HomeMy WebLinkAboutX2018-3730 - Permitswsrr,� 0ty of Newport Beach - Building Division II IIIIII� IIII II IIIIIII IIII IIII II COMB Permit: X201
100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 8 3 7 3 0 Project No : 2896-2018
Permit Counter Phone (949)644-3288
c5 ". Inspection Requests Phone (949)644-3255
Combination Type- SFP ELEC MECH PLUM GRAD Issued Date :
Inspection Arearea :2019
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: 62I ROCKFORD RD NB
Description: SFR ADDDD 14381438 SF LIVABLE, 481 SF GARAGE, 1819 SF INTERIOR REMODEL
Legal Desc.: N TR 3519 LOT 138 ,
I ,
'
Address: 2561 E CHAPMAN AV #110 Lic Expire: 0813112020
Workers Compensation Insurance Designer: ,
Address:
Owner:
CHRISTENSEN DANAE
Contractor:
BLACK PETS CONSTRUCTION INC
Architect:
OLDHAM RYAN
Address:
621 ROCKFORD RD
Address:
1788 MONROVIA AVENUE
Address:
2651 E. CHAPMAN AVE #110
CORONA DEL MAR, CA 92625
COSTA MESA CA 92627
FULLERTON, CA 92831
Phone:
Phone:
714-612-7678
Phone:
714-082-8296 State Lic:CO29715
Applicant:
OLDHAM RYAN
Con State Lic:
692383
Engineer:
LOTHROP SHAWN DUANE
Code Edit :
2016
Building Permit Fee: $6,093.00
Plan Check Fee: $4,927.16
Overtime Plan Ck: $0.00
Investigation Fee: $0.00
Record Management: $62.00
Energy Compliance: $268.00
CA Seismic Safety: $130.00
Disabled Access: $0.00
Hazardous Mat $0.00
Building Green Fee : $40.00
TOTAL FEE : $20,666.43
PROCESSED BY:
ZONING APPROVAL:
Carrier:
TOTAL FEE : $20,666.43
PROCESSED BY:
ZONING APPROVAL:
Carrier:
EXEMPT
Phone:
Special Conditions: FUEL MOD ZONE, LANDSLIDE
AREA
Excise Tax:
$0.00
Planning Department -
Additional Fee:
$294.00
Plan check Fee
Grading Bonds Fee:
$0.00
Fair Share:
Grading PC Consultant :
$1,741.68
SJH Trans :
Grading Permit Fee:
$875.00
In -lieu Housing Fee:
Grading PC Fee:
$382.32
Public Works Department -
WQ Insp. Fee:
$0.00
Park Dedication : $0.00
PNV Plan Check: $123.76
Electrical %:
$426.51
San Dist : $920.00
Mechanical %:
$243.72
NMUSD Fee: $2,645.92
Plumbing %:
$54B.37
GRADING APPROVAL: I S��
Zone :N
Fire Department
$160.00
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 : $6,157.16 Fee Due at Permit Issuance
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
$0.00
$0.00
$24.00
$197.00
$564.00
$0.00
$0.00
$0.00
$14,509.27
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
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).
11 I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) 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
im roved for the purpose of sale).
I, as owne-'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 ownei of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
GT i am exempt frcm 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 legall)
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 Coda, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Sgnawre of Property Owner or Authorized Agent Date
1_1=iSED CONTRACTOR'S DECLARATION
h€roty affirm under nenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Se n 7 of Division 3 of the Bus' and Profession�¢gde, and my license is in full force
Rod Pf ect. License Class License No Da v U Contracto nature �/Y
NCRI'ZRS' COMPENSATION DECLARATION
q'ARNING: FAILURE 10 SECI IRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (E100,000(, IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
?ierebraffirm under pe-lalty 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
ormance of the work for which this permit is issued. Policy No.
a —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' compensatior
su nce carrier and policy number are:
larder Policy Number Expiration Date
Ja a of ent Phone #
that, in the 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 work s' compensation laws of California, and agree
o become /ect [o the worke s' ompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. e,
3i nature ofA nt
9 P
]ECLARA R CARDING CONST CTION LENDING AGENCY
hereby 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).
_ender's Name Lender's Address
3y 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 thi ity or county to enter above -identified property for inspection purposes.
signature of Property Owner or Au ized Agent Print Property Owner's or Authorized A is Name
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED LJ I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED LIEPA
PERMIT EXTENDED LJAQMD
PERMIT FINAL 7, SBESTOS NOTIFICATION 15 NOT APPLICABLE TO
CERTIFICATE OF l !OS,EDDEMOLITION
OCCUPANCY ISSUED /rMITN, URE: ,/ `