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Home My WebLink AboutX2018-0299 - Permits1+04 City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 F :^ Permit Counter Phone(949)644-3288 r Inspection Requests Phone (949)644-3255 �e"rzrrnw�*`g Combination Type - BLDG PLUM ��Illllllllllllllllllllllllllllllllllllllllllillllll �� COMB Permit: X2018-0299 x 2 0 1 6 0 2 9 9 Project No : 0252-2018 Issued Date: 01131/2018 Inspection Area : 1 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: 1045 W BALBOA BLVD NB Description: DEMO 2 -UNIT BLDG 1225 SF (3 BDRM TOTAL) Legal Desc.: N TR 234 BLK 10 LOT 12�C CTORr�."' Owner: PACK INVESTMENT GROUP LLC Address: 2288 N BATAVIA ST Record Management: ORANGE CA 92865 Phone: 714-323-7860 Applicant: BURKHART BROTHERS CONSTR Address: 12 BALBOA COVES Hazardous Mat NEWPORT BEACH CA 92663 Phone: 714.350-3892 Code Edit: 2016 Type of Construction: VB Occupancy Group: R1/U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 1 No of Units: 2 Bldg Height: 0 Bldg Sprinklers: Construction Building Permit Fee: $103.00 Plan Check Fee: $189.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $4.00 Energy Compliance: $0.00 CA Seismic Safety: $0.0U�01 Disabled Access: SAN CLEMENTE CA 92672 Hazardous Mat 00 Building Green Fee : O $1.00 11 TOT L FEE PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Contractor: BURKHART BROTHERS CONSTR Architect: LIN JUINTOW Address: 12 BALBOA COVES Address: 392 CAMINO DE ESTRELLA In -lieu Housing Fee: NEWPORT BEACH CA 92663 Public Works Department - SAN CLEMENTE CA 92672 Phone: 714-350-3892 Phone: 949.325-3001 State Lic:C033054 Con State Lie: 905510 Engineer: om 0 Lie Expire: 1013112019 Address: o 0 Bus Lie: 8730026859 Lie Exp Date: 0313112018 Phone: State Lie: Worker's Compensation Insurance Carrier: STATE COMP Policy No: 9041905 Expire: 02/01/2018 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: / Front: / Left: I Right: I 3arkina Spaces $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $9.27 Plan Check Fee: Designer: Address: Phone: Special Conditions: JD DEMO 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 PNV Plan Check : $0.00 San Dist: $0.00 NMUSD Fee: $0.00 $0.00 Fee PUBLIC WORK PPR PLAN CHEC BY: APPROVAL T ISSUE: mem• Fire Department $0.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm •memo• General Service 0 Refund Deposit Grading Bond: mem• e o•e• m C • m mOmmOU •memo• o 0 0 0 0 0 0 0 0 om 0 m o m o m o 0 00 0o e u eoc o m00000 •meso 0 0 omocc 0 000000 o m e 00000m m o ooeooc mm m o m o 0 0000 oe • $0.00 $0.00 $24.00 $197.00 $1,692.00 $0.00 $0.00 $0.00 $2,309.27 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(:) (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). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) 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). 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 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 legally 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 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Secti 7000 Diyi iqn/3 of the Business and Prof as R e, and my license is in full force and effect. License.Class License No Date / � //1A Contractor Slgnar++rFr`C zaA WORKEFS' CaMPEdSAT10N DECLARATION I Ara &SOMILURE TD,SECUBE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO C� INAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE CriIST OF CCMPENS/MdN!VMAAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES I I�fP•by�(firm under• penalty of perjury one of the following declarations: ave 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 qce of t*6%ligrtTor which this permit is issued. Policy No. • ay 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 insura e.carrier ani porky number are: ••• C r'•r • Policy Number Expiration Date Mme of Agent Phone # 6aertify that, in the pefformance 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 th%, jf lo,Aould bi;&OLI jubject he workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant - Date_ I t DECLARATION REG DI CONSTRUCTION LENDING AGENCY I 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 3097 Ivil 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. SignaI agree to comply with all applicable city and county ordinanc sand state laws relating to building construction. I authorize representatives of this city or count to enter th bove-identified pr party for inspection purposes. ture of Property Owner or Authorized Agent rint PropertyOwner's or Authorized Agent's Name C6 611 a 5l ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL IVFOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED SUBMITTED ASBESTOS NOTIFICATION TO Al PERMIT EXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCY ISSUED LJ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMIOLITION