HomeMy WebLinkAboutX2019-1053 - Permits/. City of Newport Beach - Building Division 11IIIIIIIIIIIIJill II1IIIIIIIIIIIIIIIIIIIIIIIIIIIII 11 COMB Permit: X2019-1053
cr ar 100 Civic Center Drive, Newport Beach, CA 92660 X 2
Project No :0730-2019
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
"e"cr�sxn"x Combination Type - SFP ELEC MECH PLUM Issued Date 06/20/2019
Inspection Area : 4
Applicant: LUSHBAUGH WILLIAM
Address: 17191CITRON
IRVINE CA 92612
Phone: 949.251.1710
Code Edit 2016
Type of Construction: V-A- SPR
Occupancy Group: R3
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units : 1
Bldg Height: 0
Bldg Sprinklers: Y
Building Permit Fee: $833.00
Plan Check Fee: $724.71
Overtime Plan Ck:
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
Investigation Fee:
$0.00
Record Management:
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
Energy Compliance:
$0.00
Job Address:
59 VICTORIA NB
Disabled Access:
$0.00
Hazardous Mat
Description:
Legal Desc.:
SFR KITCHEN, LAUNDRY ROOM & MASTER BATHROOM REMODEL (200 SF)
NTR15409LOT24`g��d'{f.
$3.00
ey
NMUSD Fee:
$0.00
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Owner:.
GORMAN-CHUNG Contractor: DHT GENERAL CONTRACTOR
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Architect: LUSHBAUGH WILLIAM/ ;� g ,o
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Address:
59 VICTORIA Address: 2415 E OCEAN BLVD #2
Address: 17191 CITRON
NEWPORT BEACH, CA 92660 LONG BEACH CA. 90803
IRVINE CA 92612
Phone:
Phone: 562.277-6733
Phone: 949-251-1710 State Lic:CO24867
-
Applicant: LUSHBAUGH WILLIAM
Address: 17191CITRON
IRVINE CA 92612
Phone: 949.251.1710
Code Edit 2016
Type of Construction: V-A- SPR
Occupancy Group: R3
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units : 1
Bldg Height: 0
Bldg Sprinklers: Y
Building Permit Fee: $833.00
Plan Check Fee: $724.71
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 :
$3.00
TOTAL FEE: $1
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Con State Lie:
1016960
Lie Expire:
08/3112020
Bus Lie:
BT30067178
Lie Exp Date:
05/3112020
Worker's Compensation Insurance
Carrier: EXEMPT
Policy No:
Expire:
Building Setbacks
Use Zone:
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: /
Left: /
Right: /
$0.00
$0,00
$0.00
$0.00
$0.00
$0.00
$0.00
$58.31
$33.32
$74.97
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
Special Conditions:
Planning Department -
Fire Department
Plan check Fee
Fire Inspection:
Fair Share:
Fire Plan Rev
SJH Trans:
Demolition Fee
In -lieu Housing Fee:
Building Dept Adm
Public Works Department -
Park Dedication :
$0.00
PAN Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
State Lie:
o°o®
Fire Department
$40.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00.
Building Dept Adm
General Service
.,$0.00°
Refund Deposit
0$0.00.
Grading Bond:.
o°o®
0000
o °
o
0000
0 0
$0.00
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0000.
0
.,$0.00°
0$0.00.
00000
X0.00°°
om 0
sa..OB °
0000
0000
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o°o°
$0.00
0000<
.,$0.00°
0$0.00.
00000
X0.00°°
°moo
sa..OB °
$0.00
$0.00
$0.00
Plan Check Fee: $764.71 Fee Due at Permit Issuance : $1,010.60
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
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)
lection 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
ie 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
'rofessions 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
of more than five hundred dollars ($500).
7 1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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
nprovements 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
nproved for the purpose of sale).
1 I, 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
pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' Slate License Law).
I am exempt from licensure under the Contractors' State License Law for the following reason:
Iy 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
ell 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
'rofessions Code, is available upon request when this application is submitted or at the following Web site:hltp://www.leginfo.ca.gov/calaw.html.
'signature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Secti 70 ) of,Divisigg3 of the Busine and Pr jons ll ode, and my license is in full force
nd effect. License Class License No a GGfiYY ``ii Contracto ignatur 11
VORKERS' COMPENSATION DECLARATION
'ARNING: 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 ($100,000), IN ADDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
have and wul maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for
ance of the wo6IG for which this permit is issued. Policy No.
e and will p�lntain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensa
dzn a carrigir and policy number are:
Policy Number
Date
fy that•ifies pe mance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' mpensation laws of California, and agre
•I(I should o� to the rkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
jltaRure of 11t D - i
iC&ILARATION KEGAR G CONSTRUCTION LENDING AGENCY
ere$j affiral ander 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).
ridn's Name • • • • Lender's Address
;�).signaturgpelokv, I certify to each of the following:
I am the p•ripp§ rowner or authorized to act on the property owners behalf.
I have read this application and the information I have provided is correct.
I agree to comply with all applicable city and un ordirr(jances and state laws relating to building construction.
1 authorize representatives of this city or cou o teihe above -identified property for inspection purposes. - p` / c
mature of PFODertv Owner or Authorize Ae nt /'� Print Property Owner's or Authorized Agent' me % �t Dat 6 2t' C
ACTION DATE Imo) BY \RDECLARATION EGULATIONS OF COMPLIA
0 NTCE LE WITH
C DE OFAQMD FEDE
ERAL FOR OFFICE USE ONLY PART 61
PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED EP
PERMIT EXTENDED qM
PERMITFINAL , (J _ ASB STOS T ATION I NOT APPLICABLE TO
OCERTIFICATE CCUPANCYISF (7 �,� z(,57 PR SED D -I ITIO
OCCUPANCYISSUED O TURE: