HomeMy WebLinkAboutX2018-2971 - PermitsAnna City of Newport Beach - Building Division IIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIII II COMB Permit: X2018-2971
# 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 8 2 9 7 1 Project No: 2354-2018
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Permit Counter Phone (949)644-3288
-st Inspection Requests Phone (949)64.4-325E,
°a,,p �w+* Combination Type - SFP ELEC MECH PLUM Issued Date
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: 363 NEWPORT GLEN CT NB
Description: SFR 170 SF TO (E) BEDROOM & 102 SF TO (E) STORAGE ROOM @ GARAGE
Legal Desc.: N TR 9776 LOT 7
Owner:
WILLIAMS DAVID
Contractor:
Address:
363 NEWPORT GLEN CT
Address:
NEWPORT BEACH CA 92663
Phone:
Phone:
Applicant:
WILLIAMS DAVID
Con State Lic:
Address:
363 NEWPORT GLEN CT
Lic Expire:
NEWPORT BEACH CA 92663
Bus Lic:
Phone:
949-678-0291
Lic Exp Date:
Code Edit: 2016
Type of Construction: VB
Occupancy Group: R31U
Added /New sq.ft. Bldg: 170
Added /New sq. ft. Garage: 102
No of Stories: 2
No of Units: 1
Bldg Height: 0
Bldg Sprinklers: N
Building Permit Fee: $784.00
Plan Check Fee: $607.00
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$40.00
Energy Compliance:-
$56.00
CA Seismic Safety:
$B.95
Disabled Access:
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$3.00
TOTAL FEE: $1,857.00
PROCESSED BY:
ZONING APPROVAL:
OWNER/BLDR
UTH AGENT:
CAROLL MIKE
O/B
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: I
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$54.88
$31.36
$70.56
Architect
Address:
Phone: State Lic
Engineer:
CASTILLO MARGARITO
Address:
1205 PINE AVE
LONG BEACH CA 90813
Phone:
562-961-5600 State Lic:S-004808
Designer:
CAROLL MIKE
Address:
10392 FLORENCE AVE
BUENA PARK CA 90620
Phone:
714-728-0954
Special Conditions: COSTA MESA SANITATION
Planning Department -
Plan check Fee
Fair Share :
SJH Trans:
In -lieu Housing Fee:
Public Works Department -
Park Dedication :
$0.00
PAN Plan Check:
$41.25
San Dist:
$0.00
NMUSD Fee:
$0.00
Fire Department
$160.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
C
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee : $911.00 Fee Due at Permit Issuance : $946.00
PUPLIC.WORKi APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL: <.PPrC''AL 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 (cort iifieocifig 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).
7 I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U portions of the work, and the structure is not intended proffered for sale (Section 7044,
Iusiness 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).
1 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 I am exempt from licensure under the Contractors' State License Law for the following reason:
ly my signature below I acknowledge that, except for my personal reside99eeED2�n which I must avy 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 n9t been c sr structe in its enti y py licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Busines and
'rofessions Code, is available upon request whe t appl' ati is to IS r he lowing Web site:http://www.leginfo.ca.gov/calaw.htmi.
'signature of Property Owner or Authorized Agent _ Daly
.ICENSED CONTRACTOR'S DECLARATI '
hereby affirm under penalty of perjury that I am licens4 under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
nd effect. License Class License No Date Contractor Signature
VORKERS' COMPENSATION DECLARATION
'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000(, IN ADDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
I have and will 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 thi
erformance of the work for which this permit is issued. Policy No.
]I have and will maintain 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' compensatiol
Isurance carrier and policy number are:
arrier Policy Number Expiration Date
'same of Agent Phone #
kcertify that, in the performance oft work for Ich this permit is issued, I shall not employ any person in any manner so as to became subject to the workers' compensation laws of California, and agre'
lat, if I should become�ject to th o ers' tion pr ns of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. J'! j
ignature of Applicant ' c e 7
:reby affirm under penalty fif 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 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 orc ina es and a I�y�'s reI tin -t building construction.
I authorize representatives of this city or coun t enter t ove . i�cj,prope tin
purposes. ` �, e��1 /�
nature of Pronertv Owner or Authorized ADent " (�'�G Print Property Owner's or Authorized Agent's Narr]a� //"eL C-X
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
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