HomeMy WebLinkAboutX2019-3487 - Permits,., City of Newport Beach - Building Division
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COMB Permit: X2019-3487
100 Civic Center Drive, Newport Beach, CA 92660
X 2 0 1 9 3 4 8 7
Project No: 2220-2019
ti Permit Counter Phone (949)644-3288
.Inspection Requests Phone (949)644-3255
e'rrrr�5� Combination Type - SFP ELECMECH PLUM
Issued Date , 10/31/2019
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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
Job'Address: 26 HERMITAGE LN NB
Description: SFR *ADD'L SCOPE* KITCHEN REMODEL 50 SF
`
Legal Desc.: N TR 7223 LOT 109
owner: YJ CHIN Contractor:
MICHAEL ROBERTS HOME BUILDER INC
Architect I NS P D"'31
SKENDERIAN TODD
Address: 26 HERMITAGE LN Address:
6 CALLE ALIMAR Address:
.1100 S COAST HWY, #316
NEWPORT BEACH CA 92660
RANCHO SANTA MARG CA 92688
- LAGUNA BEACH CA 92677
Phone. :.949-858-7540 Phone:
` 949-858-7540
Phone
949-715-5461 >-. State Lic:C030518 °
Applicant SKENDERIAN TODD Con State Lic
: 681116
Engineer:
KHOURY NADER o.
Address. 1100 S COAST .HWY,#316 Lic: Expire:
` 09/30/2021'
- Address;.:
1278 GLENNEYERE'ST#201 °°m°O° m°°
' LAGUNA BEACH CA 92677 Bus Lic
: BT30060668
LAGUNA BEACH CA 92651®I
Phone: 949-715-5461 Lic Exp. Date
:. 09/3012020:
Phone: :
949.637-8357 ' State Lic:C-061402
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o
Code Edit: 2016 Workers Compensation
Insurance"
: Designer.
Type; of Construction: VB ° Carrier:
BENCHMARK
INS CO Address.
Occupancy Group: R3IU Policy No:
CST5015128
......
Added /New sq ft Bldg: : 0 Expire:
01124/2020:
Phone
Added /New sq. ft. Garage 0
No of Stories 1 Building Setbacks
Rear: /
Special Conditions: REV19.1822, DELTA 1
No of Units: 1
.Front: I
`
Bldg Height: 0
Left I
cc o:°0p1p�
Bldg Sprinklers
Right I
`oo�� o000
'Flood
Zone. Use Zone: Parking Spaces:
0 Fire Hazard Zone:N`
Construction Valuation: $4.000.00
Building Permit Fee: $136.00 Excise Tax.
$0,00
Planning Department -
Fire Department
-Plan Check Fee: $118.32 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: :`$6.00 :Grading Permit Fee:
$0.00
In -lieu Housing fee. '-$0.00
Building Dept. Adm $0.00
Energy Compliance: :x$0.00 Grading PC Feel.
$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
'PAN Plan Check: _$0.00
..Grading Bond $0.00
Hazardous Mat'- - $0.00 Electrical %:
$9.52
San Dist: $0.00
Building Green Fee: -.$1.00 Mechanical %:
-..$5.44
NMUSDFee: - $0.00
$0.00
Plumbing %:
:$12.24
.' . $0.00
TOTAL FEE : $288.5 Plan Check Fee:
$0.00 Fee Due at Permit Issuance : $288.52
PROCESSED BY:
! PUBLIC WORKS APPROVAL:
..
ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
APPROVAL TO ISSUE:.
i
I
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).
❑, 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,
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).
❑ I am exempt from licensure under the Contractors' State License Law for the following reason:
Byi 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 Q0WTMCTOR'S DECLARATION /
I hereby affirm under denalty of perjury that I am licensed under provisions of Chapter 9 (commencing with S ti 000) of Div'sion 3 of the Bus and Professigns QW01ode an. my icens is in full force
tl. ect. LicenseC1ass - License No .ate Contract Ignature
WORKERS' CONIPENSATION DECLARATION
ARNINO: 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
OSl dF COMPEVAT1001, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
j11greEyaffirm Dgile6r enalty of perjury one of the following declarations:
I*have and wlig R.Intain 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 IN
worinance Agee wo* for which this permit is issued. Policy No. I.
Band will Tnaintain 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' compensatio
near ripe carrier-ang pplicy number are:
Calrrier f ' Policy Number Expiration Date
..I..
Majpep}Agent •' • Phone#
the
I 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 work rs' compensation laws of California, and ogre
that, if I should become subject to th w ker c pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with provisions.
Signature lic'a to 1
0131
DECLARATIO EGARDING C S RUCTION LENDING AGENCY
I hereby 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 30 , Civil Code).
Lender's Name': Lender's Address
By 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 readthis application and the information I have provided is correct
I agree to comply with all applicgble city and county ordinances and state laws relating to building construction.
I authorize representati f. -this' city -or county t n r the bo d ntified property for inspection purposes.
Signature of Pro ert Owner brtAuthorized Agent - Print Property Owner's or Authorized Agent's Na
ACTION I DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
I ant
PERMITEXPIRED U I SUBMITTED ASBESTOS TIFICATION TO
PERMITCANCELLED EPA
PERMIT EXTENDED q -
PERMIT FINAL'�� TOS NOTIFICATIONION/PLICABLE TO
'CERTIFICATEOF' DE 10
O&UPANCYISSUED RE:
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