HomeMy WebLinkAboutX2019-0573 - Permits�,
City of Newport Beach - Building Division I IIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIillllllllllllllllll II
COMB Permit: X2019-0573
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
100 Civic Center Drive, Newport Beach, CA 92660
-,Job Address: 224 JASMINE AVE NB
X 2 00 1 9 0 5 7 3
Project No : 0419-2019
';
Permit nter Phone
SMMN KLM
c'")
Inspection Requests Phone(949)644-3265F
Owner: ANDERSON REV TRUST
' a,7ta„ eta
Combination Type - SFP ELEC GRAD MECH
PLUM C"Jt NL"'lAt
M
Issued Date:
CDM CA 92625
NEWPORT BEACH CA 92660
t�w�ti4if
Inspection Area : 5
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: 224 JASMINE AVE NB
Description: NEW SFR & GARAGE 45001659 SF
Legal Desc.: RESUB OF CORONA DEL MARLOT 22 BLK 137(AND NELY 15FT LOT 20 BLK1
37
Owner: ANDERSON REV TRUST
Contractor. NICHOLSON CONSTRUCTION CO Archfgc�t0
Address: 301 HELIOTROPE AV
Address: 1 CORPORATE PLZ #110 Addr CONSTRUCTION: NOISE
CDM CA 92625
NEWPORT BEACH CA 92660
Phone:
Phone: 949-872-6637
Phone: State Lie:.
Applicant: NGUYEN ANNA
Con State Lie: 660295 -
Engineer:. WONG ARIV NATHANIEL
Address: 31511 CAMINO CAPISTRANO STE A Lie Expire: 1213112020
Address: 116q
SAN JUAN CAPISTRANO CA 92675
Bus Lin: BT98032850
UFpAF=0W�KEND
7�}$¢t}•I rg�78
Phone: 949496-8991
Lie Exp Date: 04/3012020
Phone: 714-838.9898 State Lic:C-055045
Code Edit: 2016
.Worker's Compensation Insurance
Designer: SUMICH GEOFF
Type of Construction: V -B -SPR
Carrier: STATE FUND
Address: 31511 CAMINO CAPISTRANO STE A
Occupancy. Group: R31U
Policy No: 9074266
SAN JUAN CAPISTRANO CA 92675
Added /New sq.ft. Bldg: 4500 `.
Expire: `.. 1 0/0112 01 9
Phone:. 949-496-8991
Added /New sq. ft. Garage 659
No of Stories: 2
Building Setbacks Rear 5 -
Special Conditions: �1
No of Units : 1
Front 20
�n�®
J v
,... Bldg Height: 0
Left:. 4
Bldg Sprinklers: Y....
Right: 4
Flood Zone:
Use Zone: Parking S p aces:
0 ' Fire Hazard Zone : N
Construction Valuation. $1.200.000.00
Building Permit Fee: $5,494.00
Excise Tax: $1,083.39
Planning Department - Fire Department
Plan Check Fee:: $4,108.00
Additional Fee : $0.00
Plan check Fee : $417.00 Fire Inspection:
$0.00
Overtime Plan Ck: $0.00
Grading Bonds Fee: $0.00
Fair Share: $0.00 Fire Plan Rev
$0.00
Investigation Fee: $0.00
Grading PC Consultant: $0.00
SJH.Trans : $0.00 Demolition Fee
Record Management: $100.00
Grading Permit Fee: $875.00
In -lieu Housing Fee :. $0.00. Building Dept Adm
$0.00
Energy Compliance: $268.00
Grading PC Fee: $0.00
Public Works Department- General Service
$0.00
CA Seismic Safety: $156.00
WO Insp. Fee: - $108.00..
Park Dedication : $0.00 Refund Deposit
$0.00
Disabled Access: $0.00
PAN Plan Check: $330.00 Grading Bond:
$0.00
Hazardous Mat $0.00
Electrical %: $384.58
San Dist: $1,794.00
Building Green Fee: $48.00.
Mechanical %i .$219.76
NMUSD Fee: $5,503.44
$0.00
Plumbing%: $494.46
$0.00
TOTAL FEE : $21,383.63
Plan Check Fee :
$5,743.00 Fee Due at Permit Issuance : $15,640.63
PROCESSED BY:
a m `'
° ° J: -PUBLIC WORKS APPROVAL:
A,(�J
V—
y
ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
-
oc eon c n oo. uo�
APPROVAL TO ISSUE:
;
.v„
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contracto i n Lbw r(�I�(('toted 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 requir it . t�pe a m vq d olish, or repair any structure, prior to its issuance, also requires the appligant for
he permit to file a signed statement that he or she is licensed pursuant to the p on a tors to ic°°e°�°RRs��$$$$""""""Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Bus! rwand
'rofessions Code) or that he or she is exempt from licensure and the basis for the alleg n of Section 7031.5 by any applicant for a permit subjects the applicant to a civil piprdlty of
lot more than five hundred dollars ($500). " ' i
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,
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
Tlprovements 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
reproved 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
Tly 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:
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 legaill
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://www.leginfo.ca.gov/calaw.htmi.
>ignature of Property 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 71 ofj�Ivisio 3 of the Business and Profe s Code, and licen;a is in full force
Ind effect. License Class - - License No Da -SLS-�� Contractor Signatu
VORKERS' COMPENSATION DECLARATION
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 ($100,000), IN ADDITION TO THE
:OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 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 the
Six rmance of the work for which this permit is issued. Policy No.
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'
carrier and policy number are:
Policy Number
Date
me of Agent Phone #
certify 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 agre
should
Applica t�bje�c�tlto. �the workers' comp �sati� ovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature D� siCC
CLARATION REGARDING CONSTRUCTION LENDING AGENCY �"eA�/�—
)reby 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).
Ider'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 ordinances and state laws relating to building construction.
I authorize representatives of this city or county toc¢g��n.ter the aboveodentified property for inspection purposes.
nature of Prooertv Owner or Authorized ADent� S1/IOn.CTVI lC 1.1 1l L, Print Prooertv Owner's or Authorized ADent's Name J( S�a/yC J �'��U9, Date9-30 -19
ACTION DATE BY" ' DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE
1403
PERMIT EXPIRED 0 I SUBMITTED ASBESTOS NOTIFICATIOIQTQ '•e •i ••
PERMITC1INCELLED EPA . . . • + • •s
•� e • e
PERMIT EXTENDED q
PERMIT FINAL UASVESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF ,/,II PROPOSED DEMOLITION • • • • • • • • `
OCCUPANCYISSUED SIGNATURE:
•