HomeMy WebLinkAboutX2019-1484 - Permits�w1 City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIjIIIIIII III
COMB Permit: X2019-1484
4.
'' 100 Civic Center Drive,. Newport Beach, CA 92660
x 2 0 1 9 1 4
4
$264.00
Project No: 1043-2019
- W
6
Permit Counter Phone (949)644-3288
$0.00
"c
�@ Inspection Requests Phone(949)644-3255
Issued
m1� '` Combination Type - MFP ELEC MECH PLUM
Date : 05/09/2019
$0.00
Building Green Fee:
Inspection Area: I I
714-724-1599 State Lic:C•046231 ®° • ° C
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
PM Plan Check:
$0.00
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:.
3121 W COAST HWY NB St: 1 FI: 7 Unit: 7-D
' . ,.
Description:.
MFR "WORK IN PRGRS" BATHROOM REMODEL (150 SF)
Address:
Legal Desc.:
TR 919 LOT L ELY1/2.
NO EMPCarrie:
LIOYEES)
AS
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uALLSATm1F�t/•(JCTU�"[�AL,'.�
..Expire:
Owner
JR FORD INVESTMENTS LLC Contractor: FERNANDEZ ROBERT CONSTR INC Architect
EXPOSE
Address:
2857 PARADISE RD #602 Address: 923 EVERGREEN PLACE Address:
Special Conditions: C2019-0087ELECTRICAL, PW Y;BIN`X9"��`P "®
LAS VEGAS NV 89109 COSTA MESA CA 92627
-
Phone:
Phone: 949-981-9169 - Ph
Fire Hazard Zone : N • m.. ` .. _ _ I.
Applicant: FERNANDEZ ROBERT
Address: 923 EVERGREEN PL
COSTA MESA CA 92627
Phone: 949-981-9169
Code Edit: 2016
.Type of Construction: 1-A
Occupancy Group: R2/U
Added /New sq.ft.. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 8
No of Units : 1
Bldg Height: 0
Bldg Sprinklers:
r•i d 7nno. 11 ry
Building Permit Fee:
$264.00
Plan Check Fee: $229.68
Overtime Plan Ck
$0.00
Investigation Fee:
$264.00
Record Management:
$8.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :.
$0.00
Hazardous Mat
$0.00
Building Green Fee:
$1.00
.VV
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee :
TOTAL FEE: $896.44
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Electrical %:
Mechanical %:
Plumbing %:
$0.00
Planning Department-
one.
State Lic.
Con State Lie:.
677390
Engineer:
SOMA JR PHILIP GEORGE. ••....
Lie Expire:
04/30/2020
Address:.
252 SOUTH BRENTWOOD
Bus Lie:
BT30046730
$0.00
ANAHEIM CA 92804 • . o° ®® ......
Lie Exp Date:
03/31/2020.
Phone:
714-724-1599 State Lic:C•046231 ®° • ° C
$0.00
PM Plan Check:
$0.00
b
Compensation
Worker's Compensation Insurance
Designer.
' . ,.
NMUSD Fee:
WIC PT
Address:
�....
iBUILT. PE -M T
Policyr No:
NO EMPCarrie:
LIOYEES)
AS
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uALLSATm1F�t/•(JCTU�"[�AL,'.�
..Expire:
Phone:
EXPOSE
Building Setbacks
Rear: I
- Front:
Special Conditions: C2019-0087ELECTRICAL, PW Y;BIN`X9"��`P "®
Left. /
Right I
'
NIECHANICALS_,IW IP®w,4TS
Use Zone: _ Parking Spaces: 0
Fire Hazard Zone : N • m.. ` .. _ _ I.
.VV
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee :
TOTAL FEE: $896.44
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Electrical %:
Mechanical %:
Plumbing %:
$0.00
Planning Department-
$0.00
Plan check Fee
$0.00
$0.00
Fair Share :
$0.00
$0.00
SJH Trans :
$0.00
In -lieu Housing Fee:
$0.00
$0.00 -
Public Works Department-
$0.00
Park Dedication :
$0.00
$0.00
PM Plan Check:
$0.00
$36.96
.San Dist: -
$0.00
$29.04
NMUSD Fee:
$0.00
$23.76
Plan Check Fee : $286.68 Fee Due at Permit Issuance `. $609.76
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE: i
Fire Department
$40.00
Fire Inspection:
$0.00
$0.00
Fire Plan Rev
$0.00
$0.00
Demolition Fee
$0.00.
Building Dept Adm
$0.00
General Service
$0.00
Refund Deposit
$0.00
Grading Bond:
$0.00
$0.00
$0.00.
Plan Check Fee : $286.68 Fee Due at Permit Issuance `. $609.76
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE: i
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).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U 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 -Builder will have the burden of proving that it was not built or
improved 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).
❑ 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 this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
L
ature of Pryperty Owner or Authorized Agent Dale
ENS96 CQNTRACTOR'S DECLARATION
reby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 ' ' io f the Business and Professio Co d n full force
effects° ticeNse Class License No Date Contractor Signature
RKERS' COMPENSATION DECLARATION
• AGNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMIN L PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
° COST OF comp"ATJON, DAMAGES AS PROVIDED FOR IN SECTION 5708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
°
I hereby aftimp rAler penalty of perjury one of the following declarations:
•I have arTd will•maintain acertificate 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 the
.• effarmancence MIN work for which this permit is issued. Policy No.
3rhave 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'
IMInce carfI)i Rnd policy number are:
:arrier _. Policy Number Expiration Date
certify that, in the performance o he work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' c mpensation laws of California, and agree
t1.if I should become su t to t wo rs' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. —./' �)
nature of Applicant - Dat .`7
CLARATION REGA I C ST ON LENDING AGENCY
3reby affirm under p al f rjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 30 , Civil Code).
lder's Name Lender's Address
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 r a'�ces a state Is
relating to building construction.
I authorize representatives of this city or county to n t (e a -i Rt d property for inspection purposes. 1
mature of Prooertv Owner or Authorized AGent Print Property Owner's or Authorized Agent's Nam to
ACTION
DATE
BY CLAWATION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
3
PERMIT EXPIRED
0 1 SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED
DEPA
PERMITEXTENDED
QMD
PERMITFINAL
ESTOS TIFICATION IS NOT APPLICABLE TO
CERTIFICATEOF
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PROPOSE ION
OCCUPANCYISSUED
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i SIGNATUppp���