HomeMy WebLinkAboutX2019-0234 - PermitsCity of Newpoft Bench° B0i'dtgg Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit ;X2019-0234
100 Civic Center Drive �Nervport`6'aph G/ 62E30 a x 2 0 1 9 6 2 3 a Project No: 0174-2019
Permit Counter Phone (949)644-3288 " °
er inspection Requests Phone (949)644-3255
C51
Combination Type, Cdl3°GRAI),'El-Fe MECH• Pi,.UM �. Issued Date: 06/19/2019
co ,
Inspection Area
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° °PERMI°Tso�EMA1RE 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: 4700 LIDO SANDS DR NB
Description: NEW COMM COMMUNITY POOL HOUSE 1,150 SF
Legal Desc.:
Owner: SANDS COMMUNITY ASSN LIDO
Contractor:
MILO CONSTRUCTION Architect:
FULSANG ERIC .-1 f
Address: PO BOX 1373
Address:
101 VIA MONTE PICAYO Address:
3471 VIA LIDO STE202 T' '
NEWPORT BEACH CA 92659
SAN CLEMENTE CA 92673
NEWPORT BENCHrOA 92561.;,;? 4
Phone:
Phone:
949.290-6429
Phone:
949.838-4139 State Lic:C030716
Applicant: FULSANG ERIC
Con State
Lic: 871429
Engineer:
Address: 3471 VIA LIDO STE 202 -
Lic Expire:
03131/2020
Address:
NEWPORT BEACH CA 92663
Bus Lic:
- ST30038762
Phone: 949-838.4139
Lic Exp Date: 03/31/2020
Phone:
State Lic:
Code Edit: 2016
Worker's Compensation
Insurance
Designer:
Type of Construction: V -B -SPR
Carrier:
NO EMPLOYEES Address:
Occupancy Group: A3
Policy No:
Added /New sq.ft. Bldg: 1150
Expire:
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 1
Building Setbacks Rear: 10
Special Conditions: LIQUEFACTION AREA
No of Units : 0
Front: 20
Bldg Height: 0 .
Left: 4
Bldg Sprinklers:�1t
Right: 4
Flood Zone: 'J.2
Use Zone:
Parking Spaces:
0 Fire Hazard
Zone : N
Construction Valuation: $650,000.00
Building Permit Fee: $4,327.00
Excise Tax:
$241.50
Planning Department-
Fire Department
Plan Check Fee: $3,764.49
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
$547.00
Investigation Fee: $0.00
Grading PC Consultant:
$1,161.12
SJH Trans :
$0.00 Demolition Fee
Record Management: $182.00
Grading Permit Fee:
$1,171.00
In -lieu Housing Fee ;
$0.00 Building Dept Adm
$0.00
Energy Compliance: $455.00
Grading PC Fee:
$254.88
Public Works Department -
General Service
$0.00
CA Seismic Safety: $182.00
WQ Insp. Fee.:
$0.00
Park Dedication : $0.00
Refund Deposit
$0.00
Disabled Access: $650.00
PIW Plan Check: $247.50
Grading Bond:
$0.00
Hazardous Mat $0.00
Electrical %:
$1,132.81
San Dist: $0.00
Building Green Fee : $26.00
Mechanical %:
$890.06
NMUSD Fee: $251.70
$0.00
Plumbing%:
$728.23
$0.00
TOTAL FEE : $1 12.29
Plan Check Fee :
$6,207.41 Fee
Due at Permit Issuance : $10,004.88
PROCESSED BY:
PUBLIC WORKS APPROVAL:
ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
APPROVAL TO ISSUE:
•.• s • 0- •e 4
*0
OWNER -BUILDER DECLARATION o
I hereby affirm under penaltyof perjury that I am exempt from the Contract rs' State License Law for the reason(s) indicated l5q)Jw by the oheckmark(si I IrMoplaced next to the applicable item(s)
'Section 7031.5, Business and Professions Cade: Any city or county that req emolish, 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 th ` e 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 all i 1 tion of action 70 1.5 by any applicant:gr a pLI t wtje cts the applicant to a civil penalty of
lot more than five hundred dollars ($500). '' : : �' • ;,' : • • • ; ;
:11, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the wtlk, andthe structure i got int%cled or offered for sale (Section 7044,
3usiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employess'VIIpersondl 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
Em 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).
❑ I am exempt from licensure under the Contractors' State License Law for the following reason:
By my signature below 1 acknowledge that, except for my personal residence in which 1 must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally
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://w .leginfo.ca.govlcalaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Secti n 00 of Division of the Business and Pr. fe sions oIt and m licens@_,,y�Jn full force
and effect. License Class License No t �� L Contractor Signat �fA SQ— fg47 a
WORKERS' COMPENSATION DECLARATION
NARNING: 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 ($700,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 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 Cade, for th
performance of the work for which this permit is issued. Policy No.
❑I 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' compensatiol
Itttsurance carrier and policy number are:
Policy Number
lade of Agent 1OV, 1. f
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 becomesubject to the worcompensation laws of California, and agre
Wit, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
ignature of Applicant i !y- /9
IECLARATION REG CONSTRUCTION LENDING AGEN
hereby affirm under penalty of perjury that there is a construction nding agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
ender's Name Lender's Address
ly 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 to er the above-identified,pro�`rty for inspection purposes.
lianature of Prooertv Owner or Authorized ADellit�l�G w� o� 'Z�'+1� Print Property Owner's or Authorized Agents Names v/Y6GHld 6 GO�I+� Date 'l
ACTION
PERMITEXPIRED
PERMIT CANCELLED
CERTIFICATE OF
OCCUPANCYISSUED
DATE BY DECLARATION OF COMPLIANCE INITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE
SUBMITTED
TO
NOTIFICATION IS NOTAPPLICABLE TO
PROPOSED DEMOLITION