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Home My WebLink AboutX2017-3783 - Permits (2)City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 ra sa�scg Combination Type - BLDG ELEC Owner: BEACON BAY COMMUNITY ASSOC Address: 2195 ORLANDO RD SAN MARINO, CA 91108.. Phone: Applicant: Construction Hours: Monday Job Address: 1 BEACON BAY NI3 Description: MONUMENT SIGN "BEACON BAY" Legal Desc.: R S 009-42 PAR 1 POR OF PAR Owner: BEACON BAY COMMUNITY ASSOC Address: 2195 ORLANDO RD SAN MARINO, CA 91108.. Phone: Applicant: DIANE/PALMER MASONRY Address: 2672 NEWPORT BLVD Record Management: COSTA MESA CA 92627 Phone: 949.642-8442 Code Edit: 2016 Type of Construction: Occupancy Group: U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 0 No of Units : 0 Bldg Height: 0 Bldg Sprinklers: Building Permit Fee: $472.00 Plan Check Fee: $410.64 Overtime Plan Ck: $0.00 Investigation Fee:. $0.00 Record Management: $8.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access: $0.00 Hazardous Mat $0.00 Building Green Fee : $2.00 TOTAL FEE: $991.92 PROCESSED BY: ZONING APPROVAL: III IXIII�IIII0IIIIIIII�I3IIuIIII�II�IIIY II COMB Permit: X2017-3783 Project No: 2649-2017 Issued Date :1210612017 Inspection Area : 2 ITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. 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 Contractor: PALMER MASONRY Address: 2672 NEWPORT BOULEVARD SJH Trans : COSTA MESA CA 92627 Phone: 949-642.8442 Con State Lie: 679138 Lie Expire: 10/31/2019 Bus Lie: BT00002142 Lie Exp Date: 1 2/3112 01 8 Workers Compensation Insurance Carrier: INSURANCE CO OF THE WEST Policy No: WSD503121102 Expire: 1010112018 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: I Front: I Left: / Right: / $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $61.78 $0.00 $0.00 0 Planning Department - Architect: LINSDAY BRANDON R Address: 1571 ORANGE AVENUE'B' COSTA MESA, CA 92627 Phone: State Lic:C035799 Engineer: MANSHADI FARHAD Address: 1800 E 16TH ST UNIT B SANTA ANA CA 92701 Phone: 714.835.2800 State Lic:C-036840 Designer: Address: Phone Special Conditions: DUPLICATE Plan check Fee: Fire Department Fair Share: $37.50 SJH Trans : $0.00 In -lieu Housing Fee Fire Plan Rev Public Works Department - Park Dedication : $0.00 P/W Plan Check : $0.00 San Dist: $0.00 NMUSD Fee: $0.00 Plan Check Fee: $991.92 Fee Due at Permit Issuance : $0.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: 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 Plan Check Fee: $991.92 Fee Due at Permit Issuance : $0.00 PUBLIC WORKS 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 resson(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). ❑ 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 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 legal) 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,html. Signature of Property 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 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 WORKERS' 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 ($700,000), IN ADDITION TO THE 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 Cade, for th performance of the work for=which this permit is issued. Policy No. 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 workers' compensatio insurance carrier and policynumber are: - Carrier Policy Number Expiration Date Name of Agent Phone # I certify that, in the performance 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 ogre that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant Date_ DECLARATION REGARDING CONSTRUCTION LENDING 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 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 stale laws relating to building construction. I authorize representatives of this city or county to enter the above-identified property for inspection purposes. Si nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name Date ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMITEXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED DEPA PERMIT EXTENDED QMD PERMITFINAL ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: ' � r