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Home My WebLink AboutX2018-1668 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIVIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit: X2018-1668 100 Civic Center Drive, Newport Beach, CA 92660 1Illt x 2 I 1 8 1 6 6 811111 Project No: 7293-2018 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - SFP ELEC MECH PLUM Issued Date : 06112/2018 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: 1915 HOLIDAY RD NB Description: SFR INTERIOR REMODEL (KITCHEN, DINING RM) CREATE NEW BEDROOM AND NEW BATHROOMS (2) 1924 SF Legal Desc.: N TR 3763 LOT 59 Owner: KINSTLER LYNDSAY Contractor: OWNER/BLDR Address: 1915 HOLIDAY RD Address: NEWPORT BEACH, CA 92660 Phone: Phone: Applicant: KINSTLER LYNDSAY Con State Lic: O/B Address: 1915 HOLIDAY RD Lic Expire: NEWPORT BEACH, CA 92660 Bus Lic: Phone: 714-932-0775 Lic Exp Date: Code Edit, 2016 Type of Construction: V-B Occupancy Group: R3IU Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 1 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Flood Zone: Building Permit Fee: $1,066.00 Plan Check Fee: $927.42 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $34.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $4.00 TOTAL FEE: $3,089.12 PROCESSED BY: ZONING APPROVAL: Worker's Compensation Insurance Carrier: Policy No: Expire: Building Setbacks Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: / Front: / Left: I Right: / $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $74.62 $42.64 $95.94 Architect: Address: Phone: State Lic: Engineer: KARIMI MOHSSEN + 44 Address: 8502 E CHAPMAN, STE 177 ORANGE CA 92869 Phone: 7141932-0775 State Lic:C-057364 Designer: Address: Phone: Special Conditions: O/B FORM ATTACHED Planning Department - Plan check Fee Fair Share: SJH Trans : In -lieu Housing Fee: Public Works Department - Park Dedication : $0.00 PAN Plan Check: $76.00 San Dist: $731.00 NMUSD Fee: $0.00 Plan Check Fee : $1,040.92 Fire Department $37.50 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: omom o�m .• • emoomm $BOO .$vq $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $2,048.20 PUBLIC WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: I APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION N 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 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 not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions Of the work, and the structure is not intended or offered for sale (Section 7044, Business 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 improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of cc pletion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 704 , Business and Professions Code: The Contractors' State License Law does not apply 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). ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason: By 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 legal) sell 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 Professions Code, is available upon request whatthis ap licatio i d or at the following Web site:hftp://w .legIinfo.ca.gov/calaw.html. - Signature of Property Owner or Authorized Agent <_ - 'i I Date Z LICENSED CONTRACTOR'S DECLARATI I hereby -affirm under penalty of perjury that I am licensed under provi ' ns of Chapter 9 (commencing with Section 7000)i of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No Date Contractor Signature WORKERS' COMPENSATION DECLARATION FAILURE ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINE$ UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE ES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. Z@WP%pffirm under penalty of perjury one of the following declarations: and lbill'ryaifltain 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 th, ice of thee ork for which this permit is issued. Policy No. and wilLmainjain 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' compensatior carrief'aIld policy number are: Policy Number Expiration Date \gent. o ' Phone# that, in fie 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 agree lould become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. of reby affirm utcler-penalty of perjury that there is a construction lending agency for the performance of the work for wl 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 provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or cou ooeent�er the �above-ident letd property fo spection purposes. ADent I nature of PrODertv Owner or Authorized \DY nt Prorertv Owner's or ACTION DECLARAION OF I DATE I BY I REGULATIONS PA T0610 TILT TITLE AOMD RULE CE WITH CODE OF �L FOR PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED OEPA PERMIT EXTENDED UAQMD PERMIT FINAL ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO 66 CERTIFICATE OF l,'l��j�/ PROPOSED DEMOLITION OCCUPANCYISSUED J SIGNATURE: Date (D I ) . J8 this permit is issued (Section 3097, Civil Code). USE ONLY q Kl<�ISAti (X 11-A