HomeMy WebLinkAboutX2015-1127 - Permitsxyn $ City of Newport Beach - Building Division "X20151127"
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
U,- Inspection'Requests'Phone(949)644-3255
r rrwe`tr Combination Type - SFP ELEC MECH PLUM
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR
INSTALL OR VERIFY SMOKE/CARBON MONOXIDF nfiW%rP=R"
Job Address: 49 SHEARWATER PL NB
Description: SFR -ADD INTERIOR BATHROOM,
Legal Desc.: N TR 12530 LOT 24
Owner:
LEVY HEATHER
Address:
571 SOMERBY PARKWAY
Excise Tax:Plan
BRYON MN 55920
Phone:
LNe.Building
Additional FOvertime
Applicant:
TALLERU WALTER
Address:
3311 FINLEY AVE
$0.00
NEWPORT BEACH CA 92663
Phone:
949-338.5599
Code Edit: 2013
Type of Construction: VB
Occupancy Group: R3/U
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:
ALL BETWEEN KIT&HEN W&NIN
COMB Permit: X2015-1127
Project No : 0873-2015
Issued Date : 04/27/2015
Inspection Area : 3
TO BE UPGRADED
if applicable:
❑80%oro
to whom: _----
State Lic:
a: 078-'- Engineer: CHU TIEN MANH
L xpve: PACIFIC AVE _
Bus Lic: A EIM CA 92804
a P ne: 71 29-5053 State Lic:C-072324
Expire:
Construction Valuation: $8.000.00
Permit Fee:
$169.00
Excise Tax:Plan
Check Fee:
$136.08
LNe.Building
Additional FOvertime
Plan Ck:
$0.00
General Service
Investigation Fee:
$0.00
Grading PCRecord
Management:
$10.00
GradingPer
Energy Compliance:
$55.00
Grading PC Fee:
CA Seismic Safety:
$0.00
WQ Insp. Fee:
Disabled Access :
$0.00
Hazardous Mat
$0.00
Electrical %:
Building Green Fee :
$1.00
Mechanical %:
Plumbing %:
tion u esigner: GRAFF BRAD
Address: 12231 BLUEBELL AVE
yn�
GARDEN GROVE CA 928
49
p"Re ry an }"'� ", p e Spe i1i 09B U ATT ED
��JpLe 9�_P 0.,m a a {no Work started)
LeH. /
�Wbrk started)
$0.00
$0.00
$0.00
$13.23
$9.45
$18.90
IITOTAL FEE: $502.41 Plan Check Fee
PROCESSED BY: s _D
ZONING APPROVAL: 4S
Department -
play
'Fair Share
Fire Plan Rev
Demolition Fee
In -lieu Housing Fee :
$0.00
Building Dept Adm
Public Works Department -
General Service
Park Dedication :
$0.00
Refund Deposit
P/W Plan Check:
$37.75
San Dist :
$0.00
NMUSD Fee:
$0.00
$502.41
Fee Due at Permit Issuance
PUBLIC WORKS APPROVAL: ICC
PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE: &D Gh
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
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 pLoced 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
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).
I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
Iusiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who;.thfough 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).
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' State License Law).
I am exempt from licensure under the Contractors' State License Law for the following reason:
ly 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:http://w .leginfo.ca.gov/calaw.html.
',ignature 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 Section 7000) of Division 3 of the Bu§iness and Professions Code, and my license is in full force
nd effect. License Class License No DateContractor Signature
✓ORKERS' COMPENSATION DECLARATION
'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVILFINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
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 the
erformance of the work for which this permit is issued. Policy No.
]I have 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' compensation
Isurance carrier and policy number are:
Policy Number
Date
is of Agent' Phone #
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
, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
ignature of Applicant Date__
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY
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
y 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 county ordinances and state laws relating to building construction.
I authorize representatives of this city or county to enter the above -identified property for inspection purposes.
ignature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name
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