HomeMy WebLinkAboutX2018-3741 - PermitswrtPn City of Newport Beach - Building Division IIIIII�III�IIIIIIIIUIII�III�lllllll�llllllllq II
4 100 Civic Center Drive, Newport Beach, CA 92660 X 2 8 1 8 3 7 4 1
F Permit Counter Phone (949)644-3288
x"7 Inspection Requests Phone (949)644-3255
�x nar Combination Type - SFP PLUM
COMB Permit: X2018-3741
Project No:
Issued Date: 12112/2018
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 - BATH REMODEL 45 SF
:
Owne
INSPECTOR
:
TANAKA TAMOTSU
Contractor: PACIFIC ONE CONTRACTORS Architect:
Address:
1300 ANTIGUA WAY
Address: 609 E RIVERVIEW AVE Address:
NEWPORT BEACH, CA 92660
Phone:
Applicant: PACIFIC ONE CONTRACTORS
Address: 609 E RIVERVIEW AVE
ORANGE CA 92865
Phone: 714-974-3600
Code Edit: 2016
Type of Construction: VB
Occupancy Group: R3/U
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:
Building Permit Fee: $152.00
Plan Check Fee: $132.24
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
TOTALFEE:
PROCESSED BY:
ZONING APPROVAL:
ORANGE CA 92865
Phone:
714-974-3600
Con State Lic:
501759
Lic Expire:
1113012020
Bus Lic:
BT30066336
Lic Exp Date:
12131/2019
Worker's Compensation Insurance
1 Carder:
NO EMPLOYEES
Policy No:
Expire:
Building Setbacks
Rear: I
Front: I
Left: /
Right: /
Phone: State Lic:
Engineer:
Address:
Phone: State Lic:
Designer:
Address:
Phone:
Special Conditions:
Excise 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:
$0.00
In -lieu Housing Fee:
Grading PC Fee:
$0.00
Public Works Department -
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
PAN Plan Check:
$0.00
drical %:
$0.00
San Dist:
$0.00
Me anical %:
$0.00
NMUSD Fee:
$0.00
Plum ing %:
$13.68
Plan Check Fee:
$0.00
F
Fin: Department
$40.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
°
°
'$0.00 °
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
at Pellpit Issuance : $340.92
PUBLIC WORS APPROVAL:
PLAN CHECK Y:
GRADING APPROVAL: lr q ° APPROVAL TO ISSUE: \
0
° o
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)
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).
J I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portior
lusiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, thrc
nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of
nproved for the purpose of sale).
1 I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section
pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Cont.
7 I am exempt from licensure under the Contractors' State License Law for the following reason:
ly my signature below I acknowledge that, except for my personal residence in which I must have resided for at least
ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractor:
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www
signature of Property Owner or Authorized Agent
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of pep ry that am license under provisions of C�ter 9 (commencing with Section
nd effect. License Class 4 License No !7! %'F 4% Oat
VORKERS' COMPENSATION DECLARATION
DARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI L
DST OF COMPFNSATIpN, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
of the work, and the structure is not intended or offered for sale (Section 7044,
3h employees' or personal effort, builds or improves the property, provided that the
�mpletion, the Owner -Builder will have the burden of proving that it was not built or
Business and Professions Code: The Contractors' State License Law does not
pursuant to the Contractors' State License Law).
s year prior to completion of the improvements covered by this permit, I cannot
understand that a copy of the applicable law, Section 7044 of the Business and
Date
f Div)'Ior)3fjlye Business and Prof ssi n v lice�lsull force
Z ontractor Signature
VZZ
TIES AND CIVIL FINES UP TO ONE HUNDRED THOUS D OLLARS ($100,000), IN ADDITION TO THE
rreby affiM 84A penalty of perjury one of the following declarations:
J have and wjltolaintain a certificate of consent to self -insure for workers' compensation, issued by the Direct) r of Industrial Relations as provided for by Section 3700 of the Labor Code, for
foTmance 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
Nance carrier arl(tpolicy number are:
^� Policy Number Expiration Date
.. A..e.,r• • • u
that, in the performance of
could become subject to the
of A'pD1d'anG\10
this permit is issued, I shall not employ any person in any mariner so as to become subject to the workers' compensation laws of California, and agree
atio pro ' ions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
1 Datek,,�n �2—AeV
QFC6ARATION•RF•C+ARDING 9ONSTRUCTION LENDING AGENCY 1 ' —
flgr,Pjifr affirm un-Jer�enalty 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).
Lender'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 behalf.
I have read this application and the information I have provided is correct.
I agree to comply with all applicable city and county ordinan nd tat la relating to building construction. �� /�r,•� 7
I authorize representatives of this city or county to enter th ov is roperty for inspection purposes. /
Signature of Property Owner or Authorized Agent Print Property Owner's 01` Authorized Agent's Nam f-1YAJ < '"r1 ' D
ACTION DATE BY ACLARATION OF COMPUANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED
U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED
OEPA
PERMIT EXTENDED
QMD
PERMITFINAL
CERTIFICATE OF
i ,4PROPOSED
ASBESTOS NOTIFgTI N SNOTAP I LE TO
DETIQOCCUPANCYLLSSUED NATURE: Li Y>,,,fff�����fff���////////////