HomeMy WebLinkAboutX2019-3214 - Permitstr City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIII II
100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 3 2 1 4
,+ Permit Counter Phone(949)644-3288
'cT Inspection Requests Phone (949)644-3255
"aS.csra'`b Combination Type- SFP GRAD ELEC
COMB Permit: X2019-3214
Project No : 2220-2019
Issued Date : 1012212019' -
Inspection Area : 4
-
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
$412.00
Job Address: 26 HERMITAGE LN NB
Plan Check Fee: $365.00
Additional Fee: .
Overtime Plan Ck
Description: SFR -DETACHED OPEN LATTICE PATIO COVER 261 SF WIYARD DRAINAGE
Grading Bonds Fee:.
Z -.
Legal Desc : N TR 7223 LOT 109
Grading PC Consultant:
Record Management:
$0.00
Owner: Yl CHIN
Contractor. MICHAEL ROBERTS HOME BUILDER Architect: SKENDERIAN TODD
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Address: 26 HERMITAGE LN
Address: 6 CALLE ALIMAR
Address: 1100 S COAST HWY, #316
WQ Insp. Fee:
NEWPORT BEACH CA 92660
RANCHO SANTA MARG CA 92688.
LAGUNA BEACH CA 92677
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Phone: 949-858-7540
Phone 949-858-7540
Phone: 949.715.5461 State Lic C030518
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Applicant SKENDERIAN TODD
Con State Lic: 681116
Engineer: KHOURY NADER
`J, -
Address 1100.S COAST HWY, #316
Lic Expire: 09/30/2021.
Address: 1278 GLENNEYERE ST#201
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LAGUNA BEACH CA 92677.
Bus Lic BT30060668
LAGUNA BEACH CA 92651
Phone: 949-715-5461 -
Lic Exp Date: 09/30/2020
Phone: 949-637.8357 State Li¢C-061402
Code Edit 2016
Worker's Compensation Insurance
Designer:
Type of Construction:
Carrier. BENCHMARK INS CO
Address:
Occupancy Group: U.
Policy. No: CST5015128
Added /New sq.ft, Bldg: 0
Expire: 01/2412020
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 0
Building Setbacks Rear: I
Special Conditions:
No of Units : 0
Front:
Bldg Height:. 0
Left: /
_
Bldg Sprinklers:
Right: /.
Plead Zone: X
Use Zone' Parkinn Rnarwc 0
Fire Hazard 7nne N
Construction Valuation:
$3.550.00
Building Permit Fee.
$412.00
Excise Tax.
Plan Check Fee: $365.00
Additional Fee: .
Overtime Plan Ck
$0.00
Grading Bonds Fee:.
Investigation Fee:
$0.00
Grading PC Consultant:
Record Management:
$0.00
Grading Permit Fee:
Energy Compliance:
$0.00
Grading PC Fee:
CA Seismic Safety:
$0.00
WQ Insp. Fee:
Disabled Access: $0.00
Hazardous Mat $0.00 Electrical W
Building Green Fee : $1.00 Mechanical %:
Plumbing W
TOTAL FEE : $1,470.84
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
$0.00..
Planning Department-
$0.00
- Plan check Fee:
-$0.00.
Fair Share:
$0.00
SJH Trans :
$312.00
In -lieu Housing Fee:
- $312.00
Public Works
Department -
-$0.00
Park Dedication:
$0.00
PAN Plan Check:
$0.00
$28.84
San Dist:
$0.00
$0.00
NMUSD Fee:
.$0.00
$40.00
$0.00
$0.00
$0.00 `
Fire Department
Fire Inspection:
Fire Plan Rev
Demolition Fee
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
$0.00
Plan Check Fee : $405.00 Fee Due at Permit Issuance
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$1,065.84
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;DRF£'S APPROVAL:
PLAN CHECK BY:
v: o APPRGV'RL TOO ISSUE:
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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
he 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
lot 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,
iusiness 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
mprovements 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
Jroved for the purpose of sale).
1, 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
Ipply 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:
3y my signature below 1 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
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 7044 of the Business and
'rofessions Code, is available upon request when this application is submitted or at the following Website: httpl/www.leginfo.ca.gov/calaw.htmi.
iignatureof 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 700 ) of Division 3 of the Business and Proff�@��,,sslIons Code, an y e e In full force
Ind effect. License Class License No Date D Contractor Signaturg�CN
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 ($100,000), IN ADDITION TO THE
:OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION $706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
7 I 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 thr
erfgrmance of the work for which this permit is issued. Policy No.
and1 alntain 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'
carria ar policy numbK are: n
of umber Expiration Date
of Agent< _ r ( 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 agree
I, if I should become, subject to the w9C e c p nsation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. s,�
nature of Applicant /� Ali/.�/^/ Datc�L1 21-4
CLARATION REGAVDIRG CONSTRUCTION LENDING AGENCY
areby affirm under p nalty 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 tgenter the aboye jdgntijied property for inspection purposes.
Owner or Authorized Agent Print Property Owner's or Authorized Agent's N e nL/�✓c' V"
DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403 • y•• •••
I SUBMITTED ASBESV,5 NOT(FICATION•"AJ •�
PERMITEXTENDED ZX> UAQMD
PERMITFINAL LttU ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATEOF PROPOSED DEMOLITION •• ••• • • • •••
OCCUPANCY ISSUED SIGNATURE: _