HomeMy WebLinkAboutX2017-3297 - Permitswt City of Newport Beach - Building Division *X2017-3297* COMB Permit: X2017-3297
0 4 100 Civic Center Drive, Newport Beach, CA 92660 Project No: 2293-2017
E+ Permit Cbuntet Phone (949)644-3288
'' +q Inspeclion Requests Phone (949)644-3255
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°a,¢ ° Combination Type - BLDG PLUM Issued Date :10113/2017
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Inspection Area : 4 a....° ••..00
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PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. • o m ° o
Construction Hours: MondayFriday 7:00 a.m. to 6:30 m. and Saturday from 8:00 a.m. to 6:00 m. No work on Sundays or Holida
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Job Address: 1212 SANDCASTLE DR NB
Description: DEMO SFR 2157 SF W/ ATT GAR 551 SF (3) BEDROOMS AND SEWER CAP e ° • ° o
Legal Desc.: N TR 6634 LOT 12
ae000
Owner: RUBIN FAMILY LIVING TRUST Contractor: HOBSON'S J REMODELING Architect: CHERSON ERIN JUSTINE
Address: 707 BELLS ST Address: 6462 ACACIA LN Address: 606 CENTRAL AVE l ` e° •.: °
NEWPORT BEACH CA 92660 YORBA LINDA CA 92886 SEAL BEACH CA 90740
Phone: Phone: 714-225-6365 °°O. i ° e�•o°
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Phone: 562-596-0495 State Lic:C032745
Applicant: HOBSON JEREMY Con State Lic: 930528 Engineer:
Address: 6462 ACACIA LN Lic Expire: 03/31/2019 Address:
YORBA LINDA CA 92886 Bus Lic: BT30045866
Phone: 714-225-6365 Lic Exp Date: 01131/2018 Phone: State Lic:
Code Edit : 2016 Worker's Compensation Insurance Designer:
Type of Construction: Carrier: STATE FUND Address:
Occupancy Group: R3/U Policy No: 9135149
Added /New sq.ft. Bldg: 0 Expire: 06/14/2018 Phone:
Added /New sq. ft. Garage: 0
No of Stories: 1 Building Setbacks Rear: I Special Conditions: VHFHSZ 8 FUEL MOD
No of Units : 1 Front: / TIGHT QUARTERS
Bldg Height: 0 Left: / 3 STREET TREES
Bldg Sprinklers: Right: /
Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N
Construction Valuation: $15.000.00
Building Permit Fee: $103.00 Excise Tax: $0.00 Planning Department - Fire Department
Plan Check Fee: $0.00 Additional Fee : $0.00 Plan check Fee : $37.50 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 $24.00
Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department - General Service $197.00
CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $1,692.00
Disabled Access : $0.00 PAN 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 %: $9.27 $0.00
TOTAL FEE : $2,067.77 Plan Check Fee: $2,067.77 Fee Due at Permit Issuance : $0.00
PROCESSED BY: PUBLIC WORKS APPROVAL:
ZONING APPROVAL: PLAN CHECK BY:
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 the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s)
(Section 7031.5+ t3usiigiss 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
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
Rrofesions Code)p& 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
rj'pl morethan fiae�hLy((11ed dollars ($500).
❑. I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
Msiliv and Professiogs Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
imgrovEWnents are.not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
irnpro � d -for the purpose of sale).
0 I��S owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
apply t� an owne} 5 droperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
0 �mgxempt from licensure under the Contractors' State License Law for the following reason:
B)rmy sigh elute 13Q4Nf acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally
se11 a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
Pro19S3i o Code* is aveiFable upon request when this application is submitted or at the following Web site:http://wewa.leginfo.ca.gov/calaw.html.
Signeture of Prop$r4j Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section) of Division 3 of the Business and Pro sions e, and my license is in full force
and effect. License Class License No Date0 W/ t5h7 Contractor Signatur
WORKERS' 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 0705 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 Code, for th
MEMance of the work for which this permit is issued. Policy No.
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'
carrier and policy number are:
Policy Number
Date
le of Agentppp rnone s
certify that, in the performa0tte 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 agre
if I should becomg subjecj�'��tddthewyrkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
of
Date`c 14�/ r5 f /7
CLARATION REGARDING CONSTRUCTION LENDING AGENCY / T
: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
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 o d' ante d'state laws relating to building construction.
I authorize representatives of this city or count to, t e above -identified property for inspection purposes. \ ,, _
nof„rc of PrnneMy rlumcr nr Ai fhnrmarl Ancnf �/ Print Pmnerty Owner's or Authorized Anent's Name X V1
ACTION DATE BY /DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 63 OF TITLE 40 AND AQM D RULE
PERMIT EXPIRED I I VJIWSUBMITTED ASBESTOS NOTIFICATION TO
PERMITFINAL UASBESTOS N TIFICATION IS NOTAPPLICABLE TO
OCCUPANCYISSUED , ,g \� SIGNATURE• T�
Civil Code).
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