HomeMy WebLinkAboutX2019-2361 - Permits1. , City of Newport Beach Building Division IIIIIIIIilllllllllllllllllllllllllllllllllllllllll COMB Permit: X2019-2361
0 100 Civic Center Drive, Newport Beach, CA 92660 x 2 9 1 9 2 3 6 1
Project No :1699-2019
F n Permit Counter Phone (949)644-3288
c'" :- d1 Inspection Requests Phone (949)644-3255
'u}g Combination Type - MFP ELEC MECH Issued Date: 0 910 6/201 9
0-, - Inspection Area : 4
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 6:00 a.m. to 6:00 p.m. No work on Sundays or Holidays
Job Address: 952 GARDENIA WAY NB
Description:. MFR -CONVERT 134 SF ATRIUM TO LIVING SPACE
Legal Desc.: N TR 12245 LOT 14
Owner:
LA POINTE JERRY
Address:
952 GARDENIA WAY
Record Management:
CORONA DEL MAR CA 92625
Phone:
$66.00
Applicant:
ZONOUZ ALI
Address:
7545 IRVINE CENTER DR #200
Hazardous Mat
IRVINE CA 92618
Phone
Code Edit: 2016
Type of Construction: V -B
Occupancy Group: R2
Added /New sq.ft. Bldg: 134
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units: 2
Bldg Height: 0
Bldg Sprinklers:
Building Permit Fee: $376.00
Plan Check Fee: $327.12
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$12.00
Energy Compliance:
$66.00
CA Seismic Safety:
$2.47
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
Contractor:
Address:
Phone:
Con State Lic:
Lic Expire:
Bus Lic:
Lic Exp Date:
OWNER/BLDR
LA POINTE JERRY
949-697-0665
O/B
Worker's Compensation Insurance
Carrier:
Policy No:
Expire:
Architect:
Address:
Phone: - State Lic:
Engineer:
ESMAILI OMID
Address:
79 CLOUDCREST
Fire Plan Rev
ALISO VIEJO CA 92656
Phone:
State Lic:C-027027
Designer:
$0.00
Address:
$0.00
Phone
Building Setbacks
Rear: I
Fire Inspection:
Special Conditions:
Fire Plan Rev
Front: I
Demolition Fee
Building Dept Adm
$0.00
Left: /
$0.00
Refund Deposit
$0.00
Grading Bond:
Right: /
$0.00
Use Zone:
Parking Spaces:
0
Fire Hazard Zone
Excise Tax:
$0.00
Planning Department -
Additional Fee :
$301.05
Plan check Fee :
$0.00
Grading Bonds Fee:
$0.00
Fair Share :
$0.00
Grading PC Consultant:
$0.00
SJH Trans :
$0.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee :
$0.00
Grading PC Fee:
$0.00
Public Works Department -
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
P/W Plan Check:
$0.00
Electrical %:
$26.32
San Dist:
$0.00
Mechanical W
$15.04
NMUSD Fee:
$0.00
Plumbing %:
$0.00
INSPECTOR
Fire Department
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
Building Dept Adm
$0.00
General Service
$0.00
Refund Deposit
$0.00
Grading Bond:
$0.00
$0.00
$0.00
II TOTAL FEE: $1,117.00 Plan Check Fee : $1,117.00 Fee Due at Permit Issuance : $0.00
�6
PROCESSED BY: PUBLIC WORKS APPROVAL:
ZONING APPROVAL: "9L�,rLA - PLAN CHECK BY:
GRADING APPROVAL: `: _ �, „ APPROVAL TO ISSUE:
Eo
ec oou n � �., vv com
OWNER -BUILDER DECLARATION
Ihereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable item(s)
ction 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
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
fessions 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
more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or `) portions of the work, and the structure is not intended or offered for sale (Section 7044,
Iiness 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
rovements 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
roved for the purpose of sale).
(/as owner of the property, am exclusively contracting with lic Con ctors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
Iyt to an owner of property who builds or improves there and who c9gl1racts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
VI m exempt from licensure under the ConfrF
By signature below I acknowledge that, exce
structure that I have built as an owner -b ' -
Professions Code, is available upon reque h
Signature of Property Owner or Authorize A e
LICENSED CONTRACTOR'S DECLARAT
I hereby affirm under penalty of perjury that I am
and effect. License Class
COMPENSATION
�r "'tate License w for the fall Ing reason:
or my person Saidence In w ch I must have resided for at least one year prior to completion of the improvements covered by thi
if it has not een construct In its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of
hys appli lop is submi �f-tpe faltbwing Web site:http://vdww.leginfo.ca.gov/calaw.html.
under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
License No Date Contractor Signature
and
my license is in full force
IARNING: 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 ($10D,000), IN ADDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th
erformance of the work for which this permit is issued. Policy No.
have and will maintain workers' compensation InsuJsnRee''a$ 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: // //
ler / Pnllr. Umher Expiration Date
in the perfor ce of the work for
becomes =act the workers' c¢
of
areby affirm under penalty of perjury tjfat there is a c
Ider's Name
my signature below, I certify to a ch of the following
1 am the property owner ora onzed to act on the
I have read this application and the information I
this permit is ssued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
ation provi ons ection 3700 of the Labor Code, I shall forthwith comply with those provisions.
AGE Y
istruction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Lender's Address
is
behalf.
I agree to comply with all applicable city an ounty ordinances and st laws relating to building construction.
I authorize representatives of this city or ounly to enter the above ' entified property for inspection purposes.
Signature of Property Owner or Authorized A 4 Print Property Owner's or Authorized Agent's Name _ 7 Date
ACTION DATE DECLA ION OF COMPUANCrWITH CODE OF FEDERAL FOR OFFICE USE ONLY
REG TIONS PART 61 OF TITLE 40AND ACIMD RULE
�403
PERMITEXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO •'„ ••. + • • • •.
PERMIT CANCELLED OEPA • • • • • • • s • `
PERMIT EXTENDED OMD • • • • • • • • • • • • • '
PERMITFINAL P -ASBESTOSN ION IS TAPPLICABLE TO
CERTIFICATE OF -1 •tf-2Q A PROPOSE MOLITION • ••• ••
OCCUPANCYISSUED Q. SIGNATOR •s• ••• • • •••
• • • •• +
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