HomeMy WebLinkAboutX2012-1289 - PermitsCity of Newport Beach
Building Division
PO Box 1768 Newport Beach, California 92658-8915 Permit Counter Telephone (949)644-3288
Combination Type - SFP/ MECH/ PLUM/ /
Job Address: 20 SURFSPRAY BLUFF NB
Description:RES KITCHEN REMODEL
Inspector Area: 6
Owner: PRESTIGE TRUST
Address: 20 SURFSPRAY BLUFF
NEWPORT COAST CA 92657
Phone:
Applicant: BADER MIKE
Address: 19 CHIMNEY LN
LADERA RANCH CA 92694
Phone: 949-395-3170
Code Edit : 2010
Type of Construction: V-S
Occupancy Group: R3/U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 1
No of Units : 1
Bldg Height: 0
Bldg Sprinklers:
Flood Zone:
Issued Date: 06/05/2012
Construction Valuation: $20,000.00
Building Permit Fee:
$365.56
Plan Check Fee:
$0.00
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$6.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access:
$0.00
Fee Increase: Fee:
$0.00
Additional Fee :
$0.00
Hazardous Mat :
$0.00
Building Green Fee:
$1.00
TOTAL FEE: $427.40
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Legal Desc.:
Contractor:
BADER HOME CONSTRUCTION
Address:
19 CHIMNEY LN
LADERA RANCH CA 92694
Phone:
949-395.3170
Con State Lic:
941589
Lic Expire:
12131/2013
Bus Lic:
BT30036307
Lic Exp Date:
07/31/2012
Worker's Compensation Insurance
Carrier:
STATE COMP INS FUND
Policy No:
497-0001667
Expire:
06101/2013
Building Setbacks
Rear: /
Front: /
Left: /
Right: /
Use Zone:
Pnrkino Snaces:
0
Architect:
Address:
COMB Permit No: X2012-121
PROJECT NUMBER:
Inspection Requestsrrelephone (949)644-a255
Phone: State Lic:
Engineer:
Address:
Phone: State Lic:
Designer:
Address:
Phone:
Special Conditions: SEE ATTACHED PLAN
Fire
Solar System PC :
$0.00
Planning Department -
Excise Tax:
$0.00
Plan check Fee
Fair Share
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
PAN Plan Check:
$0.00
Electrical %:
$0.00
San Dist :
$0.00
Mechanical %:
$18.28
NMUSD Fee:
$0.00
Plumbing %:
$36.56
Fire Department
$0.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee : $0.00 Fee Due at Permit Issuance : $427.40
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:' I ��
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
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 items)
(Section 7031.5,E 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 and
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 J 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 -Builder will have the burden of proving that it was not built or
im roved 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 Iega11,,
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://w .leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professio�e, and my license is in full force
and effect. //
U^=rae Class License No Date X(0 _6_ j 7— Contractor Signature
A'CR!<ERS' COMPENSATION DECLARATION
VARNINC. FAILURE'. TO 117CURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SU WECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($10Q000J, IN ADDITION TO THE
Jos OF,'OMPENSATION, uAMAGES 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 I have and wil' ma'ntain 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
e'�rj lance of the work for which this permit is issued. Policy No.
and volt 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'
carrier and policy number are:
Policy Number
Agent,
Date
certify that, in fhi performance 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
t, if I should Uncome subj ct to the workers' compensatiolnn provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. \ /
nature of Applicant 17� ��C�(� Date /C.z-
CLARATION REGAAA�INC' CONSTRUCTION LENDING AGENCY
:reby affirm under penalty of 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 ordinance and state laws relating to building construction.
I authorize representatives of this city or county nter the at, e-identifiedfied pronspection purposes.
nature of Property Owner or Authorized Agent e i Print Property Owner's or Authorized Agent's Name t Dai J
ACTION
DATE
BY
DECLARATION OF COMPLIANCE tMTH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 67 OF TITLE40AND
AQMD RULE 1403.
PERMIT EXPI RED
❑ I SUBMITTED ASBESTOS M077FICATION TO:
EPA
AQMD
PERMIT CA NCELLED
PERMIT EXTENDED
ESTOS N077RCAT70N IS NOT APPLICABLE TO
PROP SED DEMOLITION.
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PERMIT FINAL
(� �'(,
CERTIFICATEOF
/
OCCUPANCYISSUED
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