HomeMy WebLinkAboutX2016-0342 - PermitsCity of Newport Beach - Building Division
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a4 O 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
F
u Inspection Requests Phone (949)644-3255
y� gyp• Combination Type - MFP PLUM
IIIIIIIIIIIIIIIIIIIIIII
II COMB Permit: X2016-0342
Project No:
Issued Date : 02/02/2016
Inspection Area : 6
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
INSTALL OR VERIFY SMOKE(CARBON MONOXIDE DETECTORS /PLUMBING FIXTURES TO BE UPGRADED
Job Address: 28 SARACENO NB
Description: MFR - REPIPE W/PEX & DRYWALL PATCH
Legal Desc.:
Owner:
HUANG SHERRY
Address:
28 SARACENO
NEWPORT COAST CA 92667
Phone:
Applicant:
REPIPE 1
Address:
19326 VENTURA BLVD #201
TARZANA CA 91356
Phone:
818-342-2927
Code Edit : 2013
Type of Construction: V-B
Occupancy Group: R2
Added /New sq.ft. Bldg: 0
Added. /New sq. ft. Garage: 0
No of Stories: 2
No of Units : 7
Bldg Height: 0
Bldg Sprinklers:
Flood Zone: X
Contractor:
REPIPE 1
Address:
19326 VENTURA BLVD #201
TARZANA CA 91366
Phone:
818-342-2927
Con State Lic:
927892
Lic Expire:
01/31/2017
Bus Lic:
BT30044924
Lic Exp Date:
10/31/2016
Worker's Compensation Insurance
Carrier: NATIONAL UNION FIRE
Policy No: WC14267940
Expire: 09/16/2016
Building Setbacks Rear: /
Front: /
Left: /
Right: /
Use Zone:
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
Special Conditions:
Building Permit Fee:
$124.00
Excise Tax:
$0.00
Planning Department -
Plan Check Fee:
$0.00
Additional Fee :
$0.00
Plan check Fee
Overtime Plan Ck:
$0.00
Fair Share
Investigation Fee:
$0.00
Grading PC Consultant :
$0.00
SJH Trans
Record Management:
$0.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee
Energy Compliance.
$0.00
Grading PC Fee:
$0.00
Public Works Department -
CA Seismic Safety
$0.00
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Disabled Access :
$0.00
PAN Plan Check:
$0.00
Hazardous Mat
$0.00
Electrical W
$0.00
San Dist:
$0.00
Building Green Fee
$1.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
Plumbing %:
$11.16
TOTAL FEE: $136.16
PROCESSED BY:
ZONING APPROVAL:
State Lic:
State Lic:
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:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee : $0.00 Fee Due at Permit Issuance : $136.16
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE: ? 1,
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) Indic
;Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, derr
the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License L
Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Secti
not 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 U portions of t
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through (
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of comp
improved for the purpose of sale).
❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044,
apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor
C I al exemp; from icensure under the Contractors' State License Law for the following reason:
Ey my 3'gnature below I acknowledge that, except for my personal residence in which I must have resided for at least one y
,Fell a structure thaf I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I un
f-ro.esGions Code, is available upon request when this application is submitted or at the following Web site: http://www.legin
Signature of Property Owner or Authorized Agent
LICENSED COYTR6.CTOR'S DECLARATION
I hereby affirm urder Penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7�10f1) o'
end effent. License Class License No Date
COM?c—NSATION DECLARATION
, FAILURE TC SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
Lndet penalty of perjury one of the following declarations:
have and w'll maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of
"mance of the work for which this permit is issued. Policy No.
ve and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the pe
ace carrier and policy number are:
Policy Number
of Agent
d below by the checkmark(s) 1 have placed next to the applicable item(s)
sh, or repair any structure, prior to its issuance, also requires the applicant for
(Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
work, and the structure is not intended or offered for sale (Section 7044,
ployees' or personal effort, builds or improves the property, provided that the
ion, the Owner -Builder will have the burden of proving that it was not built or
and Professions Code: The Contractors' State License Law does not
to the Contractors' State License Law).
to completion of the improvements covered by this permit, I cannot
that a copy of the applicable law, Section 7044 of the Business and
Date
risio of the Business. and Profesgbins'Code, d I/ �y icense is in full force
Contractor Signature
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
Relations as provided for by Section 3700 of the Labor Code, for
of the work for which this permit is issued. My workers'
Date
certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner 40 as to become subject to the workers' compensation laws of California, and
, if I should become subject to the workers�,:ompensation provisions of Section 3700 of the Labor Code, I shall forthwith 1comply with those provisions.
re of
CLARATION REGARDING OONVRUCTION LENDING AGENCY
3reby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which
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 ordinances and state laws relating to building construction.
I authorize representatives of this city or county enter the above-identifie roperty for inspection purposes.
mature of Property Owner or Authorized Agent ..m.T (,[ L SgdnejS Print Property Owner's or Aut
Date All
permit is issued (Section 3097, Civil Code).
Agent's Name)e�� Dat �'iTs.
ArThW DATF
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