HomeMy WebLinkAboutX2017-1595 - Permits (3)Q r�x'to4T City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
t~ Perrnyit Counter Phone (949)644-3288
v £( Inspection Requests Phone (949)644-3255
Ccmbination Type - SFP ELEC MECH PLUM
COMB Permit: X2017-1595
IIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIII�II� II
Project No: 1091-2017
Issued Date: 08121/2017
Inspection Area : 4
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.
15 SAN ANTONIO NB
Description:
SFR-ADD BEDROOM/BATH, BONUS & PLAYROOMS, BAR 1154 SF
Legal Desc.:
N TR 15517 LOT 59
Owner:
BARON LIVING TRUST
Contractor:
NEILSON DAVID H CONSTR INC
Address:
15 SAN ANTONIO
Address:
1451 E CHAPMAN AVE
NEWPORT BEACH CA 92660
FULLERTON CA 92831
Phone:
Phone:
714-812-6855
Applicant:
MCCANN JAMES
Con State Lic:
787748
Address:
333 N MARWOOD AVE
Lic Expire:
11/3012018
FULLERTON CA 92831
Bus Lic:
BT30049226
Phone:
714-394-5992
Lic Exp Date:
11/30/2017
Code Edit: 2016
Type of Construction: VB
Occupancy Group: R31U
Added /New sq.ft. Bldg: 1154
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units : 1
Bldg Height: 29
Bldg Sprinklers:
Flood Zone: X
Construction Valuation: $207,940.00
Building Permit Fee: $2,896.00
Plan Check Fee: $2,112.89
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$40.00
Energy Compliance:
$145.56
CA Seismic Safety:
$27.03
Disabled Access:
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$9.00
TOTAL FEE: $9,752.04
PROCESSED BY:
ZONING APPROVAL:
Worker's Compensation Insurance
Carrier: CA INS COMPANY
Policy No: 4684609001
Expire: 12/01/2017
Building Setbacks Rear: 5
Front: 15
Left: 5
Right: 5
Use Zone: PC-50 Parking SF
Architect:
Address:"``"
Phone:
State Lic:
�
Engineer:
MCCANN MAXWELL
Address:
1541 W AMERIGE AVE
FULLERTON AVE CA 92833
Phone:
714-803-6954 State Lic:C-077614
Designer:
Address:
Address:
Phone:
Special Conditions:
Excise Tax:
$0.00
Planning Department -
Additional Fee :
$0.00
Plan check Fee:
Grading Bonds Fee:
$0.00
Fair Share
Grading PC Consultant:
$0.00
SJH Trans
Grading Permit Fee:
$0.00
In -lieu Housing Fee:
Grading PC Fee:
$0.00
Public Works Department -
WQ Insp. Fee:
$0.00
Park Dedication : $0.00
PM Plan Check : $114.00
Electrical W
$202.72
San Dist: $770.00
Mechanical %:
$115.84
NMUSD Fee: $2,123.36
Plumbing %:
$260.64
Fire Department
$0.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
Plan Check Fee : $2,445.95 Fee Due at Permit
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
$0.00
$0.00
$24.00
$197.00
$564.00
$0.00
$0.00
$0.00
$7,306.09
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 (_) all of or (_) 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 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 legally
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.
signature of Property 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 70 ) f Division 3 of the Business and Profe ion o e,a d 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 ($100,00D(, IN ADDITION TO THE
DST 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 the
,ra rmance of the work for which this permit is issued. Policy No.
JI have and will mairf{aip 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' compensatior
Isurance carrier and Do "c number areYl _ n
Date
of Agent
I certify that, in the performance of th 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 agree
t, if I should become s 'act to thr r ars' gomperysati o provis s of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant ,1/ ��fy/ ✓
CLARATION REGAAWN15'11OKSTRUlYTIONLIENDMG AGENCY
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. �J /, Q�/J
I have read this application and the information I have provided is correct. Q�!/ (/l.r'w"�
I agree to comply with all applicable city and county ordinances and st a laws relating to building construction.
I authorize representatives of this city or coun t entarftfified property for inspection purposes. "i%� '//
ACTION DATE BY — DErLARATION OF 1 G3 REGULATIONS PART OMPLIANCE WITH CODE OF 63 OF TITLE 40 AND AQMD RULE
FOR OFFICE USE ONLY
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