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Home My WebLink AboutX2013-2014 - Permitsww' City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2013-2014 a 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 3 2 0 1 4 Project No : 1701-2013 Permit Counter Phone (949)644-3288 `O,r;¢* Combination Type - SFP ELEC PLUM Inspection Requests Phone (949)644-3255 INSPECTOR Job Address: 15 SAN SEBASTIAN NB Issued Date : 07/26/2013 Description:SFR - R/R FIREBOX Inspector Area: 6 Legal Desc.: N TR 9860 LOT 17 Owner: TRINITY CHRISTIAN CENTER Contractor: JUSTIN CONSTRUCTION Architect: Address: 2442 MICHELLE DR Address: 11443 KNOTT AVENUE Address: TUSTIN, CA 92780 CYPRESS CA 90630 ° ° .... Phone: 714-325-1096 Phone: 714-315-4480 Phone: State Lic: Applicant: JUSTIN CONSTRUCTION Con State Lic: 812129 Engineer: Address: 11443 KNOTT AVENUE Lic Expire: 08/31/2014 Address: CYPRESS CA 90630 Bus Lic: BT30044166 Phone: 714-315-4480 Lic Exp Date: 07/31/2014 Phone: State Lic: Code Edit : 2010 Worker's Compensation Insurance Designer: Type of Construction: VB Carrier: EXEMPT Address: ° Occupancy Group: R3 Policy No: Added /New sq.ft. Bldg: 0 Expire: Phone: Added /New sq. ft. Garage: 0 No of Stories: 1 Building Setbacks Rear: / Special Conditions: No of Units: 1 Front: / Bldg Height: 0 Bldg Sprinklers: Left: / Right: / / Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N �" f Construction Valuation: $6.000.00 Building Permit Fee: $156.68 Solar System PC : $0.00 Planning Department- Fire Department Plan Check Fee: $112.81 Excise Tax: $0.00 Plan check Fee : $31.25 Fire Inspection: $0.00 Overtime Plan Ck: $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 Investigation Fee: $0.00 SJH Trans : $0.00 Demolition Fee Record Management: $12.00 Grading Permit Fee: $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $0.00 Energy Compliance: $0.00 Grading PC Fee: $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 Fee Increase: Fee: $0.00 Electrical %: $10.97 San Dist: $0.00 Additional Fee : $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Hazardous Mat : $0.00 Plumbing %: $15.67 $0.00 Building Green Fee : $1.00 TOTAL FEE : 40.38 Plan Check Fee : $340.38 Fee Due at Permit Issuance : $0.00 PROCESSED BY: PUBLIC WORKS AP OVAL: APPROVAL: Q ZONING PLAN CHECK BY:pp GRADING APPROVAL: APPROVAL TO ISSUE: V� PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID 1NSPECTIO . INSTALL OR VERIFY SMOKE AND CARBON MONOXIDE DETECTORS ARE EXISTING PER CRC 31 .1 & 315.2 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"ore than five hbndred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) 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 exerpptjrpm licensure under the Contractors' State License Law for the following reason: my signature pglbw 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 legally I q, structure Nat 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 Ifecsions "oda, is available upon request when this application is submitted or at the following Web site:http://www. leginfo.ca.gov/calaw.html. nature of Ffoperty Owner or Authorized Agent Date %NSED CONTRACTOR'S DECLARATION ffeby affirm-under�)enalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Secti�0) f Divi ion 3 0 e' usiness and Profess'ons Code, and m lice se is full force i IeVect. L9osnse Class License No ate 7 tractor Signature 9RKERS' GOMPPENSATION DECLARATION eJI FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER /ES. IMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDI J TO THE WOF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S Ibo affirm Ujider penalty of perjury one of the following declarations: eS hd've anriwi.ll*maintain a certificate of consent to self -insure for workers' compensation, issued by the rfTnce of the work for which this permit is issued. Policy No. ave and III rridlntain workers' compensation insurance, as required by Section 3700 of the Labor Code, ante carrier and policy number are: Policy Number Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for for the performance of the work for which this permit is issued. My workers' Date ly 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 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. of DECLARATION REGARDING CONSTRUCTION LENDING AGENCY 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 ender's Name Lender's Address y 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 topp enter the above -i ent'fi p perty for inspect'lo .purposes. nature of Property Owner or Authorized Agent /A� Lirbf rn 47 erty Owner's or Authorized Agent's Name Civil Code). A1:THNt IM 7F RV A f EWITH4ODEt7F ON ()FNLt FEDERdLRE VLARDNSPARTB1OFTiPiE4PAN6 AOWRI/LC1403' PFRk#fT:FXPIRFn r srmzf+Trrrratf�Tns NonrlrnTlnN rn: EPA PERA41T CRPICELLED PERWITEXT€A01FD ASBESTOS NOBFICARM fS NOT APPLICABLE TO PROPOSEDDEMOUTION PLRMIT T11V4L 1P A_A_,. CERTrFrCATEOF �l3 �/ ty po ~" SIGNAIUHL: OCCURAIJCYUSUEP Z3 1