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Home My WebLink AboutX2013-3565 - Permits (3)gw1o� City of Newport Beach - Building Division r3 - 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 M u rr gvn Combination Type - SFP GRAD ELEC MECH PLUM Job Address: 4507 HAMPDEN RD NB Description:NEW SFR W/ATT GARAGE 5139 & 662 SF, ROOF DECK 677 SF Inspector Area: 6 Legal Desc.: N TR 3357 LOT 9 Owner: 4507 HAMPDEN NB LLC Contractor: Address: 4507 HAMPDEN RD Address: CORONA DEL MAR, CA 92625 Phone: Phone: Applicant: HERRON JACK Con State Lic: Address: 161 FASHION LN, STE 206 Lic Expire: TUSTIN CA 92780 Bus Lic: Phone: 949-633-7103 Lic Exp Date: Code Edit : 2010 Type of Construction: V-B-SPR Occupancy Group: R3/U Added /New sq.ft. Bldg: 5139 Added /New sq. ft. Garage: 662 No of Stories: 1 No of Units : 1 Bldg Height: 14 Bldg Sprinklers: Flood Zone: X Construction Valuation: $929, Building Permit Fee: $5,420.40 Plan Check Fee: $3,902.69 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $56.00 Energy Compliance: $261.00 CA Seismic Safety: $92.92 Disabled Access : $0.00 Fee Increase: Fee: $0.00 Additional Fee : $0.00 Hazardous Mat: - $0.00. Building Green Fee: $38.00 TOTAL FEE: $21,297.30 II�X 2 013356 5�NII OWNER/BLDR Architect: HERRON JACK Address: Phone: O/B Engineer: Address: Phone: Worker's Compensation Insurance Carrier: Policy No: Expire: Building Setbacks Rear: 6 Front: 16 Left: 6 Right: 6 -1-6000 Excise Tax: $1,218.21 Grading PC Consultant: $0.00 Grading Permit Fee: $997.80 Grading PC Fee: $693.36 WO Insp. Fee: $23.20 Electrical %: $379.43 Mechanical W $271.02 Plumbing %: $542.04 Designer: Address: Phone: COMB Permit: X2013-3565 Project No : 3010-2013 Inspection Requests Phone (949)644-3255 Date : SHAM ZACHARY J 2600 NEWPORT BLVD #164 NEWPORT BEACH CA 92663 949-675-7322 State Lic:C005004 a oo�ol State Lic: Special Conditions: 60% maximum lot coverage CE02013068 Fire Planning Department - Plan check Fee Fair Share : SJH Trans: In -lieu Housing Fee Public Works Department - Park Dedication : $0.00 PAN Plan Check: $321.75 San Dist: $651.00 NMUSD Fee: $5,928.48 a ou o 0 0 oou�a oaa a ca o a o a m oocoom m m a o ao 0 a a o 0 m a me o O O J 3 O a aaa aaoae o m acoo a 0000 Fire Department $500.00 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 Plan Check Fee : $4,857.05 Fee Due at Permit Issuance PROCESSED BY:PUBLIC WORKS APPROVAL: ZONING APPROVAL: `� PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE:v''f/ PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. INSTALL OR VERIFY SMOKE/CARBON MONOXIDE DETECTORS /PLUMBING FIXTURES TO BE UPGRADED $0.00 $0.00 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 Iicensure 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 ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, 3usiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the h4, ovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner-Builderwill have the burden of proving that it was not built or ved for the prjre4sp of sale). aS,owner ptttj property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not ern owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). arrCexempt:8rhlCensure under the Contractors' State License Law for the following reason: Bpmgsgnature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the Improvements covered by this permit, I cannot legalt "a structure thattl have built as an owner -builder as not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and 3r9W&i$ns CoV,,%aZilable upon request when a pli io 1 submitted or at the following Web site: http://www.legi o.ca.gov/calaw.html. %1 / iignVVre of Property Flwner or Authorized Agent n 4. -�. Date !IPEISED CQNjF$CTOR'S DECLARATIO hereby affirm under penalty of perjury that I am lic ed under provisions of Chapter 9 (comme ing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force tn�.eT st. License Class License No Date Contractor Signature NORKERS' COMPENSATION DECLARATION r�ikRiJFNSWAILURBTVSECURE 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 UST OF COMPENSATIOVrDAMAGES As PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY's FEES. hereby affirm uT&.&Malty of perjury one of the following declarations: 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 )rmance 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' compensa rance carrier and policy number are: Policy Number of Agent Date 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 if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. [nature of Applicant Date_ CLARATION REGARDING CONSTRUCTION LENDING AGENCY :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 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 c ty ordin nceand state laws relating t? building construction. I authorize representatives of this city or count n 5ove-identry r inspection purposes. nature of Property Owner or Authorized Agent �� Print Property Owner's or Authorized Agent's Name 2t ACT"[ PERI.fIT E}TEM-PE ? CERTIFTCf1TE�CF 0CL7JDA7JCY155E�E,n DATF (I / By AND ❑ 1srinwarn ASflrsTris Nf)7lrft-4Tr)m Tri- ❑ EPA ❑ AQP,SG 0 ASBESTOS P1107I1FICAMMWJSIVOTAFPLWABLE TO PROPUSEDDEMOUTAOM SIf;NAI UHL. Civil Code). XP44