HomeMy WebLinkAboutX2018-3085 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIlll COMB Permit: X2018-3085
. ` 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 8 3 0 8 5 Project No: 2417-2018
k:: Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
"urnx' Combination Type - SFP Issued Date: 1 111 912 01 8
0
Inspection Area : 6
PERMITS EXPIRE 980 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: 170 SIDNEY BAY DR NB
Description: SFR REMODEL 569 SF (WINDOWS,DOORS)
Legal Desc.:
Owner: DENISON TOMIJULIE
Contractor:
W A M CONSTRUCTION Architect: OATMAN HOMER C
Address: 170 SIDNEY BAY DR
Address:
11240 MOUNTAIN AVE Address: 412 31ST ST
NEWPORT BEACH CA 92657
RIVERSIDE CA 92505 NEWPORT BEACH CA 92663
• •
o
Phone:
Phone:
949-290-1842
Phone: 949-675.1755 State Lic:C018254
°
Applicant: OATMAN HOMER C
Con State Lie: 781538
Engineer: RICHARDS GEORGE LEWIS
on
° °
Address: 412 31ST ST
Lie Expire:
0713112020
Address: 20162 SW BIRCH ST
• • •
NEWPORT BEACH CA 92663
Bus Lie:
BT30024689
NEWPORT BEACH CA 92660
Phone: 949.675-1755
Lie Exp Date:
0813112019
Phone: 949-752-0601 State Lic:C-037096pl'
° , �r ° °�
Code Edit: 2016
Worker's Compensation Insurance
Designer:`
C )'m
Type of Construction: V -B -SPR
Carrier:
STATE COMP
Address:
° ,
Occupancy Group: R3IU
Policy No:
9134943
..V
° C ° ° C ,
Added /New sq.ft. Bldg: 0
Expire:
05/19/2020
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 2
Building Setbacks
Rear: I
Special Conditions: VHFHSZ
No of Units : 1
Front: I
Bldg Height: 0
Left: I
Bldg Sprinklers: Y
Right: 1
Flood Zone: X
Use Zone:
Parking Spaces:
0 Fire Hazard Zone: Y
Construption Valuation: $75.000.00
Building Permit Fee: $938.00
Excise Tax:
$0.00
Planning Department - Fire Department
Plan Check Fee: $816.06
Additional Fee:
$0.00
Plan check Fee: $0.00 Fire Inspection:
$0.00
Overtime Plan Ck: $0.00
Grading Bonds Fee:
$0.00
Fair Share : $0.00 Fire Plan Rev
$0.00
Investigation Fee: $0.00
Grading PC Consultant :
$0.00
SJH Trans: $0.00 Demolition Fee
Record Management: $22.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee: $0.00 Building Dept Adm
$0.00
Energy Compliance: $56.00
Grading PC Fee:
$0.00
Public Works Department - General Service
$0.00
CA Seismic Safety: $0.00
WQ Insp. Fee:
$0.00
Park Dedication: $0.00 Refund Deposit
$0.00
Disabled Access : $0.00
P/W Plan Check: $0.00 Grading Bond:
$0.00
Hazardous Mat $0.00
Electrical %:
$0.00
San Dist: $0.00
Building Green Fee : $3.00
Mechanical %:
$0.00
NMUSD Fee: $0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE : $1,835.06
Plan Check Fee:
$872.06 Fee Due at Permit Issuance : $963.00
PROCESSED BY:
PUBLIC WORKS APPROVAL:
ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
APPROVAL TO ISSUE:
OWNER -BUILDER
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(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 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
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).
❑ I am exerFlpNFAM licensure under the Contractors' State License Law for the following reason:
j.vjgxsignature 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 legalll
sell a atructuredhatd j ave 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.
Sigrylture of Property Owner or Authorized Agent ..Da
LIC€NSED GONTRACTOR'S DECLARATION I/
1 -hereby affirm undetpenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 i 3 1 the Business and Profess s Co e', an m I' anise is in full force
and effect. Li[rense,Class License No Date Contractor Signature l
Of,RRKEROCAIMPENSATION DECLARATION
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRININ PENALTIES AND CIVIL FINES UP TO ONE HUNDRE THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
:0VI` 3F COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
her@by aMmiurdei penalty of perjury one of the following declarations:
I;have and wig 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
rmancEgf'tbgevork 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' compensatiol
nsurance carrier and policy number are:
;arrier Policy Number Expiration Date
Vame of Agent Phone #
:3I certify that, in the pe orma c of �OAr which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' co pensation laws of California, and agree
hat, if I should become bj ct t the 'ompensalion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicanrenalty
Date �w✓ /,.,
)ECLARATION REG CONSTRUCTION LENDING AGENCY L
hereby affirm underof perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 309 , Civil Code).
-ender's Name Lender's Address
3y my signature beloiv, I certify to each of the following:
I am the property owner or authorized to act on the pro erty owner's behalf.
I have read this application and the information I eve vided is Tact.
I agree to comply with all applicable city and co my or in nice n state laws relating to building construction.
I authorize representatives of this city or count to ante t e a ova dentified property for inspection purposes.
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Na
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
403
PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED DEPA
PERMIT EXTENDED QMD
PERMIT FINALASBESTOS NOFTIFICA I NIS NOT PPLICABLE TO
CERTIFICATEOF C/IV� SED DE ITION P
OCCUPANCY ISSUED O/ 51GNATf1RF: ��!I 1
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