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X2014-1891 - Permits
+ City of Newport Beach - Building Division II�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2014-1891 X04'' d 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 4 1 8 9 1 Project No : 1537-2014 Permit Counter Phone (949)644-3288 _. Inspection Requests Phone (949)644-3255 - �' _ _- F�; ' Issued Date :03/24/2016 Inspection Area : l� ` _Z ~� If a licable: 4"'..;Date;-- -�"TS-r DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. p INSTALL OR VERIFY SMOKE/CARBON MONOXIDE DETggT86%1p.8FInG"� gvUff �PG ADED Job Address: N MIGUE NB LI Description M D 7 SAG • � I SS P �IS ePO F Legal Desc.: :�,OM 0625 OT to Wh0f71: Owner'..C.�R SS LLC tContractor: OWNERIBLDR Architect: KOLLIN MICR EL Address 6� DON HIGHLANDS CT Address: SANDOVAL LIONSO Address: 1350 CORONA )0 LONG BEACH A AVE Phone +-.� EX P Ph90804 one: 562-597.8760 State Lic:CO21173 a°°°� r�J1 Applicant KliLt11 LEO ConIRED Engineer: TUCHSCHER MES TODD ��' Address: 135U•C RO Lic Expire: Address: 5318 E. 2ND S STE539 ..... ° ° ° LOM,G EACH CA 90804 Bus Lic: BELMONT SH RE`GA 90803 ° ° ° Phone 562q'9 8760 Lic Exp Date: Phone: ! 310.613.9980 r; State Lic:C-077649 Code it: ':) �°°""d r ensation Ins rant i K"� a r sig 1e 8;�,,,•/,I}, Ff WW �� ° ° Type of Construetyon: El "4°A 9SyR -i F'-, `�q�dr ° Occupancy Group'TT u Policy No: Added/Newsgft BId 781 (work started) Expire: (no work Start?We. Added /New sq ft:`Ga ge: 0 No of Stories 2 Building Setbacks Rear: 6 Special Conditions: 0/B FO A ACHED No of Units: t�1 6 Front' 20 E FIE Bldg Height Note. eft: 6 ,�y Bldg Sprinklers N Right: 6 It sp. initials: �,J ftl� Flood Zone. X a=R-4-6000-Par Fire Hazard Zone : N .( �j Construction ValuatioL.J2.00J Building Permit Fee: $1,611.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $1,214.92 Additional Fee : $167.00 Plan check Fee : $320.00 Fire Inspection: $0.00 Overtime Plan Ck: $0.00 fair Share : $0.00 Fire Plan Rev $0.00 Investigation Fee: $0.00 Grading PC Consultant: $4,247.70 SJH Trans : $0.00. Demolition Fee Record Management: $120.00 Grading Permit Fee: $1,503.80 In-lieu Housing Fee: $0.00 Building Dept Adm $0.00 Energy Compliance: $120.00 Grading PC Fee: $1,061.92 Public Works Department - General Service $0.00 CA Seismic Safety: $26.00 WQ Insp. Fee: $23.20 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access : $0.00 PAN Plan Check: $377.50 Hazardous Mat $0.00 Electrical %: $112.77 San Dist: $716.00 Building Green Fee : $8.00 Mechanical %: $80.55 NMUSD Fee: $1,437.04 $0.00 Plumbing %: $161.10 $0.00 TOTAL FEE : $13,308.50 Plan Check Fee : $3,779.92 Fee Due at Permit Issuance : $9,528.58 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: PUBLIC WORKS APPROVAL:^ PLAN CHECK BY: ^Al� APPROVAL TO ISSUE: �Y`DYVIL 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 applicabte item(N action 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alte�T, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for 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 tpe Business and 3fessions Code) or that-heOr 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. t 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 U 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 rovemf@ nts 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 ved fdr the purpose of sale). 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 ply 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 legalh I 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 Aessions Co4e, WdVilable upon request whe4iication is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw. html. ` e;nature of Property Owner or Authorized Agent DM4e< /�^2N§ED CQNTRACTOR'S DECLARATI- rebyy affirm undeopenally of perjury that I am der provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force ffect. License Class License No Date Contractor Signature )RKERS' COMPIGNSATION DECLARATION RNINGI FAILURE i0 SErZRE 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 3Tbt COMPENJSTTJON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I db affirm undL ee:nalty 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 providedfor by Section 3700 of the Labor Code, for th Vftnce of tl}e worj forwhich this permit is issued. Policy No. hgavg 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 uranee carrier and,policy number are: mer : �.. - Policy Number Expiration Date me 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 agre t, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant Date_ CLARATION REGARDING CONSTRUCTION LENDING AGENCY areby 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). 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 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 t r the above -identified property for inspection purposes. '' 11 nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name�La T1 45h L O�Dat • 2 4 Ac:T"I DAYF AV DE✓'LARATfONCFCOMPLiANCELUTHCODEOF FOHDFHG'ttfs'tLMY F€DER4L REGULATIONS PART 61 OF RMEJO AND AOMURIKL4403. PFAMITFXPIRR) JO.Z.2p per,%`. lSI6ib6TTFI:.AS/Y-'ST!]S NTTTIFM_ATION Tfl: ❑ EPA ❑ A©AM ' PERMIT CAP; `,CLLLD PER WITEYTENDED 0 PSEEES TOS NOOIIrR 170HIS NOT APPLICABLE TO.. PlJiARIT fIriIAL GEATlFICATEOF OCCVPANCYiSSUED SIt NAI tM&: