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Home My WebLink AboutX2016-1968 - Permitsi R�4AS4R'1A4r City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA.92660 Permit Counter Phone (949)644-32)8 Irr.`�ection Requests Phone (949)644-3255 Combination Type - SFP ELEC MECH PLUM GRAD IIillillillillillillilliillillillillillillilliililli IICOMB Permit: X2016-1968 x 2 0 1 6 1 9 6 6 Project No : 1328-2016 Issued Date: 09/21/2016 Inspection Area : 4 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. INSTALL OR VERIFY SMOKE(CARBON MONOXIDE DETECTORS /PLUMBING FIXTURES TO BE UPGRADED Job Address: 2615 BLUE WATER DR NB Type of Construction: V -B -SPR Description: NEW SFR W/ATT GAR 4260 & 700SF, PORCH 98 SF & TRELLIS 668 SF W I+ hor *, n Legal Desc.: N TR 6385 LOT 41 No of Stories: 1 Owner: NICHOLSON TOM Contractor: NICHOLSON CONSTRUCTION CO Address: 1 CORPORATE PLAZA #110 Address: 4220 VON KARMAN AVE, 210 $1,435.00 NEWPORT BEACH, CA 9266 $1,470.48 NEWPORT BEACH CA 92660 Phone: 949-872-9067 Phone: 949-756-8393 Applicant: NICHOLSON TOM Con State Lic: 660295 Address: 1 CORPORATE PLAZA #110 Lic Expire: 12/31/2016 NEWPORT BEACH, CA 9266 Bus Lic: BT98032860 Phone: 949-872-9067 Lic Exp Date: 04/30/2017 Code Edit : 2013 Type of Construction: V -B -SPR Occupancy Group: R -3/U Added /New sq.ft. Bldg: 4260 Added /New sq. ft. Garage: 700 No of Stories: 1 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Y Building Permit Fee: $4,618.00 Plan Check Fee: $4,017.66 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management : $70.00 Energy Compliance: $268.00 CA Seismic Safety: $108.16 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $p--ro Worker's Compensation Insurance Carrier: STATE FUND Policy No: 9074255 Expire: 10/01/2016 Building Setbacks Rear: 6 CHINO HILLS, CA 91709 Front: 20 909.217-1866 State Lic:CO23571 Left: 6 DEIHIMI DAMIR HOSSEIN °eeoo° Right: 6 Use Zone: Parking Spaa LAGUNA HILLS CA 92653 Phone: Excise Tax: $1,041.60 Additional Fee : $0.00 Grading Bonds Fee: $0.00 Grading PC Consultant: $1,011.47 Grading Permit Fee: $1,435.00 Grading PC Fee: $1,470.48 WQ Insp. Fee: $0.00 Electrical %: $323.26 Mechanical W $184.72 Plumbing %: $415.62 r PROCESSED BY: / ZONING APPROVAL: L/ I GRADING APPROVAL: Architect: TOBLESKY KENNETH Address: P.O. BOX 1261 Designer: Address: Phone: Special Conditions: 0 Fire Hazard Zone : N CHINO HILLS, CA 91709 Phone: 909.217-1866 State Lic:CO23571 Engineer: DEIHIMI DAMIR HOSSEIN °eeoo° Address: 23172 PLAZA POINTE DR STE 145 .... Fair Share : LAGUNA HILLS CA 92653 Phone: 949-954-7244 State LiaC-078194 Designer: Address: Phone: Special Conditions: 0 Fire Hazard Zone : N Planning Department- Fire Department Plan check Fee : $150.00 Fire Inspection: Fair Share : $0.00 Fire Plan Rev SJH Trans : $0.00 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 : $380.00 Grading Bond: San Dist: $716.00 NMUSD Fee: $2,699.28 Plan Check Fee : $5,454.07 Fee Due at PUBLIC WORKS PLAN CHECK BY: APPROVAL TO ISSUE: me o e o m c mo o m coomee 0 occo $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $13,489.18 o n mooaco e n 0 0 o m 00 0 m o m ° mo n mmmoo 0 commoo coomoo c m m commoo c o 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 checkmerk(s) I have placed next to the applicable item(s) )ction 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 reglTres the applicant for permit to file asigned 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 Ifessions 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 more than five hundred dollars ($500). 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044, siness 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 )rovements are not intended or offeredfor 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 )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 )ly 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: 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 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 �fessions Code, is available upon request when this application is submitted or at the following Web site:hltp://www.leginfo.ca.gov/calaw,html. nature of ProlatMV.Owner or Authorized Agent. Date SENSED CCNTRACTOR'S DECLARATION Lr�ky_affirm ugcter penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 700 f Division 3 of the Business and Pro as Code, and�my, lice is in full force rreff##e_c_t. License less License No Date �l Contractor Signal 00 SL2 JRiKPRS' COyIPENSATION DECLARATION MINIS: FAILUREII0 SFiC�JRE 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 IT OF COMPENSXICkN, gAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. Te gy'affirm urfAr penalty of perjury one of the following declarations: t+have and tNPItrt jtain 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( f�ov/pance of the work for which this permit is issued. Policy No. q and wil6mainyain 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 Jra ce carrier S1ld' policy number are: Policy Number Agent' Date 3 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 iat, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. c� j,., - :ignature of Applic '"l `"��VL k` IECLARATION REG ING CONSTRUCTION LENDING AGENCY hereby affirm under pbnalty 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 ly 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 thisapplicationand 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 cout J� � to/,�ntter^the above ti d property for inspection purposes. ��c � kmature of Prooertv Owner or Authorized Agent & ! �). Print Property Owner's or Authorized Agent's Na,%K 'f`-v"�C) �Lr Da ACTION DATE BY I DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMITEXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO All required alarms, latches gates and fences which serve as part of a pool/spa barrier, shall be in place prior to approval to fill pool/spa & shall remain in place & be maintained for the life of the pool. PERMIT CANCELLED UEPA PERMITEXTENDED QMD PERMITFINAL��- ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF PROPOSED DEMOLITION OCCUPANCYISSUED SIGNATURE: