HomeMy WebLinkAboutX2018-2224 - PermitsCity of Newport Beach 4Buiii9inY� CBiKisitgne•• IIIIIIIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIII II
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100 Civic Center Drive, Newport Beacji, CQ qqo o m® ®� o m X 2 0 1 8 2 2 2 4
Permit Counter Phone (949)644-3288• • • • • • ®• o
Inspection Requests Phone (949)644-3255
Combination Type -BLDG • • • • •
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COMB Permit: X2018-2224
Issued Date :
Inspection Area : 8 a ,
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Construction Hours: Monday - Ffift � t0 6:3R m. aN ! 2t :00 a.m. tQ � of k on Sundays or Hob y�+;.
Job Address: 2191 MESA DR NB . �v tJ�� v
Description: SFR PRE -CAST WALL 6' HI X 500 LF INSIDE P/L ` S-6 E" STOP WOR
Legal Desc.: TR 706 LOT 161 NWLY1/2 fi�s.� to �00M. --'"-�
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Owner: MOORE SEPARATE PROPER Contr E.sp 1W, ed: +"55
Address: 2191 MESA DR Addr s: Address:
NEWPORT BEACH, CA 92660
Phone: 714-717-7019 hon Don State LiaApplicant: MOORETHOMAS on State Lie: O/ r. KRASUSKILESZEKAddress: 2191 MESA DR Lic Exp' : 18403 COLLINS STDG:
NEWPORT BEACH, CA 92660 s Lic vise
TARZANA, CA 91356 , A
Phone: 714-717-7019 Exp Phone: 818-343-9627 A� f�-7358_
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Cade Edit: 2016 Wor omp sation Insurance OPhon
ig er: A,
Type of Construction: ier: a\
Occupancy Group: U Policy No: e 5�.c'3� J21
Added /New sq.ft. Bldg: 0 Expire: rrrrrr qqq ;,�8 e:1�0
Added /New sq. ft. Garage: 0 .� �^s �s^
No of Stories: 0 uildi Se g r. 25,.t Special Conditions: 118-2215 �^ I -
No of Units: 1 ' ig�htt}}+�, ' d) AB -F M ATTAC
Bldg Height: 0 c , t111t16 ('".
Bldg Sprinklers: 1 Right: 5' �1l ^' �` F;,y
Flood Zone: Use Zone: Parking Spaces: Fire Hazard-Zoffe-`N
Construction Valuation: $60.000.00 t��
Building Permit Fee: $786.00 Excis Tp`� $0.00 Ian ' epSRment - Fire Department
Plan Check Fee: $683.82 Additi al Fee : 0 an check Fee : $37.50 Fire Inspection: $0.00
Overtime Plan Ck: $0.00 Gradin Bgods-Fe' : Fair Share : $0.00 Fire Plan Rev $0.00
Investigation Fee: $786.00 Gradin C tt6tlr: $0.00 SJH Trans : $0.00 Demolition Fee
Record Management: $0.00 Grading rmit 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 P/W Plan Check: $0.00 Grading Bond: $0.00
Hazardous Mat $0.00 Electrical %: $0.00 San Dist: $0.00
Building Green Fee : $3.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00
Plumbing %: $0.00 $0.00
TOTAL FEE : $2,296.32 Plan Check Fee: $721.32 Fee Due at Permit Issuance : $1,575.00
PROCESSED BY: PUBLIC WORKS APPROVAL: �r
ZONING APPROVAL: PLAN CHECK BY: •U
GRADING APPROVAL: APPROVAL TO ISSUE:
",I...,
OWNER -BUILDER DECLARATION ••
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(aj i dicaled-b Iovwb,�rthe check ma rk(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, demorish, 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 sheds exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by my appligant f;r 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 (_) portiol% of4he work:andthe strueiuB i nit 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, Mughamployeea' orpersonaleifo .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
ap ly 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 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
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 t is appli n is mitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date _ I
LICENSED CONTRACTOR'S DECLARAMR-
I hereby affirm under penalty of perjury that I am licensed under pmV11tI4ns of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force"
and effect. License Class License No Date Contractor Signature
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 ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
I 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 Code, for
ormance of the work for which this permit is issued. Policy No.
ynd'"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'
carrier and policy number are:
Policy Number
Date
la a of Agent vnone s
a- rt 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 agree
'at,
f I should become subject to the wprrkcompens tion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Iignature of Applicant�5 J 1� D e v
IECLARATION REG NG CONSTRUCTION LEN IN AGENCY
hereby affirm under penalty of perjury that there is a co truction lending agency for the performance of the work for which this permit is issued (Section 309 , 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 ente t e ab o -id ntifieer - d property for inspection purposes. (. _
linnahve of Pmnertv owner or Authorized Anent A/ h �\ t�V'� Print Prooertv Owner's or Authorized Agent's Name O'v,� j'( IOClv., Date
ACTION DATE BY DECLARATIOVF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY V \
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMITEXPIRED I ❑ I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT EXTENDED
UAQMD
PERMITFINAL
LJ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF
PROPOSED DEMOLITION
OCCUPANCYISSUED
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