HomeMy WebLinkAboutX2019-1195 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
COMB Permit: X2019-1195
100 Civic Center Drive, Newport Beach, CA 92660
X
2 8 1 9
1 1 9 5Project
NoPermit
Counter Phone (949)644-3288
a
Inspection Requests Phone (949)644-3255
Combination Type - SFP MECH ELEC PLUM
Issued Date: 04/1612019
Inspection Area : 2
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: 518 SANTAANA AVE NB
Description: SFR REMODEL 220 SF (KITCHEN & 3 BATHROOMS) -CITY STD PLAN
Legal Desc.: FIRST ADD TO NEWPORT HEIGHTS BILK 32 LOT 5
Owner:. ODIORNE DENNIS Contractor:
GOFF NATHANIEL THOMAS
Architect:
Address: 518 SANTA ANA AVE Address:
1549 TUSTIN AVE
Address:='
-
IRVINE, CA
COSTA MESA CA 92627
Phone: Phone'
949-375-6135
Phone:
State Lie:
5"
Applicant: GOFF NATHAN Con State Lie:
905274
Engineer:
Address: 1549 TUSTIN AVE .Lie Expire:
10/3112019
Address:
-<-
COSTA MESA CA 92627 Bus Lie:
ST30058857
Phone: 949.375-6135 - Lie Exp Date:
05131/2019
Phone:
State Lie:
Code Edit: 2016 Worker's Compensation Insurance
Designer
Type of Construction: VB Carrier:
WC EXEMPT
Address:
Occupancy Group: R31U Policy No:
(NO EMPLOYEES)
Added /New sq.ft. Bldg: 0 Expire:
Phone:
-
Added /New sq. ft. Garage: 0
No of Stories: 2 Building Setbacks
Rear: /
Special Conditions:
`
No of Units: 1
Front: /
Bldg Height: 0
Left:
Bldg Sprinklers: -
Right:
Flood Zone: X Use Zone: Parking Spaces: 0
Fire Hazard Zone.:. N
Construction Valuation: $50,000.00
Building Permit Fee: $746.00 Excise Tax:
$0.00 Planning Department-
Fire Department
Plan Check Fee: $649.02 Additional Fee :
$0.00 Plan check Fee :
$40.00
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: $2.00 Grading Permit Fee:
$0.00 In -lieu Housing Fee
: $0.00
Building Dept Adm
$0.00
Energy Compliance: $0.00 Grading PC Fee:
$0.00 Public Works Department-
General Service
$0.00
CA Seismic Safety: $0.00 WQ Insp. Fee:
$0.00 Park Dedication :
$0.00
Refund Deposit
$0.00
Disabled Access: $0.00
P/W Plan Check:
$0.00
Grading Bond:
$0.00
Hazardous Mat $0.00 Electrical %:
$52.22 San Dist: -
$0.00
Building Green Fee : $2.00 Mechanical %:
$29.84. NMUSD Fee:
$0.00.
-
$0.00
• Plumbing%:
$67.14 -
$0.00
TOTAL FEE: $1,588.22
PROCESSED BY:
ZONING APPROVAL: 1
GRADING APPROVAL:
Plan Check Fee: $0.00 Fee Due at Permit Issuance : $1,588.22
. � a
t s w . • F. , ` r m L PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
� c
Ufa o4ui UC 4 G v�E, J�
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 U all of or L) 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
13 m roved for the purpose of sale).
1, 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).
n 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.govicalaw.htmi.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION 1ny
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) o Divisi�f the Business and Profe ions[ god` AY li� s in full force
and effect. License Class License No Date Contractor SignatunAltic
WORKERS' COMPENSATION DECLARATION
NARNING: 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
COST 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:
1 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 thI
oerformance 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
rr�e of Agent
rrtify 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 agree
t, if I should become subject to t e w ers' compensation provis' f Section 3700 of the Labor Code, I shall forthwith comply with those provisions.��„•
nature of Applicant«
CLARATION REG DING O STRUC" ION LENDING AG
: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 Frovided is correct.
I agree to comply with all applicable city and county o Ina cas
and state laws relating to building construction.
I authorize representatives of this city or coun`ty{}}o� r t above -identified property for inspection purposes. /
,...,«..e ,.r o.....va„ n,.,.,e.... A,ah...L•n Anon/ L A
a e/� Print Pronertv Owner's or Authorized Aaent's NamA(
ACTION
PERMITEXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCY ISSUED
DATE BY d§Z(ARICTION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403 • .
I SUBMITTED ASBESTOS NOTIFICATION TO
• a i•
EPA • • a• • ••
SIGNATURE:
NOTIFICATION IS,J40T APPLICABLE TO
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