HomeMy WebLinkAboutX2017-3501 - Permits*,"n" , City of Newport Beach - Building Division IIIIIIII IIIIIIIIIIIII IIIIII�III IIIIIIIIII COMB Permit: X2017-3501
100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 7 3 5 0 1 Project No: 2435-2017'
E. �_. Permit Counter Phone (949)644-3288 ) q
Inspection Requests Phone (949)644-3255
s''dasnu�"d Combination Type - SFP Issued Date : 10/3112017
`
Inspection Area : 5
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
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
Job Address: 250 HAZEL OR NB
Description: SFR RESURAFCE (2) EXISTING DECKS AND NEW RAILINGS 620 SF • e
Legal Desc.: TRACT NO 673 BLK A LOT 44 AND POR ABAND STIR (GLEN DRIVE) a ®n ®= e
9
Owner: KAN STEPHEN WAYLAND
Contractor:
OWNER/BLDR
Architect:
CHANG ERIC
Address: 250 HAZEL DR
Address:
KAN STEPHEN
Address:
10336 MONTE MAR DR
CORONA DEL MAR, CA 92625
LOS ANGELES CA 90064
Phone:
Phone:
Phone:
626-712-3698 State Lic:CO25031
Applicant: KAN STEPHEN WAYLAND
Con State Lie:
O/B
Engineer:
Address: 250 HAZEL DR
Lie Expire:
Address:
CORONA DEL MAR, CA 92625
Bus Lie:
Phone: 818-919.5678
Lie Exp Date:
Phone:
State Lie:
Code Edit: 2016
Worker's Compensation Insurance
Designer:
Type of Construction: V -B -SPR
Carrier:
Address:
Occupancy Group: R3/U
Policy No:
Added /New sq.ft. Bldg: 0
Expire:
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 3
Building Setbacks
Rear: /
Special Conditions: PLANS ATTACHED TO PERMIT
No of Units : 1
Front: I
OWNERIBLDR ATTACH
Bldg Height: 0
Left: I
Bldg Sprinklers:
Right: I
Flood Zone:
Use Zone: Parking Spaces:
0
Fire Hazard Zone : N
Construction Valuation: $15.000.00
Building Permit Fee: $292.00
Excise Tax:
$0.00
Planning Department-
Fire Department
Plan Check Fee: $254.04
Additional Fee :
$0.00
Plan check Fee:
$37.50 Fire Inspection:
Overtime Plan Ck: $0.00
Grading Bonds Fee:
$0.00
Fair Share :
$0.00 Fire Plan Rev
Investigation Fee: $0.00
Grading PC Consultant:
$0.00
SJH Trans :
$0.00 Demolition Fee
Record Management: $0.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee :
$0.00 Building Dept Adm
Energy Compliance: $0.00
Grading PC Fee:
$0.00
Public Works Department-
General Service
CA Seismic Safety: $0.00
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Refund Deposit
Disabled Access : $0.00
P/1N Plan Check:
$0.00
Grading Bond:
Hazardous Mat $0.00
Electrical %:
$0.00
San Dist:
$0.00
Building Green Fee : $1.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
Plumbing %:
$0.00
TOTAL FEE : $584.54
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Plan Check Fee:
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$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00 Fee Due at Permit Issuance : $584.54
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
,7Y -BUILDER DECLARATION
I _aby 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
Pro scions 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
more than five hundred dollars ($500).
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,
Busines-9 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
improved for the purpose of sale).
❑ I, as owner ofthe 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 btoberty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
M F amexempt foam licensure under the Contractors' State License Law for the following reason:
8fy my s15naturelv4pt}v.Packnowledge that, except for y personal residence in which I musthave resided for at least one year prior to completion of the improvements covered gy this permit, I cannot legally
sER i s9ycture that}I have built as an owner -builder' it has not been constructed in its entiret y licensed contractors. I understand that a copy of the applicable law, Section 7 44 of the Business and
F4ofesSions Code, Is available upon request when is application Is s Itte or at the ing Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of Proberty Gyuner or Authorized Agen �— Dat d G i / ze,1
L�C�P1S'ED COIUTRACTOR'S DECLARA ON
I".w.by affirm LvJV; r pAialty of perjury that I a licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions ode, and my license is in full force
and effect. License Class License No Date Contractor Signature
)RKERS' COMPENSATION DECLARATION
:RING I�.FAILURIbS� �QRE 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
TOP �OMPEN AJN, MAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
re%yaffirm *der W4ialty of perjury one of the following declarations:
*760
I have and NRI 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
'ormance of the work for which this permit is issued. Policy No.
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'
rance carrier and policy number are:
Policy Number
1e of Agent
Date
:1I certify that, in the perfo once of the work for which this per is issued, I shall not employ any person in any manner so as to become subject to the workers' c Ripensation laws of California, and agre
:hat, if I should becomes ject tc the workers' compensati ovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ` ^1
signature of Applicant Dat _ ( �/ � / r
DECLARATION G C NST CTION LENDING AGENCY I
hereby affirm under enalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 30 ,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 cc Pity ordinances and state I w relating to building construction.
I authorize representatives of this city or count to enter ab ve-iden ' property for inspection purposes.
Signature of Property Owner or Authorized Agent z r--��- Print Property Owner's or Authorized Agent's Nam S Da U 3r
ACTION DATE BY DEC RATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERMITEXPIRED��� U SUBMITTED ASBESTOS NOTIFICATION TO
U SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED EPA
PERMFICATEL I I '�QSBEED NO UTIO TION IS NOTAPPLICA LE TO
CERTIFICATE OF / PROPOSED MOLITION
OCCUPANCYISSUED j �� SIGNATURE t, ti s-----
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