HomeMy WebLinkAboutX2020-1695 - Permits1 City
o Center Drive, Beach
port Building, CA 92660 Division IIIIgIII�IIIIIIIIIIIII�II'�III�III�IIIIIIIIIII I II COMB Permit: X2020-1696
Et - Permit Counter Phone (949)644-3288 p 1' Y Project No: 1336-2020
Inspection Requests Phone (949)644-3255
Combination Type - SFP MECH ELEC PLUM Issued Date :
Inspection Arearea :2820
3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0810812023 OR PERMIT WILL BE INVALID
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: 453 TUSTIN AVE NB
Description: SFR REMODEL 350 SF
Legal Desc.: TR 919 LOT 27 BLK 1 5WLY 40 FT
Owner: LIBERTO CHADIERIN
Contractor:
EGO CENTURY CONSTRUCTION
Architect:
Address: 453 TUSTIN AVE
Address:
69 WILLOWOOD
Address:
NEWPORT BEACH, CA 92663
ALISO VIEJO CA 92656
Phone:
Phone:
949-636-7695
Phone:
State Lic:
....
Applicant: RICHART JASON
Con State Lic:
926023
Engineer:
JAMIL BASHAR S
o °
Address: 1041 W 18TH STREET
LIG Expire:
1213112020
Address:
751 SHASTA DR
COSTA MESA CA 92627
Bus Lic:
BT30050816
CORONA CA 92881
Phone: 949-422-9191
Lic Exp Date:
08131/2020
Phone:
714-883-4124 State Lic:C-083129
Code Edit: 2018
Workers Compensation Insurance
Designer:
Type of Construction: VB
Carrier:
EXEMPT
Address:
f °
Occupancy Group: R3iU
Policy No:
°°°o
Added /New sq.ft. Bldg: 0
Expire:
Phone:
�NSPEV
(/{, Q �p-�{
l°o
^
Added INew sq. ft. Garage: 0
No of Stories: 1
Building Setbacks
Rear: I
Special Conditions:°-
NoofUnits: 1
Front: I
Bldg Height: 0
Left: I
Bldg Sprinklers: N
Right: 1
Flood Zone: X
Use Zone: Parking Spaces: 0
Fire Hazard Zone : N
Construction Valuation: $28.000.00
Building Permit Fee: $520.00
Excise Tax:
$0.00 Planning Department
-
Fire Department
Plan Check Fee: $452.40
Additional Fee:
$0.00 Plan check Fee:
$41.50 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: $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
P1W Plan Check:
$0.00
Grading Bond:
$0.00
Hazardous Mat $0.00
Electrical %:
$36.40 San Dist:
$0.00
Building Green Fee: $2.00
Mechanical W
$20.80 NMUSD Fee:
$0.00
$0.00
Plumbing %:
$46.80
$0.00
II TOTAL FEE: $1,131.90 - Plan Check Fee
PROCESSED BY:
ZONING APPROVAL: \I/
GRADING APPROVAL:
$493.90 Fee Due at Permit Issuance : $638.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
I
hereby affirm um ler penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) t have placed next to the applicable Items).
(Section 7031.5, Busl:Iess and Professions Code: Any city or county that requires a permit to construct ager, 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 ricensed 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 U all of or U portions or 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
El
for the purpose of sate).
u 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 Lew 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' Stele License Lew).
❑ 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 peril, 1 cannot legal.
sell a structure that I have built as an owner4builder If it has not been constructed In its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 ofthe Business and
Professions Code, is svailable upon request when this application is submitted or at the following Web ske:hftp:/Avww.leginfa.m.gov/Calow.htmi. of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty, of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 0 f Ivist n 3 of the Business and Pro Ions C e, r license is in full (arca
and effect. License Class License No Dat Contractor SignatureRy�
NORKERS' COMPCNSATION DECLARATION >r`
VARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOU A LL.AR9IS100,0001, I ADDITION TO THE
MSTOF COMPENSATION, 0AMAGESAS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under p>nalty or perjury one of the following declarations:
7 1 have and will maintain a cefcste or consent to seg -Insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th
3,rrnance of the work for which -this permit Is issued. Policy No.
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'
rance carrier and policy number are:
e of Agent
xartlfy that
If I should
ature of AID
In the performance of the work
Policy Number Expiration Date
this permit is issued, 1 shall not employ any person in any mannerso as to become subject to the workers' compensation laws of California, and ogre
Olon provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Dale_.NG ENCY
hereby affirm under penalty of erj hat there is aconst ctlon lending agency for the performance of the work for which this permit is Issued (Section 3097, Civil Code).
.endel's Name Lender's Address
ly my signature below. I cetokkh of the following;
I am the property 0.vner r 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 couqqIIVV enter the Voy7en ed property for inspection purposes.
lanature Of Proverty Owner or Aufhnrbed Anen�%. 7// / / zAl�n
OF COMPLIA E WITH CODE OF FEDERAL
PART 610E LE 40 AND AQMO RULE
TO
PERM?FINAL $DEST ISI ICATON IS N 9APPUCABLE TO
CERTIFICATEOF I-�'� 0 OSED DEM ntO ��� ,M
OCCUPANCY ISSUED <v_uen,ec. G /'/ . /1 /i
USE ONLY
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