HomeMy WebLinkAboutX2017-0406 - PermitsCity of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
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Permit Counter Phone (949)644-3288
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Inspection Requests Phone (949)644-3255
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Combination Type - SFP MECH ELEC PLUM
COMB Permit: X2017-0406
Project No :
Issued Date : 02/07/2017
Inspection Area : 3
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
Job Address: 1830 GALAXY DR NB
Description SFR REMODEL BATHRQO (CITY STD PLAN) I
Legal Desc: NTR4224LOT 29 e. Z If applicable:
Owner: BIG CANYON INC Contra. ERICK ALLEN BUILDERS Arch[ t: 0 0 _^c•
Address: 30 CORPORATE PARK#,�09 Ad A
N D Addre=80% or'❑"100 �0 refund
IRVINE CA 92606 8 E
Phone: 10P e: Phone: State Lic:
Applicant: ERICK ALLEN BUILDERS. Con e gmeeer:whom: LI
Address: 372 OLINDA DRIVE Lic Expire: 08/31/2017 Address:
BREA-CA 92823 J..B T 97
Phone: 714-524-2406 Li xp at 02 StateLis:�..:Code Edit : 2016 rker' om en P in ranee signer:
Type of Construction: VB C UAR O Done:
dtess:�,,_
Occupancy Group: R31U Policy No: ERWC764746
Added /New/TI sq.ft. Bldg: 0 Expire: 07/26/2017 Phone:
Added Mew sq. ft. Garage: 0 ,
No of Stories: 1 B _ S iakC rr�f
No of Units : 1 or : ��
Bldg Height: 0 eft: / @@@__}
Bldg Sprinklers: N (jl}JOrk str,: / (no work started) irfp
Flnod 7nne' X Use zone: ar mo Daces: 0 Fire Hazard Zone : N :aiY
Construction
Building Permit Fee:
Plan Check Fee:' "
Overtime Plan Ck:
Investigation Fee:
Record Management
Energy Compliance:
CA Seismic Safety:
Disabled Access:
Hazardous Mat
Building :Green Fee
PROCESSED BY:
$367.00
$319.29
$0.00
$0.00
$2.00
$0.00
$0.00
$0.00
$0.00
$1.00
TOTAL FEE: $800.19
ZONING APPROVAL:
t V'Etxdf,.: 1r x' manning Department - �-`-
Additional Fee : $0.00 Plan check Fee : $,;, -
Gradiag-Boads-F-ee;.---$OAO Fair -&here-=-------- pip
Grading PC Fee:
WQ Insp. Fee:
Electrical W
Mechanical %:
Plumbing %:
$0.00
In -lieu Housing Fee:
$0.00
Building Dept Adm
$0.00
$0.00
Public Works Department-
General Service
$0.00
$0.00
Park Dedication :
$0.00
Refund Deposit
$0.00
P/W Plan Check :
$0.00
Grading Bond:
$0.00
$25.69
San Dist:
$0.00
$14.68
NMUSD Fee:
-$0.00_
$0.00
$33.03
-
$0.00
Plan Check Fee:
$0.00
Fee Due at Permit Issuance :
$800.19
• Y P
tlRUBLIC WORKS APPROVAL:
Y tl Y P Y •f
Y • 4 Y•B • Y6Y
PLAN CHECK BY: r
ll
GRADING APPROVAL: e Y ..APPROVAL TO ISSUE: •
0 0 • Y P G
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v s
-
Y e c o
cc. �c oc o c oca mmY
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) �t
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 ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
;iness and Professions Code: The Contracto Ii�4Af.2p �..,�..%meugA ripbnifd�r•iawposves tdo� roperty, provided that the
rovements are not intended or offered ffrae. If, however, the buildin o imy�p ent's d within one year of completion, the Owner -Builder will have the burden of prov g that it was not built or
roved for the purpose of sale).�4,,�4.,�,.I, as owner of the property, am exclusicoRrcywith r__rancPn s rajeGt{Sesgerr;r044, Businsrlf5S96Code: The Contractors' St to Lieense Law does not
ly to an owner of property who builds oroves thereon, and who con racts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
J I am exempt from licensure under the
ntraMonal
icense r th lowiNr,5LiLa.GLVoIl
- IU
"'
ly my signature below I acknowledge that,
xcep Ide in I
prior to completion of the improvements covered
y thj5 permit, cannot legally
ell a structure that I have built as an owne
uildt bee onstruct eostand
that a copy of the applicable law, Section 7
4 otthe Business and
'rofessions Code, is available upon reques
hetion a
,li=
signature of Property Owner or Authorized
gent
Date
.ICENSED CONTRACTOR'S DECLA
TION
`'
hereby affirm under penal perjury that
am li r pro. 3,f,'ha j r j� m cisl
S 'v' to 3 of the Business an
�i se is in full force
nd effect. License Class
tens o
6 Contractor Signatur`+V
VORKERS' COMPENSATION DEC
TI
;t�'p
'ARNING: FAILURE TO SECURE WORKERS' COMPEN ATIO UN AL ECT AN P
ER P S AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLA
($.f 000), IN ADDITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED
R IN F THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES..-
�„ `,
hereby affirm under penalty of perjury one
the following declarations:
�'
_
I have and will maintain a certificate of onsent to self -insure for workers' comp nsation, issued by the or dI{strial Relations as ovided f r by Section 370
ertOrmance of the work for which this Perm is is e liv
of a Labor Code, for th
have and maintain workers' compe
atio n y Le a t
Labor Cod e p i1e rk wh t Is issue
orkers' compensatiol
Isurance carrie ahg policy number are:
A
P rk started)
(no WoaiP�a} ti�jDaPt�)
arrier
yNU�6
ame of Agen
Phone #7(•'4a
]I certify that, in the ante wor ' per it is issued, I shall not emplo any
person in any manner so as to become sub'ect to the workers' c do
la' ,f California, and agre
Iat, if I she come sub a
pe at ovlslons o ec Ion o he Labor Code, I shall forthwith comply with those provisions.
- Insp. initialer
ignature of ppli nt
ECLARATION R CT I D G AGENCY
hereby affirm under penalty of perjury that th a rmance o e wor or w Ic Is permlt Is Issue ectlon 9 IVI o
Bnder's Name
Lender's Address
By my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owner's beha .
have read this application and the information I have provided is come
I agree to comply with all applicable tit ounty ordi sad be)
aw sating to building construction.
I authorize representatives oft or cou abo e- led operty for inspection purposes.
Signature of Property Owner or Authorized A Print Property Owner's or Authorized Agent's Na Da
=AL-ytME
ACTION DATE TION OF OMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERMITEXPIRED 1A rep, AWUBMITTED ASBESTOS NOTIFICATION dO . . . • ••
PERMITCANCELLED PA • • • • •..loll I'Vuired`ali1m3,•I3tches gates and fences which serve as part of a pool/spa barrier, shall
PERMITEXTENDED QMD be in place prior to approval to fill pool/spa & shall remain in place & be maintained for the
PERMIT FINAL TSIGNM
BESTOS NOTIFICATION IS T PPLICfjgtE •jQ • life: f the• pool.
CERTIFICATE OF 0 IN
7�
OCCUPANCYISSUED •• ••
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