HomeMy WebLinkAboutX2015-2183 - PermitsCity of Newport Beach - Building Division COMB Permit: X2015-21
(1)
100 Civic Center Drive. Newport Beach, CA 92660 x 2 0 1 5 2 1 8 3 Project No
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255Issued Date:O6103`2015Combination Type - MFP -
Inspection Area : 5
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
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INSTALL OR VERIFY SMOKE/CARBON MONOXIDE DETECTORS /PLUMBING FIXTURES TO BE UPGRADED
Job Address: 212 MARGUERITE AVE NB
M`.13
Description: MFR REMODEL, CLOSE DOOR BETWEEN
UNITS, ADD DOOR
TO (E) BEDROOM, RETURN TO ORIGINAL DESIGN
Legal Desc.: RESUB OF CORONA DEL MAR BLK 139 LOT 10
Owner: 212 CDM LLC
Contractor:
ALL SEASONS HOME IMPROVEMENT Architect:
Address: 5020CAMPUS DR
Address:
14535 VALLEY VIEW AVE STE J Address:
NEWPORT BEACH CA 92660
SANTA FE SPRINGS CA 90670
Phone:
Phone:
562-407-5370
Phone: State Lic:
Applicant: ALL SEASONS HOME IMPROVEMENT
Con State Lic: 830895
Engineer:
Address: 14535 VALLEY VIEW AVE STE J
Lic Expire:
01/31/2016
Address:
SANTA FE SPRINGS CA 90670
Bus Lic:
BT30061973
Phone: 562-407-5370
Lic Exp Date:
08/3112016
Phone: State Lic:
Code Edit : 2013
Worker's Compensation Insurance
Designer: MITCH/ALL SEASONS
Type of Construction: V-B-SPR
Carrier:
STATE COMP
Address: 14535 VALLEY VIEW AVE #J
Occupancy Group: R3/U
Policy No:
9087612
SANTA FE SPRINGS CA 90670
Added /New sq.ft. Bldg: 0
Expire:
01/30/2016
Phone: 562-307-5350
Added /New sq. ft. Garage: 0
No of Stories: 2
Building Setbacks
Rear: /
Special Conditions: PLAN ATTACHED TO PERMIT
No of Units : 2
Front: I
Bldg Height: 0
Left: /
Bldg Sprinklers: Y
Right: /
Flood Zone: X
Use Zone:
Parking Spaces:
0 Fire Hazard Zone : N
Construction Valuation: $6,200.00
Building Permit Fee: $174.00
Excise Tax:
$0.00
Planning Department - Fire Department
Plan Check Fee: $125.28
Additional Fee :
$0.00
Plan check Fee : $32.00 Fire Inspection:
$0.00
Overtime Plan Ck: $0.00
Fair Share : $0.00 Fire Plan Rev
$0.00
Investigation Fee: $0.00
Grading PC Consultant :
$0.00
SJH Trans : $0.00 Demolition Fee
$0.00
Record Management: $0.00
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
Disabled Access : $0.00
PAN Plan Check: $0.00
Hazardous Mat $0.00
Electrical %:
$0.00
San Dist : $0.00
$0.00
Building Green Fee : $1.00
Mechanical %:
$0.00
NMUSD Fee: $0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE : $332.28
Plan Check Fee
: $0.00 , Fee Due at Permit Issuance :
$332.28
PROCESSED BY:
_ _
- �PUD,LIC WORKS APPROVAL:
ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
APo RyOVAL TO ISSUE:
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
is permit to file a sighed 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).
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,
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).
7 I am exempt from Iicensure under the Contractors' State License Law for the following reason:
Iy 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 7000) of Division 3 of the Business and Prof essjb s Code, a Iic�e is in full force
no effect. License Class License No Date x is, f�� Contractor Signature �X] 0-1 o awe
VORKERS' COMPENSATION DECLARATION
'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUB.IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
I 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 th(
erformance of the work for which this permit is issued. Policy No.
have 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
Isurance cg.H"nd policy number are:
Expiration Date
of
:ertify 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 workers' compensation laws of California, and
if I should become subiect to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
of
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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 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 toe t he above-ide ifi d pert for inspection purposes.)
nature of Property Owner or Authorized Agent `Y'u �/�^int Property Owner's or Authorized Agent's Name, r- i'L4L)
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