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:.
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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 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
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