HomeMy WebLinkAboutX2019-1360 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9
' r�S Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - SFP PLUM
COMB Permit: x2019-1360
1 3 6 6 Project No : 2496-2018
Issued Date : 0412912019
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: 3215 OCEAN BLVD NB -
_r
Description: SFR DELTA 2,'INCREASE SCOPE OF WORK, RE -ROOF 24 SQ W/SLATE (BORAL, 6psf MAX) REMOVE/REPLACE (E) (2) FIREPLACES
. Legal Desc; TR 1026 LOT 13 SELY112 -RIS 12 -35 -(AND NWLY112 LOT14
Investigation Feer $0.00.
SJH Trans
Record Management: $16.00
Owner GUARRIELLO RITA P Contractor: FOREHAN CONSTRUCTION
Architect r-4
Address: 3216 OCEAN BLVD Address: 1442 N KENNYMEAD
Address:
CORONA DEL MAR CA 92625 ORANGE CA 92869.
Disabled Access : $0.00
Phone: 714.606-7794 Phone: 714-602-7511 -
Phone: State Lie:
Applicant FOREHAN CONSTRUCTION Con State Lie:. 980956
Engineer: .....At
Address. 13982 SANDCASTLE PL Lie Expire: 0212812019-
Address:
SANTA ANA CA 92703 Bus Lic: BT30059890'`
$0.00
Phone. Lie Exp Date: 07/3112019
Phone: State Lie:
- Code Edit : 2016 Worker's Compensation Insurance
Designer: MICHAEL DAVID
Type of Construction: VB : Carrier: BENCHMARK INS
Address: 712 CENTER ST -
Occupancy Group: R3IU Policy. No: CST5003692
COSTA MESA IIA 92627
Added lNew sq.ft. Bldg: 0 Expire: 03101/2019
Phone: 949-701-9539 e
Added /New sq. ft. Garage: 0
No of Stories: 2 Building Setbacks Rear: /
Special Conditions: LIQUEFACTION & LANDSLIDE
No of Units : - 1 Front: /
AREA
Bldg Height: 0 Left: 1.
Bldg Sprinklers: Right: /
Flood. Zone: X Use Zone: Parking Spaces: 0
Fire Hazard Zone : N
TOTAL FEE : $1,139.48
PROCESSED BY:. 1
ZONING APPROVAL:
GRADING APPROVAL:
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Feer.
Electrical %:
Mechanical %:
Plumbing %:
$0.00
Construction Valuation: $35.000.00
Building Permit Fee: $716.00
Plan check Fee ;
Plan Check Fee: $341.04
$0.00
Overtime Plan Ck $0.00
:$0.00 -
Investigation Feer $0.00.
SJH Trans
Record Management: $16.00
$0.00
Energy Compliance: $0.00
$0.00
CA Seismic Safety: $0.00
PublicWorksDepartment-
Disabled Access : $0.00
Park Dedication :
Hazardous Mat $0.00
.$0.00
Building Green Fee : $2.00
TOTAL FEE : $1,139.48
PROCESSED BY:. 1
ZONING APPROVAL:
GRADING APPROVAL:
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Feer.
Electrical %:
Mechanical %:
Plumbing %:
$0.00
Planning Department-.
$0.00
Plan check Fee ;
$0.00
$0.00
- Fair Share :.
:$0.00 -
$0.00
SJH Trans
$0.00
1n -lieu Housing Fee:
$0.00
$0.00
PublicWorksDepartment-
$0.00
Park Dedication :
$0.00
.$0.00
PAN Plan Check:
$0.00
$0.00
San Dist:
$0.00
$0.00
NMUSD Fee: -
$0.00
$64.44
Plan Check Fee
a
E =a= � •m u
v z o c m uc
$0.00 Fee Due at Permit Issuance:
.PFI®LIC WORKS APPROVAL:
I a
PLAN CHECK BY
APPROVALTO ISSUE:
o-
e
4� Y
U9 .AC AO O G [A(. pme
$1,139.48
Fire Department
$0.00
.Fire Inspection:
$0.00
$0.00
Fire Plan Rev -
:$0.00 -
$0.00
Demolition Fee
$0.00
Building Dept Adm
$0.00
General Service
- $0.00
Refund Deposit
.$0.00
Grading Bond:
$0.00
$0.00
_
$0.00
$0.00 Fee Due at Permit Issuance:
.PFI®LIC WORKS APPROVAL:
I a
PLAN CHECK BY
APPROVALTO ISSUE:
o-
e
4� Y
U9 .AC AO O G [A(. pme
$1,139.48
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 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
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
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 and Professions Code: The Contractors' State License Law does rI
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 legal)
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
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7U) o iiSion 3 of the Business and Io add
I ns�i y lice is in full force
and effect. License Class License No Date IContractor Signatur 1-2:
WORKERS' COMPENSATION DECLARATION
WARNING: 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 ($700,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
11 I 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
pe rmance of the work for which this permit is issued. Policy No.
have and will a Sin 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
surance carrier nd p icy numb e:
Carrier io er Expiration Date
Name of Agent 47K 4 ' Phone #
I certify that, in the perfo nce of the work for whit this permit i sued,.) s II not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree
that, if I should becomes je t to the r+ers'cori tion provi s of ction 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant %� D to Lf -
DECLARATION REG G CONSTRUCTION LENDING AGENCY
I hereby affirm under nalty 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).
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 ha vided is correct.
I agree to comply with all applicable city and countufordihances and state laws relating to building construction.
I authorize representatives of this city or count nter the abo : dentifi roperty 'inspection purposes.
Si nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Nam6 i!2 -24
ACTION DATE BY DirCLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED LJ I SUBMITTED ASBESTOS NOTIFICATI01M•Oi • "•
PERMITCANCELLED EPA :•• . . Z + •+ • .+� +
PERMITEXTENDED QMD ++' e + •+�
PERMITFINAL ASBESTOS NOTIF ION IS NOT APPLICAB TO
CERTIFICATE OF / PR SED DEMO I
OCCUPANCYISSUED •� SIGNATURE: :"'^'�-LLC" ••; •++ ••+ •.•
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