HomeMy WebLinkAboutX2017-1857 - Permits11��nos City of Newport Beach - Building Division, III�IIIIi�III�IIII�llllllllllllllllll II COMB Permit: X2017-1857
100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 7 1 8 5 7 Project No : 1263-2017
'` Permit Counter Phone (949)644-3288
_ Inspection Requests Phone (949)644-3255
'°"�<rraa�'�� Combination Type - MFP ELEC MECH PLUM Issued Date: 0912912017
Inspection Area : 2
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: 205 GRAND CANAL NB
Description: MFR -ADD ELEVATOR 68 SF, REMODEL EXTG 2687 SF
Legal Desc.: BALBOA ISLAND SEC 4 BLK 11 LOT 26
Owner: BERL DOUG S JANE
Contractor:
FETHER CONSTRUCTION
Architect:
TYLER ROBERT
Address: 205 GRAND CANAL
Address:
PO BOX 3551
Address:
139 S HUDSON AVE, STE 300
NEWPORT BEACH, CA 92662
eek a.
COSTA MESA
CA 92628
o
PASADENA CA 91101
Phone:
Phone:
714.751.6409
Phone:
626-396-9599X661 State Lic:C018812
Applicant: TYLER ROBERT
Con State Lic: 357301
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Engineer:
LIU JOSEPH
Address: 139 S HUDSON AVE #300
Lie Expire:
01/31/2019
Address:
825 S GOLDEN WEST AVE #9
PASADENA CA 91101
Bus Lie:
BT30051705
ARCADIA CA 91007
Phone: 626-396-9599X661
Lie Exp Date:
01131/2018
Phone:
626-823-1937 State Lic:C-060045
Code Edit: 2016
Workers Compensation Insurance
Designer:
Type of Construction: V -B
Carrier:
STATE FUND
Address:
Occupancy Group: R3/U
Policy No:
9086025
Added /New sq.ft. Bldg: 68
Expire:
05/10/2016
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 2
Building Setbacks
Rear: 5
Special Conditions: LIQUEFACTION ZONE
No of Units : 2
Front: 7
Bldg Height: 29
Left: 3
Bldg Sprinklers: it
Right: 3
Flood Zone: AE 8'
Use Zone: R -BI
Parking Spaces:
3
Fire Hazard Zone : N
Construction Valuation: $301.535.00
Building Permit Fee: $2,591.00
Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee: $2,182.85
Additional Fee :
$0.00
Plan check Fee:
$0.00 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: $50.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee:
$0.00 Building Dept Adm
Energy Compliance: $211.07
Grading PC Fee:
$0.00 -
Public Works Department-
General Service
CA Seismic Safety: $39.20
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Refund Deposit
Disabled Access: $0.00
PAN Plan Check:
$0.00
Grading Bond:
Hazardous Mat $0.00
Electrical %:
$181.37
San Dist:
$0.00
Building Green Fee : $13.00
Mechanical %:
$103.64
NMUSD Fee:
$0.00
Plumbing %:
$233.19
TOTAL FEE: $6,540.32
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
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$0.00
$0.00
$24.00
$197.00
$564.00
$0.00
$0.00
$0.00
Plan Check Fee : $2,393.92 Fee Due at Permit Issuance : $4,146.40
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 items)
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 foln
:he 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
3rofessions 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
iot 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 of or L) 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
mprovements 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
m roved for the purpose of sale).
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
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 exemgt f;pp licensure under the Contractors' State License Law for the following reason:
By my signaturelrelow 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 legally
sell a structure TRaT T 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
?"escions CQt1@,;s'dvailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
SignatLre of Property Owner or Authorized Agent to
CIF2NSED CONTRACTOR'S DECLARATION
heT9by affirm undeapenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 o ivis' n 3 of the Business and Prof ss' ins Code rlmy.0 nse is in full force
and effect. LiCe�vb (Dass License No Date 146 Contractor Signature
NORKERS' COMPENSATION DECLARATION
wFutui�y FAILUrfE�T06iCURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMIN L PENALTIES AND CIVIL FINES UP TO ONE Hu
D THOUSAND DOLLARS ($100,0001, IN ADDITION TO THE
YQ.%T.WCOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
.I;%rv4y affirm un der penalty of perjury one of the following declarations:
El I have and 4711 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 thi
Raance of the y(ar4 for which this permit is issued. Policy No.
6e and 46 ilvaintain 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' compensatior
nsuran rrier and policy number are:
'arrier Policy Number Expiration Date
Name of Agent Phone #
:1I certify that, in the pe rma ce 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' ompensation laws of California, and agree
:hat, if I should become bje the wo rscOmpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant at
DECLARATION RE R ING STRUCTION LENDING AGENCY
hereby affirm and penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3 7, Civil Code).
_ender'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 c0 ty ordinances and state laws relating to building construction.
authorize representatives of this city or count enter t alcove -id tified property for inspection purposes. / �t�
Signature of Property Owner or Authorized A ent Print PropertyOwner's or Authorized Agent's Names" Dat
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OFTITLE 40 AND, RULE
PERMITEXPIRED1 I LJISUBMITTED ASBESTOS
PERMIT CANCELLED EPA
PERMITEXTENDED UAQMD
44
PERMITFINAL 1JaASBESTtTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF n1 PROPOSED LITI
OCCUPANCYISSUED SIGNATURE:
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