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Home My WebLink AboutX2019-2988 - Permits1, City of Newport Beach - Building Division COMB Permit: x2019-2988 < w IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Planning Department - Fire Department Plan Check Fee: $216.76. Additional Fee : $0.00 Plan check Fee : $40.00 II c'r 100 Civic Center Drive, Newport Beach, CA 92660 $0.00 X 2 0 1 9 2 9 8 8 Project No :2088-2019 C~ Permit Counter Phone (949)644-3288 $0.00 - Inspection Requests Phone(949)644-3255 $0.00 Grading PC Consultant: E'<iraw+*,g Combination Type- MFP MECH ELEC PLUM SJH Trans : Issued Date : 0913012019 $0.00 Demolition Fee Inspection Area : 3 PERMITS EXPIRE 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: 14 BIG DIPPER NB $0.00 Description' MFR REMODEL (2) BATHROOMS 80 SF (2 Energy Compliance: °1r4, E-T®�ry Legal Desc : TR 8835 LOT 6 UNIT 11 P-11 G-11 CPA OF PROJECTLOCATED ON AP � S Owner: '. WHEELERMOLDEN Contractor: PYXIS WATER SYSTEMS INC Architect: .Address: 9104 HIGH OAK CT Address: 8544 HAMILTON AVENUE Address: FAIR OAKS, CA 95628 HUNTINGTON BEACH CA. $0.00 Phone: Phone: - Phone: State Lie: Applicant: KIMBLE STEVE Con State Lie: 896753 O Engineer: HOLDEN KELLY Address: 9121 ATLANTA AVE #882 Lie Expire: 05/3112021 - Address: 9104 HIGH OAK CT HUNTINGTON BEACH CA 92646: Bus Lie: BT30069113. FAIR OAKS CA 95626 Phone: 714-504-1860. Lie Exp Date: 09/3012020 Phone: State Lio:C-042268 Code Edit : 2016 Worker's Compensation Insurance Designer. Type of. Construction: VB Carrier: SECURITY NATIONAL INS CO .Address: Occupancy Group: R2/U Policy No: SWC1148349 NMUSD Fee: Added /New sq.ft. Bldg: 0 Expire: 05/04/2020 Phone: - Added /New sq. ft. Garage: 0 Plumbing %: No of Stories: 2 Building Setbacks Rear: I Special Conditions: No of Units : 0 Front: / TOTAL FEE : $554.36 Bldg Height: 0 Left: : $215.76 Bldg Sprinklers: Right: / Building Permit Fee: $248.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $216.76. Additional Fee : $0.00 Plan check Fee : $40.00 Fire Inspection: Overtime Plan Ck $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev 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 Energy Compliance: $0.00 Grading PC Fee: $0.00. Public Works Department - General Service CA Seismic Safety: $0.00.. WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit Disabled Access: $0.00 PNV Plan Check : $0.00 Grading Bond: Hazardous Mat $0.00 Electrical %: $17.36 San Dist: $0.00 Building Green Fee : $1.00 Mechanical %: $9.92. NMUSD Fee: .$0.00 Plumbing %: $22.32 TOTAL FEE : $554.36 Plan Check Fee : $215.76 Fee Due at Permit Issuance: PROCESSED BY:' Y ` PUBLIC WORKS APPROVAL:. \ ZONING APPROVAL: L c PLAN CHECK BY: I GRADING APPROVAL: _ APPROVAL TO ISSUE: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0,00 $0.00 $338.60 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). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) 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-Builderwill 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 legall, 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 per ury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Proles C�a, a Icense in fLill force and effect. License Class / License No 9-'J � 7-J'"" Date 19-/ Contractor SiDr gnature WORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SU&IECT 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 5706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I 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 th Gnecie �c 'ooff I a work for which this permit is issued. Policy No. anr 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' compeneatioi in,carrier andpolicy number are: Policy Number Date Jame of Agent rnune e ❑1 certify that, in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre hat, if I should become subject to...��hhhe workers' com ensat[on provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �� ))) 3ignatureof Applicani� � �� DaWd`�✓'L`� T )ECLARATION 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 3097, It t Code). -ender's Name Lender's Address 3y 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 coun to ant r a ove-id ntified,prope y for inspection purposes. signature of Property Owner or Authorized Agent Print PropertyOwner's or Authorized Agent's Nam TGPY3N f�i Date e`"f -14'- ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE . 1403 PERMIT EXPIRED (SUBMITTED ASBESTOS NOTIFICATION TO • •s •.•• ••• ��• •• PERMIT CANCELLED EPA • • • • • • • • r i PERMIT EXTENDED LJAQMD PERMITFINAL 114 ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO CERTIFICATEOF(��✓'VZ4 PROPOSED DET%LIT.I •:• • f°• OCCUPANCYISSUED I1' SIGNATURE:.T ` °�• • ••• tee•