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Home My WebLink AboutX2016-1269 - PermitsgAawrrso� City of Newport Beach - Building Division . IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 11 COMB Permit: X2016-1269 o G 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 6 1 2 6 9 F Permit Counter Phone (949)644-3288 Project NO : 0820-2016 Inspection Requests Phone (949)644-3255 nw;am4p+T Combination Type - MFP Issued Date : 04112/2016 Inspection Area : 5 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. INSTALL OR VERIFY SMOKE/CARBON • MONOXIDE DETECTORS /PLUMBING FIXTURES TO BE UPGRADED Job Address: 606 JASMINE AVE NB Description: MFR- REVISE LIVING ROOM CEILING Legal Desc.: PM 266-27 PAR 1 OF PROJECT 938-01 LOCATED ON AP 459-193-24 TOGETHER Owner: DRYFUS ALFREDO Address: 506 JASMINE CORONA DEL MAR CA 92626 Phone Applicant: MITCHELL FRANK Address: 1920 S GREENVILLE ST SANTA ANA CA 92704 Phone: 714-760-2397 Code Edit : 2013 Type of Construction: VB Occupancy Group: R3/U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 2 Bldg Height: 0 Bldg Sprinklers: Contractor: V C D 8. SONS INC Architect: Address: 526 S ROSS STREET Address: SANTA ANA CA 92701 Phone: 714.801.7604 Phone: Con State Lic: 596135 Engineer: Lic Expire: 07/31/2017 Address: Bus Lic: ST30054707 Lic Exp Date: 04/30/2017 Phone: SIV10616 State Lic FORBES DALE L - 1800 E 16TH ST #B SANTA ANA CA 92701 714-835-2800 State Lic:C-030407 Worker's Compensation Insurance Designer: Carrier: STATE COMP INS FUND Address: Policy No: 1877843 Expire: 11/01/2016 Phone: Building Setbacks Rear: I Special Conditions: Front: / Left: / Right: / Flood Zone: Use Zone: Parking Spares: 0 hire Hazard Zone : N Construction Valuation: $30,000.00 Building Permit Fee: $483.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $420.21 Additional Fee : $0.00 Plan check Fee : $37.50 Fire Inspection: Kai ' 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: $2.00 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 $0.00 Disabled Access: $0.00 PAN Plan Check : $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist : $0.00 Building Green Fee : $2.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $944.71 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $944.71 PROCESSED BY: ( ,✓ PUBLIC WORKS APPROVAL: ZONING APPROVAL: �.J-�C-� 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 ie 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 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). 7 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). I am exempt from licensure under the Contractors' State License Law for the following reason: ly 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) 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. Iignature 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 Sectto� n 7000) of Division 3 of the Business Prof Ic Of nd effect. License Class License No D 04-- /'�— /G Contractor Si ure VORKERS' COMPENSATION DECLARATION IARNING: FAILURE TO SE URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLA ,.,000), IN ADDITION TO THE CST 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: 3 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 errormance of the work for which this permit is issued. Policy No. and will mkintain 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 of Agent Date 71 certify thaF, in thra performance of the ork for whit t permit is issued, I shall not employ any person in any manner so as to become subject to the rkers' compensation laws of California, and agre re'., if I should b ccme s toe t to the k omp visions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions ignatureo App t -- Date-12�—/3—/� IECLARATIONAkE ING ONST hereby affirm under p nalty of perjury that there is a construction lending agency for the performance a work for which this permit is issued (Section 3097, Civil Code). ender's Name Lender's Address ly 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 law lating to building construction. I authorize representatives of this city or coupt,ythe inspection purposes. ow Iignature of Property Owner or A.4ftrized Agent .,��`� P t Property Owner gent's Name %BANK Date Ar7MV1 I / DA7F MY J nrn ur u nrcuvv4c wr J r.�Vv or FErEML REGULATIONS PART 81 OF TITLEAC AND PFRArrT XPrP n AQVD ROLE 1403. ❑ f StIniAJTTrnASIYSTl1S W)TfTfL:ATON TO: pr,-VArT CAPIC[LIED ❑ EPA PERMrT EXTEN DEiD A /.0 ❑./ JISBEfiTOS NO-EIRC BOX IS NOTAPIDUCA°BLE CERTFTCATFGF {� / OCCUDANCVISSLtED S Z,1 ,2, SfUNA TO FUN UiHLt Mi: umr