HomeMy WebLinkAboutX2021-1322 - Permitswtr,.
City of Newport Beach - Building Division
'X2021-1322'
COMB Permit: X2021-1322
'
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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Project No : 1158-2021
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Inspection Requests Phone(949)644-3255
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Combination Type - SFP MECH ELEC PLUM
Issued Date : 08125/2021
Inspection Area : 1
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0812512024 OR PERMIT WILL BE INVALID
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:
1116 W OCEANFRONT NB
Y
Description:
SFR ADD 45 SF, ROOF DECK WISTAIRS 632 SF, EXTEND (E)
BALCONY 91 SF & RE -ROOF
Legal Desc.:
N TR 234 BLK 11 LOT 5
0 �-
Owner :
1116 W OCEANFRONT LLC
Contractor:
MOELKE BRYAN & COMPANY
Architect:"
Address:
10717 E PIERCE LN
Address:
10 PAMPANA ST
Address:
SPOKANE WA 99206
RANCHO MISSION VIEJO CA 92694
Z° _
s
Phone:
Phone:
949-324-7440
Phone: -
State Lic:
Applicant:
SANDOVAL JT
Con State Lic:
932557
Engineer:
CARRILLO JESUS EDUARDO
Address:
5252 LONG BEACH
Lic Expire:
01/31/2022
Address:
8207 BROOKGREEN RD
LONG BEACH CA 90805
Bus Lic:
BT30074096
DOWNEY CA 90240
Phone:
310-345-8093
Lic Exp Date:
01/31/2022
Phone:
562-708-3586 State Lic:C-077737
°
Code Edit :
2019
Worker's Compensation Insurance
Designer:
_
Type of Construction: VB
Carrier:
EXEMPT
Address:
I
Occupancy Group: R3/U
Policy No:
_Z
Added /New
sq.ft. Bldg: 45
Expire:
Phone:
O
Added /New sq. ft. Garage: 0
(1)
No of Stories:
No of Units:
Bldg Height:
Bldg Sprinklers:
Flood Zone:
2
1
0
N
0.2
Building Setbacks
Use Zone:
Rear: 0'
Front: 9'
Left: 3'
Right: 3'
Parking Spaces:
Special Conditions:
0 Fire Hazard Zone :
LIQUEFACTION & HIGH
DENSITY AREA
N
-
Z
Construction Valuation: $80,000.00
Building Permit Fee:
$2,050.00
Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee: $1,369.75
Additional Fee :
$0.00
Plan check Fee : $208.00
Fire Inspection:
$0.00
Overtime Plan Ck:
$0.00
Grading Bonds Fee:
$0.00
Fair Share : $0.00
Fire Plan Rev
$0.00
Investigation Fee:
$0.00
Grading PC Consultant :
$0.00
SJH Trans : $0.00
Demolition Fee
Record Management :
$46.00
Grading Permit Fee:
$0.00
in -lieu Housing Fee: $0.00
Building Dept Adm
$0.00
Energy Compliance:
$61.00
Grading PC Fee:
$0.00
Public Works Department-
General Service
$0.00
CA Seismic Safety:
$10.40
WQ Insp. Fee:
$0.00
Park Dedication : $0.00
Refund Deposit
$0.00
Disabled Access :
$0.00
PNV Plan Check: $50.76
Grading Bond:
$0.00
Hazardous Mat
$0.00
Electrical %:
$143.50
San Dist : $0.00
Building Green Fee :
$4.00
Mechanical %:
$82.00
NMUSD Fee: $0.00
$0.00
Plumbing %:
$184.50
$0.00
TOTAL FEE: $4,199.90
Plan Check Fee
: $1,610.75 Fee Due at
Permit Issuance :
$2,589.15
PROCESSED BY:
PUBLIC WORKS APPROVAL:
�\ J
ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
APPROVAL TO ISSUE:
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
1e 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).
I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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 completion, 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:
ly my signature below P 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
roieseiyns Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
lignature of Propart, Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0 f 'vi 3 of the Business and Pr fe ions C d-aryliseas in full force
nd efiert. Lic6nse'Class License No Date I Contractor Signatu
VORKERS' COPIPIENSATION DECLARATION IN
IARNING:FAILURF TO SE4URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES A CML FINES UP TD ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
CS- J' COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
h3-E�1, affirm under penalty of perjury one of the following declarations:
I have and will rnaintain 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
a,fa,n,ance of the work for which this permit is issued. Policy No.
I have and will main"ain 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'
urance carrier and policy number are:
Policy Number
of Agent
Date
certify that, in the 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 agre
t,-41 should beco s fact teth otter ' compensa isions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
U��-
nature of Applicant Da
CLARATION REG DIN CON STRUC N LENDING AGENCY / \
)reby affirm under penalty 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).
Ider's Name Lenders Address
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 ordinances and state laws relating to building construction.
I authorize representatives of this city or county jo er((Crrt a ayqjbentiferty for ion purposes.
of Property Owner or
ACTION
PERMIT EXPIRED
PERMITCANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATEOF
OCCUPANCY155UED
Owner's or Authorized AD
BY ' DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
1 SUBMITTED ASBESTOS NOTIFICATION TO
EPA
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