HomeMy WebLinkAboutX2018-1914 - PermitsCity of Newport Beach - Building Division
'X2018-1914'
COMB Permit: X2018-1914
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a` 4 100 Civic Center Drive, Newport Beach, CA 92660
Project No
Permit Counter Phone (949)644-3288
st - Inspection Requests Phone (949)644-3255
Combination Type - SFP ELEC PLUM
Issued Date: 0612112018
Inspection Area : 5
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: 2701 SHELL ST NB
Description: SFR BATHROOM REMODEL 30 SF *CITY STANDARD•
Legal Desc.: CORONA DEL MAR LOT 7
Owner: THOMPSON GERALD L Contractor:
E Z CONSTRUCTION
& REMODELINGArchitect:
Address: 2701 SHELL ST Address:
12517 SHERMAN
WAY STE A Address:
CORONA DEL MAR, CA 92625
NORTH HOLLYWOOD CA 91605
Phone: 714-747-9852 Phone:
818-784-7252
Phone:
State Lie:
Applicant: E Z CONSTRUCTION & REMODELING Con State Lie: 792026
Engineer:
Address: 12517 SHERMAN WAY STE A Lie Expire:
03/3112019
Address:
NORTH HOLLYWOOD CA 91605 Bus Lie:
BT30057760
Phone: 818-784-7252 Lie Exp Date:
0713112018
Phone:
State Lie:
"
o 0 o
r•_
Code Edit: 2016 Worker's Compensation Insurance
Designer:
(�
Type of Construction: V-B Carrier:
Occupancy Group: R31U Policy No:
STATE COMP
9208210
Address:
-
Added /New sq.ft. Bldg: 0 Expire:
Added /New ft. Garage: 0
0410612019
Phone:
"
sq.
No of Stories: 2 Building Setbacks
Rear: I
Special Conditions:
-
No of Units: 1
Front: I
Bldg Height: 0
Left: /
!J�
Bldg Sprinklers:
Right: /
�-
Flood Zone: Use Zone:
Parking Spaces:
0 Fire Hazard Zone : N
Construction Valuation: $5,000.00
Building Permit Fee: $142.00 Excise Tax:
$0.00
Planning Department-
Fire Department
Plan Check Fee: $123.54 Additional Fee :
$0.00
Plan check Fee : $37.50
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: $2.00 Grading Permit Fee:
$0.00
In -lieu Housing Fee: $0.00
Building Dept Adm
$0.00
Energy Compliance: $0.00 Grading PC Fee:
$0.00
Public Works Department-
General Service
$0.00
CA Seismic Safety: $0.00 WQ Insp. Fee:
$0.00
Park Dedication : $0.00
Refund Deposit
$0.00
Disabled Access: $0.00
PNV Plan Check : $0.00
Grading Bond:
$0.00
Hazardous Mat $0.00 Electrical %:
$9.94
San Dist: $0.00
Building Green Fee : $1.00 Mechanical %:
$0.00
NMUSD Fee: $0.00
$0.00
Plumbing %:
$12.78
$0.00
TOTAL FEE: $328.76
Plan Check Fee
: $0.00 Fee Due at Permit Issuance : $328.76
PROCESSED BY:
PUBLIC WORKS APPROVAL:
.sue
ZONING APPROVAL: ���
PLAN CHECK BY:
i
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
ie 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).
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 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
n roved 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 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 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
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
iignature'of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under panalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0) o Division 3 of the Business and Profe io Code, mc�my license is in full force
nd effect. Licenic 'ass License No Date Contractor Signatur
VORKERS' COI•TCNSATION DECLARATION
FARMING: FAILURE TO S !UURE 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
DST OF'COMPENSATInN, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
oereuy affirm under penalty of perjury one of the following declarations:
7I have and WEI 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 th
ejformance of the work for which this permit is issued. Policy No.
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'
ranee carrier and policy number are:
Policy Number
of Agent
Date
3'. re!tlfy that, in the
`perf ante 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
iat, if I should becomes ject to the worker 'compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. / �9j
Iignature of Applicant Date (0(D—ram'— /I
IECLARATION REGA DING CONSTRUCTION LENDING AGENCY
hereby affirm under p DING
of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 309 , Civil Code).
ender's Name Lender's Address
ly 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 coun ordinances and state laws relating to building construction.
I authorize representatives of this city or county t en the abov = ntifled property for inspection purposes. ,., 7
danature of ProDertv Owner or Authorized ADent Print Property Owners or Authorized Agent's Name Rz, 1 / 4{'� Da
ACTION DATE BY / DICLAIATION 01 COMPLIANCE WITH CODE OF IREGULATIONS PART 1 O TIIT E 40 AND AQMD RULEFEDE
I FOR OFFICE USE ONLY
PERMITEXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED
PERMIT EXTENDED qMD
PERMITFINAL ASBESTOS NO F TION IS NOTAPPLICABLE TO
CERTIFICATE OF /[ PRO SED DEM LITION
OCCUPANCY/SSUED lv SIGNATURE: