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X2017-0993 - Permits
1�e City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 v Inspection Requests Phone (949)644-3255 Combination Type - SFP ELEC MECH PLUM II�IIIIIIII�IIIIIII'lllll�ll�llllll�llll�lllq II COMB Permit: X2017-0993 2 0 1 7 0 9 9 3 Project No : 0665-2017 Issued Date: 07/1212017 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: 1712 GALAXY DR NB Description: SFR GARAGE ADD 306SF & REMODEL 2457 SF Legal Desc.: N TR 4224 LOT 40 Owner: MATTHEWS JOHN Contractor: FERGUSON JAY B Architect: BEAUCHAMP DANIEL 9-✓ -a ., ,1c" ,. `'`� Address: 1712 GALAXY DR Address: 20731 CHAUCER LANE Address: 470 WALD NEWPORT BEACH, CA 92660 HUNTINGTON BEACH, CA 92646 IRVINE CA 92618 Phone: Phone: 949-412.5518 Phone: 949-727-3840 State Lic:C014593 Applicant: BEAUCHAMP DANIEL Address: 470 WALD IRVINE CA 92618 Phone: 949-727-3840 Code Edit: 2016 Type of Construction: V-B-SPR Occupancy Group: R31U Added /New sq.ft. Bldg: -184 Added /New sq. ft. Garage: 306 No of Stories: 1 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Flood Zone: X Construction Valuation: $222. Building Permit Fee: $1,680.00 Plan Check Fee: $1,224.60 Overtime Plan Ck: $0.00 Investigation Fee: $1,580.00 Record Management: $36.00 Energy Compliance: $166.40 CA Seismic Safety: $28.86 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $9.00 PROCESSED BY: Con State Lic: 466245 Engineer: YAGHI SHUCRI I _ Lic Expire: 0713112017 Address: 112 E. CHAPMAN #D ' Bus Lic: BT30059831 ORANGE CA 92866 ' Lic Exp Date: 07131/2018 Phone: 714-997-9120 State Lic:C-043205 Worker's Compensation Insurance Designer: .... • Carrier: WC EXEMPT ' Address: ° ° Policy No: (NO EMPLOYEES) ©„• o Expire: Phone: • Building Setbacks Rear. I Special Conditions: WORK IN PROGRESS • ° ° Front: I C2016-0218 °••°°• Left: / 117-0570 ° Right: / ° ° Use Zone: Parking Spaces: 0 Fire Hazard Zone : N • Excise Tax: $0.00 Planning Department - - Fire Department Additional Fee : $276.00 Plan check Fee : $150.00 Fire Inspection: • • $0.09 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev $6.p6 Grading PC Consultant: $0.00 SJH Trans : $0.00 Demolition Fee Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $24.00 Grading PC Fee: $0.00 Public Works Department- General Service $197.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $564.00 P/W Plan Check : $152.00 Grading Bond: $0.00 Electrical %: $110.60 San Dist: $0.00 Mechanical %: $63.20 NMUSD Fee: $0.00 $0.00 Plumbing %: $142.20 $0.00 TOTAL FEE: $6,292.86 ZONING APPROVAL: Plan Check Fee $2,424.15 Fee Due at Permit Issuance ,: $3,868.71 PUBLIC WORKS APPROVAL: l`, , PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: L_` 4,rl • • 0000 • • ooa• a° 000• o • 0 0 •••••• • °••• 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, de{nolish, or repair any structure, prior to its issuance, also requires the applicant for is 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 'rofessions 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 of more than five hundred dollars ($500). 1, 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, �usiness 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 nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of coipletion, the Owner -Builder will have the burden of proving that it was not built or nproved 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 pply to an 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). I am exempt from licensure under the Contractors' State License Law for the following reason: i ',y my signature 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 legall) ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.legilnfo.ca.gov/calaw.htm]. ',ignature of Property Owner or Authorized Agent Date 11) .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Se io 7Qp0).bf Divis' n 3 of the Business and Professio e, an m tense is in full force nd effect. License Class License No D e i J,/ Z 2 ©/ Cont ctor Signature -+ e COMPENSATION DECLARATION NINE: FAILURE TQ JWRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEP r OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. eby affirm und'e*r penalty of perjury one of the following declarations: AND CIVIL FINES UP TO ONE HUNDRED T OU AND DO RS ($100,000), IN ADDITION TO THE hav2 and valj 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 Irmance of the work for which this permit is issued. Policy No. have and will & aintain 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 r,sn&camerbhHbfill number are: Agent Policy Number in tM performance of work for is this permit is issued, I shall not employ any person in any q:®0 me subject t�rkers' mp sation provisions of Section 3700 of the Labor Code, I shall • qA :reby affirm under penalty ofpedLry 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 have prove d is car I agree to comply with all applicable city and county ord' es and,stat la I authorize representatives of this city N city toe r e above id tifiee Date so as to become subject to the workers' compensation laws of California, and agree r comply with those provisions. qte 7L/24z07 7 r this permit is issued (Section 3097, Civil Code). relating to building construction. Dperty for inspection purposes. _- Print ProDertv Owners or Authorized ACTION DATE �BY i ROGULATIIOCOMPLIANCE S PAT610 TAL TITLE 40 AND AQMD RULE PERMIT EXPIRED I U I SUBMITTED ASBESTOS NOTIFICATION TO PERMITEXTENDED 1 1 UAQMD PERMITFINAL CERMIT FI NAL Q, 2� I7 Z V wJ1 ASBSNOTIF ION TAPPLICABLE TO PROPO DEMO N OCCUPANCYISSUED SIGN RE: .v! _ /\ FOR OFFICE USE ONLY