HomeMy WebLinkAboutX2019-1553 - PermitsCity of Newport Beach - Building Division
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COMB Permit: X2019-1553
2 1 9 1 5 5 3
100 Civic Center Drive, Newport Beach, CA 92660
X 0
Project No: 0832-2018
Permit Counter Phone (949)644-3288
a
Inspection Requests Phone (949)644-3255
Combination Type - SFP ELEC
Issued Date : 05/16/2019
Inspection Area : 2
PERMITS EXP/RE 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: 523 SANTA ANA AVE NB
Description: SFR *REPLACE EXPIRED* DRYWALL REPAIR DUE TO FIRE
DAMAGE IN GARAGE 1,130 SF
Legal Desc.: FIRST ADD TO NEWPORT HEIGHTS BLK 31 LOT 19
Owner: ABALONE GROUP LLC Contractor:
OAKWOOD CONSTRUCTION Architect:
DENGHAUSEN HOWARD
-
Address: 523 SANTA ANA AVE Address:
4955 E. HUNTER
AVE Address:
P.O. BOX 3381`"'r";.;,
NEWPORT BEACH, CA 92663
ANAHEIM CA
92807
NEWPORT BEACH CA 92659
Phone: Phone:
714-529-8300
Phone:
949-735-2580 State Lic:C014281
Applicant: DENGHAUSEN HOWARD Con State Lie: 762628
Engineer:
YAGHI SHUCRI (-
Address: P.O. BOX 3381 Lie Expire:..
05131/2021
Address:
112 E. CHAPMAN #13
.,
NEWPORT BEACH CA 92659 Bus Lie:
BT30063128
ORANGE CA 92866
Phone: 949-735-2580 Lie Exp Date:
0513112019
Phone:
714-997-9120 State Li¢C-043205
Code Edit: 2016 Worker's Compensation Insurance
Designer.
.r..r13
Type of Construction: V -B Carrier:
AMERICAN HOME ASSUR. Address:
Occupancy Group: R3IU Policy No:
WC014629593
-
Added /New sq.ft. Bldg: 0 Expire:
07101/2019
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 2 Building Setbacks
Rear: /
Special Conditions: REPLACE.EXPIRED PERMIT
No of Units : 1
Front: /
`°X2018-1030 & J(2Q18-7396 ``
Bldg Height: 0
Left: /
\
Bldg Sprinklers:
Right: I
Flood Zone: X Use Zone:.
Parking Spaces:
0 Fire Hazard Zone : N
Construction Valuation: $0.00
Building Permit Fee:. $0.00 Excise Tax:
$0.00
Planning Department-
Fire Department
Plan Check Fee: $0.00 Additional Fee :
$341.04 -
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: $0.00 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
PM Plan Check: $0.00
Grading Bond: $0.00
Hazardous Mat $0.00 Electrical %:
$0.00
San Dist: $0.00
Building Green Fee : $0.00 Mechanical W
$0.00
NMUSD Fee: $0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE : $341.04
Plan Check Fee
: $0.00 Fee
Due at Permit Issuance : $341.04
PROCESSED BY:
.
.... . .<. 00.
` OUBL°ICeWORKS APt~rdOVAL:
m a
ZONING APPROVAL:
e
• * 4PLAN ENECK BY:
(77
GRADING APPROVAL:
APPROVAL TO ISSUE:
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c
ouoo X00 « 0 0 000 0�
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).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do C-) 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
im 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).
❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason:
By 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 legaiii
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.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 Section 700 of D' isio $ of the Business and Pr fe il! 0 and rpyjica igin full force
and effect. License Class License No Date ! Contractor Signatur
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 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
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
a of the work for which this permit is issued. Policy No.
have and will n4intain workers' cor
rance carrier n olicy number are:
Of
insurance, as requjted by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers'
Date
certify that, in the performance ork fo�:�
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
I. if I should becomes je o the
rke 'n provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant /1 Dat �7
CLARATION REGA DIN ONSTRUCTION LENDING AGENCY /
Jreby affirm under nal of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 309 ,Civil Code).
Jder's Name Lender's Address
my signature below, 1 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 ces and state laws relating to building construction. /
I authorize representatives of this city or couunt/ft enter th above-ide tified property for inspection purposes. ^'tom �� ` y� �� 11D 9
nature of Prooertv Owner or Authorized AOein A /L Print Property Owner's or Authorized Agent's Nam \ 1 a 1 C-'���
PERMIT EMENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCYISSUED
OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
PART 61 OF TITLE 40 AND AQMD RULE
1403
M ASBVrOS NOTIFICATION 15 NOT APPLICABLE TO
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