HomeMy WebLinkAboutX2020-1351 - Permits�Yt
City of Newport Beach - Building Division
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100 Civic Center Drive, Newport Beach, CA 92660
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Permit Counter Phone (949)644-3288
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Inspection Requests Phone (949)644-3255
Address:
Combination Type - BLDG PLUM
*X20201351* COMB Permit: X2020-1351
Project No : 1938-2018
Issued Date : 06/10/2020
Inspection Area : 4
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0611112023 OR PERMIT WILL BE INVALID
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: 19 ST TROPEZ NB
Description: MFR 4'H DETACHED GAS PREFAB FIREPLACE INSPECTOR
Legal Desc.: TR 9858 LOT 4 UNIT 38 OF PROJECT LOCATED ON AP 461.131.39 TOGETHER
Owner:
MOUTSATSON SOPHIA G & JOHN
Contractor:
KESKY EDDIE GENERAL CONTRACTOR INC
Address:
19 ST TROPEZ
Address:
10841 BLOOMFIELD STREET
Address:
$0.00
NEWPORT BEACH, CA 92660
$0.00
LOS ALAMITOS CA 90720
$0.00
Phone:
949.400-4302
Phone:
562-795-5755
Phone:
Applicant:
KESKY EDDIE GENERAL CONTRACTOR INC
Con State Lie:
766265
Engineer:
Address:
10841 BLOOMFIELD STREET
Lie Expire:
09/30/2021
Address:
LOS ALAMITOS CA 90720
Bus Lie:
BT30057336
Phone:
562.795-5755
Lie Exp Date:
11/3012020
Phone:
Code Edit: 2019
Type of Construction:
Occupancy Group: U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 0
No of Units : 0
Bldg Height: 0
Bldg Sprinklers:
Construction Valuation: $2.000.00
Building Permit Fee: $104.00
Plan Check Fee: $90.48
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$0.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $204.84
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Worker's Compensation Insurance
Carrier: REDWOOD FIRE
Policy No: EDWC113447
Expire: 01/0112021
Building Setbacks
Use
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: /
Front: /
Left: /
Right: I
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$9.36
Designer:
Address:
Architect:
State Lie:
MONTGOMERY MARTELLB
2226 FARDAY AVE
CARLSBAD CA 92008 ....
760-931-0290 State Lic:C-050344
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Phone: c..L�,�
Special Conditions: h10 SC's ` 0a (-S
Planning Department -
Fire Department
Plan check Fee,
Fire Inspection:
Fair Share
Fire Plan Rev
SJH Trans
Demolition Fee
In -lieu Housing Fee:
Building Dept Adm
Public Works Department -
Park Dedication :
$0.00
PAN Plan Check :
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Plan Check Fee: $0.00
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$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Fee Due at Permit Issuance: $204.84
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
0
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Fire Department
$0.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
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c000cc
0
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0
mm..
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Fee Due at Permit Issuance: $204.84
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
0
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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 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 (_) 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
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).
J 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
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 7i
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.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 Sectin70 0) fvi n.3 of the Businss and Profs ode, a
Ind effect. License Class License No Da (l ContraSignatur
VORKERS' CQNPUNSATION DECLARATION
%RNING: FfAILURE TO ORDURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLI
:OSTiQF4MPENSA'DgI� DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
Rereby Affirm uad&ppalty of perjury one of the following declarations:
of the Business and
license is in full force
($100,000), IN ADDITION TO THE
.gage and willmaintain 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
xmance of the, work•for which this permit is issued. Policy No.
• .••I
fitl�eand will mainlein 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' compensa
inp: ....
carrier number are: Policy Number Expiration Date
ertik that, n the, Narforman of o 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 agre
111 should ¢�bbmeSubje to t or rs' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. `
••.• 6 -/o
dtl]re of A f! ca0t • � RZD
CLARATION REGARDING CONSTRU ION LENDING AGENCY
:reby affirm under penalty of perjuryat 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 isWde
I agree to comply with all applicable city and county or Inanc ws relating to building construction.
I authorize representatives of this city or r�ounty toe er th ovd property forinspection purposes. ^
—+—..f 0r,.—du n...,., �r A„1hnriv, A„a,>� Print Prooertv Owner's or Authorized ADent's N e
DATEI BYE DECLARATIOI REGULATIONN9PATGI OFANCE WITH TIITE 40AND ODE OF ACMD RULE AL I FOR OFFICE USE ONLY
PERMIT EXPIRED I I I U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITFINAL I/0_,5_22 i3j,U ASBESTOS � GNATURE:NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OFPROPOSED DEMOLITION
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OCCUPANCY ISSUED
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