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HomeMy WebLinkAboutX2018-0488 - Permitst City of Newport Beach - Building Division a. 100 Civic Center Drive, Newport Beach, CA 92660 tom. Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 atrmirtp '� Combination Type- SFP PLUM ELEC 4 Job Address: 19 RENATA Description: SFR -STUCi Legal Desc.: N TR 15488 Owner MATINPOUR Address: 19 RENATA itr NEWPORT B Phone: 949.279-8601 Applicant: OAKWOOD C Address: 4955 E. HUNT ANAHEIM CA Phone: 714-529-.8300 Code Edit: Type of Construction: Occupancy Group: Added /New sq.ft. Bldg: Added /New sq. ft. Garage: No of Stories: 2 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR L, r ion fdetr i#onday - Friday 7:00 u.m, and. Saturday from t H AR WALL RPRIPLUMBING/ELEC REAR OF CH 5 s,>.. II 1 0 Ass: E. E H, A 9 ANAHEIM CA 92807 Phone: 71 -5 - iT CTI EA: o e 6 2 4VFJ 07B 0 128 E D Lic Exp Date: 0 513 112 01 9 COMB Permits X2018-0488 Project No : Issued Date: 0 212 0/2 01 8 1-h95WdrSnXtea : 6 No work on El 80% or 0 100% refund to AXhM: Address: Phone: State Engineer,; HELFRICH STEVEN Address:Z''y.30640 KRISTIN CT `REDLANDS CA 92373 Phone: 909-389-7316 State Workers Compensation Insurance Designer.. Carrier: I OF THE S F rttlr,FSa:, ,.y 841FTH EC tl�Ja...-.Af pi 12016 Phone: (w "SpEatd) t - (naw ecial Condi ��:} -R Note: ,� - Left: I.�` _ Noty e. - a.rR�� c.,..on Pi.e W�,.M 7.,,,e_ M V-� a V $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Construction Valuation: 5 0.00 "'t"` °`°°'°'°°"" itr r 8uildingpermit Fee: $1121O; ExciseSax._ --=0!98 ii�epa ment - Fve Department Plan Check Fee: $97.44 ` Additional Fee : $0.00 Plan check Fee: $0.00 Fire Inspection: Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev 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 Energy Compliance: $0.00 Grading PC Fee: $0.00. Public Works Department - General Service CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication : $61.o0 Refund Deposit Disabled Access : $0.00 PAN Plan Check: $0.00 Grading Bond: Hazardous Mat $0.00 Electrical %: $7.84 San Dist: $0.00 Building Green Fee : $1.00 Mechanical %: $0.00. NMUSD Fee: $0.00 Plumbing %: $10.08 TOTAL FEE : $228.36 Plan Check Fee: $228.36 Fee Due at Permit Issuance PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 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) iection 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 Ie 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 'rofessions 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 of more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U 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 nprovements are not intended or offered for sale. If, however, the buildingorimprovement is sold within one year of completion, the,Owner-Builder will have the burden of proving that it was not built or n 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 only 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: y my signature below I acknowledge that, except for my personal residence in which I must have resided for at laast one year prior to completion of the improvements covered by this permit, I cannot legally ell a structure that 1 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 '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 Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force nd effect. License Class License No Date Contractor Signature YORKERS' COMPENSATION DECLARATION ARNING: 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 ($100,00D), IN ADDITION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 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 )rmance of the work for which this permit is issued. Policy No: - 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' compenss rance carrier and policy number are: Policy Number Date is of Agent - Fmone 77 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 , if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. of CLARATION REGARDING CONSTRUCTION LENDING AGENCY -reby 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 owners 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 to enter the above -identified property for inspection purposes. nature of Property Owner or Authorized ADent - Print Property Owner's or Authorized Agent's Name ACTION DATE BY DECLARATION OF II REGULATIONS PA T0610 TIITLE 40 AND QMD RULE CE WITH CODE OF AL FOR OFFICE USE ONLY PERMIT EXPIRED 10-7.-20 -(SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED OEPA PERMIT EXTENDED 13AQMD PERMITFINAL CERTIFICATE OF OCCUPANCYISSUED OASBESTOS NOTIFICATION IS NOTAPPLICABLE. TO PROPOSED DEMOLITION SIGNATURE: Date