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Home My WebLink AboutX2012-0255 - Permits (3)c City of Newport Beach Building Division COMB Permit No: X2012-0255 ram. PROJECT NUMBER: 0203-2012 PO Box 1768 Newport Beach, California 92658-8915 Permit Counter Telephone (949)644-3288 Inspection Requestslrelephone (949)644-3255 0�aGwY�Y Combination Type - MFP/ ELEC/ PLUM/ MECH/ Job Address: 303 VISTA TRUCHA NB Description: KITCHEN REMODEL & RMV BEARING WALL 353 SF Inspector Area: 3 Legal Desc.: N TR 6885 LOT 36 INSPECTOR Owner: KNOPF SHOSHANA Contractor: LANDMARK CARPENTRY Architect: Address: 303 VISTA TRUCHA Address: 3153 KILLARNEY LN Address: NEWPORT BEACH, CA 92660 COSTA MESA CA 92626 Phone: Phone: 714-549-1681 Phone: State Lie: Applicant: BURKE LEO Con State Lie: 882871 Engineer: BURKE LEO Address: 34167 PACIFIC COAST HWY Lie Expire, 08/31/2012 Address: 34167 PACIFIC COAST HWY DANA POINT CA 92629 Bus Lic y�iT', bo -Sin b2. DANA POINT CA 92629 Phone: 949-226-7130 Lie Exp Date:/ 3 Phone: 949-226-7130 State Lic:C-067404 Code Edit : 2010 Worker's Compensation Insurance Designer: , Type of Construction: VB Carrier: EXEMPT Address: Occupancy Group: R3/U Policy No: , Added /New sq.ft. Bldg: 0 Expire: Phone: ANGEXIST Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear: I VERIFY SMOKE NON - Special Conditions: WgjA LOOA ARE No of Units: 2 Front: / DETE�ORS PER GRCR 814.1&3152 ' Bldg Height: 0 Left: / Bldg Sprinklers: Right: Flood Zone: Use Zone: - - Issued Date: 02/03/2012 Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $16,000.00 Building Permit Fee: $290.96 Solar System PC: $0.00 Planning Department - Fire Department Plan Check Fee: $209.49 Excise Tax: $0.00 Plan check Fee : $31.25 Fire Inspection: $0.00 Overtime Plan Ck: $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 Investigation Fee: $0.00 SJH Trans : $0.00 Demolition Fee Record Management: $15.00 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 P/W Plan Check : $0.00 Fee Increase: Fee: $0.00 Electrical %: $20.37 San Dist : $0.00 Additional Fee : $0.00 Mechanical W $14.55 NMUSD Fee: $0.00 $0.00 Hazardous Mat : $0.00 Plumbing %: $29.10 $0.00 Building Green Fee: TOTAL FEE � Plan Check Fee: $0.00 Fee Due at Permit Issuance : $611.72 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: PUBLIC WORKS PLAN CHECK BY APPROVAL TO IE PERMITS EXPIRE IN DAYS AFTER ISSUANCE OR LAST VALI. 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 anG 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). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business 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 improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner-Builderwill have the burden of proving that it was not built or improved for the purpose of sale). ❑ 1, 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 apply 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). ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason: By 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 sell 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 Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Signature of Prop:Ia, Owner or Authorized Agent Date ZI LICENSED CONTRACTOR'S DECLARATION 1• be-Ety affirm urder renalty of perjury that I am licensed under provisions of Chapter 9 (commencing with. Section 7000) of Division 3 of the Business and Professions ode, and licens ' infu roe and effect. Z _ 3 , ( Z ( iuense Class _ License No to )Q'ol]tfactor Signature WORKERS' COMPENSATION DECLARATION 61 NIAPNING FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUR'Fr AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN AD ITION TO THE COST 3- COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 1 ha-cty affirm imd�r penalty of perjury one of the following declarations: 0 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 IN t,er.oaoance of the work for which this permit is issued. Policy No. ❑I have and will malrtain 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 insuranne carrier and policy number are: Policy Number Date i ce fy that, in the performance of the or for which this rm it sued, I shall no mploy any person in any manner so as to become subject to the workers' compensation laws of California, and ac t, should become subject to the ers' compens provi ns of Section 3 0 of the Labor Code, shall forthwith comply with those provisions nature of Applicant CLARATION REGARDING COYtT RUVTON LENDING AGE ereby affirm under penalty of p jury that there is a constructs n nding agency f r the performance of the work for which this permit is issued ( ection 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 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 ordina, es and state I ws rel gdt,,n,,g construction. )I authorize representatives of this city or county to enterf above-ide ed pe on purposes.fiature of Property Owner or Authorized Agent ' roperty Owner's or Authorized Agent's Name a 1Z_ Z,d AC77ON DAIF By DE TfON OF COMPLIANCE WITH CODE OF FOROF EDNLY FE RAL REGULATIONS PART 61 OF TITLE40 AND A IM RULE 1403. PERMIT EXPIRED ❑ ISUBMITTEDASBESTOS NOTIFICATIONTO: ❑ EPA ❑ AOMD PERMIT CANCELLED PERMIT EXTENDED ❑ ASBESTOS M07IRCAIIONIS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL ?. CERTIFICATEOF SIGNATURE: OCCUPANCYCSSUED