HomeMy WebLinkAboutX2020-1800 - PermitsCity of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
`i Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
`"asou" Combination Type - SFP ELEC MECH PLUM GRAD
PERMIT
Col
Job Address:
1601 HARM
Description:
SFR REMOI
Legal Desc.:
TRACT NO 7
Owner:
VISTA PARK
Address:
6 SHADE TR
IRVINE CA 9.
Phone:
Applicant:
BENSON JEI
Address:
234 BROADV
COSTA MES.
Phone
Code Edit:
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 2
No of Units : 1
Bldg Height: 0
Bldg Sprinklers:
Construction
Building Permit Fee:
$2,437.06
Plan Check Fee: $0.00
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$94.00
Energy Compliance:
$210.00
CA Seismic Safety:
$39.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$12.00
PROCESSED BY:
*X2020-1800*
COMB Permit: X2020-1800
Project No: 0829-2020
jNF
Y 08/11/2023 OR PEF
�/No work on Sunc
CE B F. _ V P IO OF ATHR 1`SOF.O rJr ❑ 100% refund
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"ntm r: B tQAILTfOeCt: AM
Address: 2021 W COMMONWEALTH AVE STE S Address: 234
FULLERTON, CA 92833 COSTA MESA CA 92627
: 949-534-2724 Sta
Na,-- D
tt - Engineer: DEIHIMI AMIR
I 20 Address: 4400 CAMPUS DR
us Lic: BT30061480 NEWPORT BEACH CA 9
Lic Exp Date: 03/31/2021 Phone: 949-752-1612 Star
08/10/2020
Worker's Compe sation Insurance • Desi net:
rri14 EXEMPT 'IS
ca P lic :an
EMPLOYE a 6 s 7 s ti
Expir Phone:
(vvor . taEtod) (no work started)
wl mg etbac s Rear: 6 Special Conditions: FUEL MOD, 5 - 5 B RObi
Front: 10 LANDSLIDE
L
Note:. eft: 6 8,
TOTAL FEE: $4,644.40
ZONING APPROVAL:
GRADING APPROVAL:
x�Tax:
$0.00
Planning Department -
Additional Fee:
$0.00
Plan check Fee:
Grading Bonds Fee:
$0.00
Fair Share:
Grading PC Consultant:
$0.00
SJH Trans :
Grading Permit Fee:
$232.00
In -lieu Housing Fee:
Grading PC Fee:
$195.00
Public Works Department -
WQ Insp. Fee:
$0.00
Park Dedication : $0.00
PAN Plan Check, $129.00
Electrical %:
$170.69
San Dist: $0.00
Mechanical %:
$97.48
NMUSD Fee: $0.00
Plumbing %:
$219.33
Plan Check Fee
Fire Department
$0.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
BE INVALID
19Z
• °
cac.ae
•
°woc
$0.00
$0.00
$26.00
$219.00
$564.00
$0.00
$0.00
$0.00
$0.00 Fee Due at Permit Issuance : $4,644.40
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
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OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark s I
ction 7031.5, Busihess and Profs repalr any s ruc ure, prlo[
permit to file a signed ement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with
fessions Code) or that or she is exempt from licensure and the basis for the alleged exemption. Any violatiqD 9�$ ti4t7�t.igby any applicant for a f
more than five hu`odred ollar lft• ( ).2 2 5 11 N�' 1 .
I, as owner of the
siness and Profes.
)rovements are nc
)roved for the purr
I, as owner of the
Ay to an owner of
I am exempt fron
my signature belo
I a structure that I
)fessions Code, is
[nature of Prop0rLl
affirm
farm underr
•a ee
and.will m;
ice of the via
and wig majj
V, or my employees with wages as their sole compensation, will do (_) all of or U pgltioapfoZe work,.a{id tl)@�tfJScture i not it
de: The Contractors' State_L.icenselaw does notaoolvAoPan ovnre�fsDroaertv wh tii6rdd55oh tM o me oh21 � 1944
one year of completion, the Owner -Builder will have
idIJfflJ1Mproves'tflWon�hnd wfl'8• d"ohtracTs for tfiFprojects with a licensed Contractor pursuant to the Contractors' State
under the Contractors' State License Law for the following reason:
rl cept f n Mat
I t si t least one year prior to completion of the impn
a n ovine ilder_ it has n n atr t in t ' n d c „ rectors. I understand that a copy of the applica
perjury that I am licensed under provisions of Chapter 9 (commencing wit
License No
SUBJECT
h Section 700 fpi Lsioy of
the BuymeandProfre)
J d1�
ttg1hC_�_ontanature(N I rN IL IF �
BUNDRED
pepuryoneoft follow gui�L2la� (no work stated)
certificate of consento se f-Insure fo workers' compensation, issued by the Director of Industrial Relations as provided for
ch this permit is issued. Policy No.
Number IBa"%• la
next to the applicable item(s)
ce, also requires the applicant for
)) of Division 3 of the Business and
is the applicant to a civil penalty of
or offered for sale (Section 7044,
proves the property, provided that the
den of proving that it was not built or
State License Law does not
Law).
Section 7044 of the Business and
Date
is in full force
DOLLARS [$100,000), IN ADDITION TO
Section 3700 of the Labor Code, for
is issued. My workers'
In bfAgent• • Er;:
certify that, in the performance f the work fo w ich this permit is issued, I shall not employ any person in any manner so as to become subject to the works s' compensation laws of California, and
I, if I should beco a subject t e rke s' ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Appli nt t
CLARATION REGARDING CO STRU NDING AGENCY
:reby affirm under penalty of perjury that ere 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
I agree to comply with all applicable city and c yei'T and st2 we relating construction.
I authorize representatives of this/c�y�r my toe: r the ovg-I n ed property for inspection oses. /
Owner or
ACTION
PERMIT EXPIRED
PERMITC4NCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCY ISSUED
WITH CODE OF FEDERAL
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
I SUBMITTED ASBESTOS NOTIFICATION TO
NOTAPY119tBLE TO
or Authorized A nt's Name %'� 12 ciI (?J
IFFICE USE ONLY
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