HomeMy WebLinkAboutX2018-3712 - Permits#a� City of Newport Beach - Building Division IIIIIIIIII�IIIIIIII�IIIIIIII�IIIIIIIIII�III� II COMB Permit: X2018-3712
100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 8 3 7 1 2
s P Project No : 2898-2018
t�, - _� n Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
r.0 t xT Combination Type - SFP PLUM Issued Date : 0112912020
Inspection Area : 3
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: 1300 ANTIGUA WAY NB
Description: SFR REMODEL 2ND FLOOR BATHROOM 45 SF (CITY STD PLAN)
Legal Desc.: N TR 3852 LOT 23
Owner: TANAKA TAMOTSU
Address: 1300 ANTIGUA WAY
NEWPORT BEACH, CA 92660
Phone:
Applicant: VAUGHN BRUCE
Address: 1740 N TUSTIN
ORANGE CA 92864
Phone: 714-974-3600
Code Edit: 2016
Type of Construction: VB
Occupancy Group: R3IU
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units : 1
Bldg Height: 0
Bldg Sprinklers:
Flood Zone: X
Building Permit Fee: $232.00
Plan Check Fee: $201.84
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$2.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $497.72
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Contractor: OWNERIBLDR
Architect:
Address: TANAKA TAMOTSU
Address:
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Phone:
Phone:
State Lie:
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Con State Lie: O/B
Engineer:
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Lie Expire:
Address:
Bus Lie:
Lie Exp Date:
Phone:
State Lie:
Worker'sCa Compensation Insurance
Designer:
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Carrier:
Address:
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Policy No:
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Expire:
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Phone:
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Building Setbacks Rear: I
Special Conditions:
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Front: /
Left: /
Right: /
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical W
Plumbing %:
$0.00
Planning Department -
Fire Department
$0.00
Plan check Fee :
$40.00
Fire Inspection:
$0.00
$0.00
Fair Share :
$0.00
Fire Plan Rev
$0.00
$0.00
SJH Trans :
$0.00
Demolition Fee
$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
PM Plan Check: $0.00
Grading Bond:
$0.00
$0.00
San Dist: $0.00
$0.00
NMUSD Fee: $0.00
$0.00
$20.88
$0.00
Plan Check Fee:
$0.00 Fee Due at Permit Issuance :
$497.72
PUBLIC WORKS APPROVAL:
.21
PLAN CHECK BY:
APPROVAL TO ISSUE:
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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 items)
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 BusinAs 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 ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or L) portions f the work, and the structure is not intended or offered for sale (Section 7044,-
driess and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
rovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
roved for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
Ny,to a~*er of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
I am eAft$Tfrom licensure under the Contractors' Sta License Law for the following reason:
C
my signaKVr;Alow I acknowledge that, except for my ersonal residence in which I must have resided for at least one year prior to completion of the improvements covered Py this permit, I cannot legal
-a structure thdt I have built as an owner -builder if it)(as not been constructed in its_entirety by licensed contractors. I understand that a copy of the applicable law, Section 7944 of the Business and
fessions Cade, is available upon request when thi '�M u mi e Web site:http://www.leginfo.ca.gov/calaw.html. Date {
Mature of eroppQy Owner or Authorized Agent . ; win
SENSED gONTRACTOR'S DECLARATI
Rby affiA uncle; penalty of perjury that I am liCenskunder provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions 94e, and my license is in full force
f effect. 11 6sLAClass License No Date i Contractor Signature
DECLARATION
NING: FAILURE TOS�S5€CURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
MQF COMPS ISSAQ ti DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
�eey affirm aifder penalty of perjury one of the following declarations:
have antSwill rp5intain a certificate of Consent to self -insure for workers' compensation, issued by the Dire
6nnance of Pne 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
rance Carrier and policy number are:
Policy Number
of Agent
certify that, in the performanc of the work for which this permit is issued, I shall not employ any person in any
, if I should become subje o the workers' compensationprirovisions of Section 3700 of the Labor Code, I shall
Iature of Applicant -
-reby affirm under pert4lty dperjury that there is a construction lending agency for the performance of the work for
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 owners behalf.
I have read this application and the information I h e provided is correct.
I agree to comply with all applicable city and coun ordinances and state laws relating to building construction.
I authorize representatives of this city or county t enter love-ide ig ' roperty for inspection purposes.
(nature of Prooertv Owner or Authorized Agen - -- Print Property Owner's
ACTION
PERMIT EXPIRED
PERMITGINCELLED
PERMITEXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCY ISSUED
DATE I BY /'}-DECLARATION OF COMPLIANCE WITH CODE OF FEDEF
II REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
Iti1.1ti
I SUBMITTED ASBESTOS
IS NOTAPPLICABLE TO
TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
of Industrial Relations as provided for by Section 3700 of the Labor Code, for
performance of the work for which this permit is issued. My workers'
Date
so as to become subject to the workers' ompensation laws of California, and agre
h comply with those provisions.
n this permit is issued (Section 3)�J97, Civil Code).
FOR OFFICE USE ONLY