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Home My WebLink AboutX2016-2929 - Permits0- 00r,SUIP2% City of Newport Beach - Building Division e 4 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - SFP MECH ELEC PLUM 11I111111111111111111111111111111111111111111111111111 COMB Permit: X2016-2929 x 2 e 1 6 2 9 2 9 Project No : 2029-2016 Issued Date : 09/30/2016 Inspection Area : 8 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. INSTALL OR VERIFY SMOKE(CARBON MONOXIDE DETECTORS /PLUMBING FIXTURES TO BE UPGRADED Job Address: 20352 KLINE DR NB Description: SFR ADD 413 SF (MASTER BEDIBATH) & REMODEL 102 SF Legal Desc.: Owner: GOLSON GARY Contractor: JASON GOLSON CONST. INC Architect: AHN KENNETH _" Pp Address: 7924 DALEN ST Address: 20352 KLINE DR Address: 2040 LOMITA BLVD #104 DOWNEY CA 90242 NEWPORT BEACH CA 92660 GARDENA CA 90717� Phone: Phone: 714.391-1392 Phone: 310-341-3436 State Lic:C030675 ®e Applicant: GOLSON SUNSHINE Con State Lie: 993270 Engineer: KWON OHSUNG --- Address: 20352 KLINE DR Lie Expire: 05/31/2018 Address: 2915 MONTROSE AVE #622 NEWPORT BEACH CA 92660 Bus Lie: BT30056465 LA CRESCENTIA CA 91214 , Phone: 714-723-8499 Lie Exp Date: 09130/2017 Phone: State Lic:C-085429 i� Code Edit : 2013 Worker's Compensation Insurance Designer: Type of Construction: VB Carrier: NO EMPLOYEES Address: Occupancy Group: R3/U Policy No: - Added /New sq.ft. Bldg: 413 Expire: Phone: Added /New sq. ft. Garage: 0 No of Stories: 1 Building Setbacks Rear: I Special Conditions: COSTA MESA SANTATION No of Units : 1 Front: I Bldg Height: 0 Left: / Bldg Sprinklers: N Right: / Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $81,137.10 Building Permit Fee: $926.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $805.62 Additional Fee : $0.00 Plan check Fee : $37.50 Fire Inspection: $0.00 Overtime Plan Ck: $0.00 Grading Bonds Fee: $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 Record Management: $22.00 Grading Permit Fee: $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $0.00 Energy Compliance: $56.80 Grading PC Fee: $0.00 Public Works Department - General Service $0.00 CA Seismic Safety: $10.55 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access : $0.00 PM Plan Check: $38.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $64.82 San Dist: $0.00 Building Green Fee : $4.00 Mechanical %: $37.04 NMUSD Fee: $0.00 $0.00 Plumbing %: $83.34 $0.00 TOTAL FEE : $2,086.67 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $2,085.67 PROCESSED BY: _ _ _ _ _ PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL 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 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 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 -Builder will have the burden of proving that it was not built or improved 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 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 Iegall) 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:// n .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 700 0 ;vision 3 e Business and Pro io Code, a li, �s in full force and effect. License Class License No Date -' Contractor Signature WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION ]TITS OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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 performance 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 rance carrier and policy number are: ier Policy Number Expiration Date to of Agent Phone # certify that, in the performance of the work for which this gwM 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 if I should become subject tot workers' co `8U Weons of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Iature of ApplicantY ^ 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 y 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 ordi 0nces and state laws relating to building construction. I authorize representatives of this city or county It's eobove-identified property for inspection purposes. 1 �, . 'signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Nam�%`�\ em DATE BY r DKLARATION OF COMPLIANCE WITH CODE OF FEDEI REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED EIEPA _ PERMIT EXTENDED QM D PERMITFINAL CERTIFICATE OF OCCUPANCY ISSUED S_31-22i yn3• o°T 0,r9-A ASBESTOS NOTIYCATION IS NOTAPPLICABLE TO OPOSED IT SIGNATURE FOR OFFICE USE ONLY P,II required ularms, latches gales and fences which serve as part of a pool/spa barrier, shall be in place prior to approval to fill pool/spa & shall remain in place & be maintained for the life of the pool.