HomeMy WebLinkAboutX2017-0422 - Permits (2)r City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIII�III�IIIIIIIIIIIIIIIIIIIII� II
`. 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 7 0 4 2 2
Permit Counter Phone (949)644-3288
-0Y Inspection Requests Phone (949)644-3255 t l r t A l 2___7 Combination Type - CIP ELEC U L
A I V
I7-7_1 \/� (-00A ITO
COMB Permit: X2017-0422
Project No : 0291-2017
Issued Date : 05/0812017
Inspection Area : 7
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
Job Address:
1221 W COAST HWY NB
Investigation Fee:
$0.00
Description:
POOL DECK & RESTROOMS WI ELECTRICAL "BALBOA BAY
CLUB"
Legal Desc.:
IRVINE SUB BILK 54 LOT 171 POR OF LOT
$0.00
Disabled Access :
Owner:
BALBOA BAY CLUB VENTURES LLC
Contractor:
R D OLSON CONSTRUCTION
Address:
2532 DUPONT DR
Address:
2955 MAIN ST, 3RD FL
IRVINE CA 92612
IRVINE CA 92614
Phone:
949-861-4700
Phone:
949-474-2001
Applicant: MARTIN JR WILLIAM
Address: 1350 CORONADO AVE
LONG BEACH CA 90804
Phone: 562-597-8760
Code Edit: 2016
Type of Construction:
Occupancy Group: U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 0
No of Units : 0
Bldg Height: 0
Bldg Sprinklers:
Construction Valuation: $353.000.00
Building Permit Fee: $2,360.00
Plan Check Fee: $2,053.20
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$0.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$15.00
TOTAL FEE: $5,581.10
PROCESSED BY:
ZONING APPROVAL:
Con State Lie:
953845
Lie Expire:
10131/2018
Bus Lie:
ST30009757
Lie Exp Date:
05/31/2018
Worker's Compensation Insurance
Carrier: STARR INS
Policy No: 100001219
Expire:
Building Setbacks
Use Zone:
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
07/01/2018
Rear: /
Front: I
Left: I
Right: /
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$330.40
$0.00
$0.00
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone
KOLLIN MICHAEL
1350 CORONADO AVE
LONG BEACH CA 90804
562-597-8760 State Lic:c021173
Special Conditions:
Planning Department -
Fire Department
Plan check Fee:
Fire Inspection:
Fair Share :
Fire Plan Rev
SJH Trans :
Demolition Fee
In -lieu Housing Fee
Building Dept Adm
Public Works Department -
Park Dedication:
$0.00
PAN Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
State Lie:
$0.00
$0.00
$24.00
$197.00
$564.00
$0.00
$0.00
$0.00
Plan Check Fee : $5,581.10 Fee Due at Permit Issuance : $0.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
Fire Department
$37.50
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
$0.00
$0.00
$24.00
$197.00
$564.00
$0.00
$0.00
$0.00
Plan Check Fee : $5,581.10 Fee Due at Permit Issuance : $0.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
OWNER -BUILDER
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 items)
lection 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
is 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
'rofessions 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
of more than five hundred dollars ($500).
3 I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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
nprovements 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
n 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
pply 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 exemot"ffom licensure under the Contractors' State License Law for the following reason:
ly 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
ell 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
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http:/Auww.leginfo.ca.gov/calaw.html.
signature of ProggWy Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
nd effect. License Class _ License No Date Contractor Signature
COMPENSATION DECLARATION
'ARNING: 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
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 5705 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 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:
Policy Number
Date
is of Agent rnone s
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
if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
ignature of Applicant Date_
iECLARATION 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, Civil Code).
ender's Name Lenders Address
y my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owners behalf.
I have read this application and the information 1 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 enter the above -identified property for inspection purposes.
innahlre of Pmnerty Owner or Authorized Aaent Print Prooertv Owners or Authorized Agent's Name
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AC MD RULE
1403
PERMIT EXPIRED I Ul SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCYISSUED
UASBESTOS NOTIFICATION 15 NOT APPLICABLE TO
PROPOSED DEMOLITION
Date