HomeMy WebLinkAboutX2018-3415 - PermitsCity of Newport Beach - Building Division
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�
COMB Permit: X2018-3415
Q '.. 100 Civic Center Drive, Newport Beach, CA 92660 -
X 2 9 1.
8 3 4 1 s
Project No : 1748-2018
)
Permit Counter Phone (949)644-3288
Y - Inspection Requests Phone (949)644-3255
oar��xvcT ` Combination Type- BLDG PLUM
Issued Date: 1110912018
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: 311 ORCHID AVE NB
Description: DEMO (E) DET. GARAGE
Legal Desc.: CORONA DEL MAR LOT 11 BLK 241(AND SWLY1112 LOT 13 BLK 241
-
Owner. RABINOVICH LEV Contractor. SHORELINE DEVELOPERS Architect:
Address: 5 SEA VIEWLN Address: 'P O BOX 551
Address:
`
NEWPORT COAST CA 92657 NEWPORT BEACH CA 92661
Phone: Phone: 949-697-3993
Phone:
State Lic:
Applicant: SHORELINE DEVELOPERS Con State Lie: 890871
: Engineer:
-
7, v
Address P O BOX 551 Lie Expire: 0113112019
Address:
NEWPORT BEACH CA 92661 Bus Lie: BT30041079
t e
Phone: 949-697-3993 Lie Exp Date: 1 013112 01 9
Phone:
State Lie:
_
Code Edit : 2016 Worker's Compensation Insurance
Designer.
Type of Construction: Carrier: STATE COMP
Address:
Occupancy Group: U Policy No: 9038773
".
Added/New sq.ft. Bldg: 0 Expire: 01/0112019
Phone:
r `"
Added /New sq. ft. Garage: 0
No of Stories: 0 Building Setbacks. Rear: I
Special Conditions:
No of Units: 0 Front: I
Bldg Height: 0 Left:
' Bldg Sprinklers: Right:
Flood Zone: Use Zone: Parking Spaces:
0 Fire Hazard Zone : N
Construction Valuation: $1.000.00
Building Permit Fee: $103.00. Excise Tax: $0.00
Planning Department-
Fire Department
Plan Check Fee:. $0.00 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: .$0.00 Grading Permit Fee:. $0.00
In -lieu Housing Fee : $0.00
Building Dept Adm $0.00
Energy Compliance: $0.00. 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
PNV Plan Check: $0.00
Grading Bond: $0.00
Hazardous Mat $0.00 Electrical W $0.00
San Dist: $0.00
Building Green Fee : $1.00 Mechanical%: $0.00
NMUSD Fee: $0.00
$0.00
Plumbing %: "$9.27
$0.00
TOTAL FEE : $113.27 Plan Check Fee :
$0.00 Fee Due at Permit Issuance : $113.27
eco eo a ase o00 0.
PROCESSED BY: _`, E _°� _ D
PUBLIC WORKS APPROVAL:
ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL: `, ° '' c Fuo <c
APPROVAL TO ISSUE:'
G
c o
OVJ OD CIO D € 400 O^J
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable items)
(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 (_) 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 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 legall,
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.htmi.
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 0 ) f Disign 3 of the Business and Prfe ode and my license is in full force
and effect. License Class License No Date k ( Contractor Signature
NORKERS' COMPENSATION DECLARATION
NARNING: 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
:OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
❑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
rel rmance of the work for which this permit is issued. Policy No.
have and
of
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'
Number
Date
I certify that, in the perform of the w k for which tt permit i ' a not employ any person in any manner so as to become subject to the workers' compensation laws of California, and ogre
t, if I should become su ' ct to the wor rs' compen wsions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant Da f 14 6g
CLARATION REGA UCTION LENDING AGENCY
;rebyaffirm under penalty Or perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
ider's Name Lender's Address
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
I agree to comply with all applicable city and county gxhawroK and state laws relating to building construction.
I authorize representatives of this city or county VSkeLthe ab)ve-_t1Ja"fi0Xrl for inspection purposes. _ „/�� y/ 7, kX
11
of
PERMITCANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATEOF
OCCUPANCYISSUED
Owner or Authorized
I DATE I BY
OF COMPLIANCE WITH CODE OF FEDERAL
PART 61 OF TITLE 40 AND AQMD RULE
IS NOTAPPLICABLE TO
FOR OFFICE USE ONLY
• • • • • • • • • •
i