HomeMy WebLinkAboutX2019-2276 - Permits1 $ City of Newport Beach - Building Division
100 Civic CenMr D 'eve, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
- v Inspection Requests Phone (949)644-3255
Combination Type - SFP MECH ELEC PLUM
COMB Permit: X2019-2276
IIIIIIII III0IIIIIIIIIIIII IIIIIIIIIIIII�II
Project No :
Issued Date : 0712212019
Inspection Area : 4
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 6:00 a.m. to 6:00 p.m. No work on Sundays or Holidays
Job Address: 1736 PORT ABBEYPL NB
Description: SFR REMODEL (3) (E) BATHROOMS & INSTALL SOLAR TUBE @ MASTER BATH "CITY STD PLAN"
Legal Desc.: N TR 6621 LOT 18 �..
Owner: - STERN JASON
Contractor:
TREEIUM INC
Address: 1736 PORT ABBEY PL
Address:
5352 LAUREL CANYON BLVD #200
NEWPORT BEACH, CA 92660
$0.00
VALLEY VILLAGE CA 91607
Phone:
Phone:
855-833-8733
Applicant: LITTMAN ETEL
Con State Lic:
617148
Address: 5352 LAUREL CANYON BLVD #200
Lic Expire:
04130/2021
VALLEY VILLAGE CA 91607
Bus Lic:
BT30053191
Phone: 713.550-8398
Lic Exp Date:
1113 0/2 01 9
Code Edit : 2016
Worker's Compensation Insurance
Type of Construction: VB
Carrier:
CAROLINA CASUALTY
Occupancy Group: R31U
Policy No:
BNUWC0144084
Added /New sq.ft. Bldg: 0
Expire:
05/18/2020
Added/New sq. ft. Garage: 0
$0.00
Public Works Department-
No of Stories: 2
Building Setbacks
Rear: 1
No of Units : 1
$0.00
Front: I
Bldg Height: 0
Left: I
Bldg Sprinklers:
Right: I
Building Permit Fee: $581.00
Plan Check Fee: $505.47
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management :
$2.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access:
$0.00
Hazardous Mat
$0.00
Building Green Fee:
$2.00
TOTAL FEE: $1,246.67
PROCESSED BY:
ZONING APPROVAL:
Architect:
Address:
Phone:
Engineer:
Address:
State Lic:
Phone:
State Lic:
Designer:
LITTMAN ETEL
Address:
5352 LAUREL CANYON #200
VALLEY VILLAGE CA 91507
Phone:
713-550.8398
Special Conditions:
Fire Hazard Zone : N
Excise Tax:
$0.00
Planning Department-
Fire Department
Additional Fee:
$0.00
Plan check Fee:
$40.00
Fire Inspection:
$0.00
Grading Bonds Fee:
$0.00
Fair Share :
$0.00
Fire Plan Rev
$0.00
Grading PC Consultant:
$0.00
SJH Trans :
$0.00
Demolition Fee
Grading Permit Fee:
$0.00
In -lieu Housing Fee:
$0.00
Building Dept Adm
$0.00
Grading PC Fee:
$0.00
Public Works Department-
General Service
$0.00
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Refund Deposit
$0.00
PM Plan Check:
$0.00
Grading Bond:
$0.00
Electrical %:
$40.67
San Dist:
$0.00
Mechanical %:
$23.24
NMUSD Fee:
$0.00
$0.00
Plumbing %:
$52.29
-
$0.00
Plan Check Fee
: $0.00
Fee Due at Permit Issuance:
$1,246.67
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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 plaaad 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 L) 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
improved for the purpose of sale).
❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business andProfessionsCode: The Contractors' State License Law does not
apply to an owner of property who buildsorimproves 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 1 must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally
sell a structure that I have built as an owner -builder if it has not been constructed in its entirely 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 700 of Di ision 3 of the Business and PrnfeSsions and my license is in full force
and effect. -License Class License No Date Contractor Signature
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 9706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
1 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
Derjormance of the work for which this permit is issued. Policy No.
have and will, intain 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' compensatiol
nsurance carrier olicy number are:
A
carrier oli bar Expiration Date
Name of Agent Phone #
:1I 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 agree
:hat, if I should become subject tp�he repo kers' con tion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applican�� �/ �1/®�� -ll
DECLARATION REGARDINGWN TION LENDIN ENCY
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).
-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 provi ed is correct.
I agree to comply with all applicable city and county ordin s and state I s vela' to building construction. D 22. IJ
I authorize representatives of this city or count to enter h -id pro rt for inspection purposes.
3i nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name Dat
ACTION DATE BY DECLARATION OF COMPLIANCE WITCODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 610E TITLE 40 NO AQMD RULE
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