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HomeMy WebLinkAboutX2019-3062 - Permitsp� � City of Newport Beach - Building Division IINIIIIIIIIIIIIIIIIII�IIIIIIII�IIIIIIII�IIIIIII� II COMB Permit: X2019-3062 100 Civic Center Drive, Newport. Beach, CA 92660 X 2 8 1 9 3 9 6 2 Project NO r. fy, Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 c Issued Date : 09126/2019 "dena"�`' ' Combination Type - SFr' MECH ELEC PLUM 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: 2018 GALAXY DR NB - Description. SFR REMODEL KITCHEN 149 SF *CITY STD PLAN* - LegalDesc: NTR4224LOT12 ���^ Owner: GULAJAMES LEE Contractor THE RIGHT CALL HOME REPAIR - Architect: v'rIOR ...... Address: 2018 GALAXY DR Address: 9729 ORTANO LN Address: °°•• o NEWPORT BEACH, CA 92660 - CYPRESS, CA 90630 a • o one. Phone: (562) 2013054 Phone: State Lie: Applicant: RUIZ GILBERT. Con State Lie: 1023876 Engineer: - Address: 9729 ORTANO LN Lie Expire: 02/28/2021 Address: CYPRESS CA 90636 Bus Lie: BT30069063 - Phone: 562-201-3054 Lie Exp Date: 09/30/2020 Phone: State Lie, Code Edit: 2016 Worker's Compensation Insurance -Designer: Type of Construction`. VB Carrier: EVEREST Address: Occupancy Group: R3 Policy No: -7600018618191 Added /New sq.ft. Bldg. 0 Expire: 0113012020 Phone: Added /New sq. ft. Garage: 0 No of Stories: 1 Building Setbacks Rear: I Special Conditions: LANDSLIDE AREA No of Units : 1 Front: / Bldg Height: 0 Left: Bldg Sprinklers: - N Right: Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $25,000.00 Building Permit Fee: $472.00 Plan Check Fee: $410.64 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: $1,020.04 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Excise Tax: Additional Fee: Grading Bonds Fee: Grading PC Consultant: Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $33.04 $18.88 $42.48 Plan Check Fee Planning Department - Plan check Fee Fair Share SJH Trans In -lieu Housing Fee Public Works Department - Park Dedication : $0.00 PNV Plan Check: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 Fire Department $40.00 Fire Inspection: $0.00 Fire Plan Rev $0.00. Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Band:. $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $1,020.04 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE:. • o • o 0 •• • • • • • • o• e°oe• 0 o • ooeoo• • • ago• 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, 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).. LI I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, throu improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of cc improved for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 70 apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contra ❑ 1 am exempt 4ro"icensure under the Contractors' State License Law for the following reason: By my signature tielcurl acknowledge that, except for my personal residence in which I must have resided for at least o� ,Syjl a%tMGture thy); I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. Professions Code, is available upon request when this application is submitted or at the following Web site:http:/Avww.lf Signatwre of Propeorty00wner or Authorized Agent LICENSED COhfTRACTOR'S DECLARATION 14pretyy affirm Wfdel; P4nalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 77 Indgf(eCt. LiceOs-a CIBSS License No Date W.QfJKERS' 000PE,NSATION DECLARATION qIjljtlj . FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE COST OF COMPENSATJON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. l eseVyaffirm under penalty of perjury one of the following declarations: jp6pye and will malhtain a certificate of consent to self -insure for workers' compensation, issued by the Directc rformance of ttvelwork for which this permit is issued. Policy No. have and wilt maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for thi ins�uta=e carrier and policy number are: Carrier Policy Number ie of Agent certify that, in the peIf o manta of the work for which if I should becomes ject to the wor�ersenr lature of Applicant permit is issued, I shall not employ any person in any I provisions of Sin 3700 of the Labor Code, I shall areby affirm under 4enalty of perjury 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 provided is correct. I agree to comply with all applicable city and co my ordinances and state laws relating to building construction. I authorize representatives of this city or couno to enter the b -identified property for inspection purposes. nature of Prooertv Owner or Authorized ADen 17 Print Property Owners ACTION DATE BY( DECLARATION OF COM UAN WITH CODE OF FEDERAL FOR REGULgTIONS PART 610 TI LE 40 AND AO,MD RULE PERMITEXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED LIEPA PERMIT EXTENDED OMD PERMITFINAL CERTIFICATE OF OCCUPANCY ISSUED ! 't0 r ESTO NOTIFICATION IS NOTAPPLICABLE TO OPOSED EMOLITIO SIGNATUC the work, and the structure is not intended or offered for sale (Section 7044, employees' or personal effort, builds or improves the property, provided that the pletion, 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). year prior to completion of the improvements covered by this permit, I cannot legall) nderstand that a copy of the applicable law, Section 7044 of the Business and ifo.ca.gov/calaw.html. Dale If Division 3 of the Business anXDRED ssiona�,o nd my license is in full force ! - <'=",. Contractor Sign - LTIES AND CIVIL FINES UP TO ONE HUTHOUSAND DOLLARS ($100,00(1), IN DLLON 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' co ensation laws of California, and agree i comply with those provisions. Dat �—"—f� I this permit is issued (Section 30 , Civil Code). USE ONLY r >. -ZC--t9