www.leginfo.ca.gov/calaw.html. }-7 Signature of Property Owner or Authorized Agen Da{!a� LICENSED CONTRACTOR'S DECLARATI I hereby affirm under penalty of perjury that I am licensed under provision 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 INORKERS' COMPENSATION DECLARATION NARNING: 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 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES, hereby affirm under penalty of perjury one of the following declarations: 1 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 Code, for th 3erformance of the work for which this permit is issued. Policy No. :1I 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 workers' compensatio nsurance carrier and policy number are: -arrier Policy Number Expiration Date !m)of Agent Phone # �I cElffffy that, in the performance of the work fo 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 agre :hat I should become subj to he wo erscpens n provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. '' signature of Applica DI d �- DECLARATION REGOMINO 00ft8TR0UTFON1FrNMG AGENCY hereby affirm under penalty of perjury that ther 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 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 county ordinances an state I wS relating to building construction. I authorize representatives of this city or count a er th al:-identif' property for inspection purposes. �z j signature of Property Owner or Authorized Agen Print Property Owner's or Authorized Agent's Na L Date ACTION DATE BVDE�4RATI0 OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY ULATIO S PART 61 OF TITLE 40 AND AOMD RULE PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMITFINAL ASBESTOS CERTIFICATE OF ( S'K OUED RE'. ,OUTOA\'Y NIS TAPP. 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