HomeMy WebLinkAboutX2016-3466 - Permits- Building Division IIIIIIIII�II�IIIIIIIIIIIIII II COMB Permit: X2016-3466
wive, Newport Beach, CA 92660 X 2 0 1 6 3 4 6 6 PrOjecl NO
i Permit Coumer Phone (949)644-3288
U Intpection Requests Phone (949)644-3255
n^�caxuc'8'� Combination Type - SF' 'TELEC PLUM Issued Date : 10l24/2016
Inspection Area : 4
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
Job Address:
58 ROYAL SAINT GEORGE RD NB
Description:
SFR REMODEL KITCHEN 400 SF (CITY STD PLAN)
Legal Desc.:
N TR 7223 LOT 39
Owner:
LOPEZ SASHA EDWARD Contractor:
Address:
58 ROYAL SAINT GEORGE RD Address:
NEWPORT BEACH, CA 92660
Phone
Applicant: MIZRUCHI OMRI
Address: 1941 SANTA ANA AVE
COSTA MESA CA 92627
Phone: 949-698-314B
Code Edit : 2013
Type of Construction: VB
Occupancy Group: R31U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units: 1
Bldg Height: 0
Bldg Sprinklers:
Flood Zone: X
Construction Valuation: $67,000.00
Phone:
Con State Lic:
Lic Expire:
Bus Lic:
Lic Exp Date:
LION BUILDER CONSTRUCTION
1941 SANTA ANA AVE
COSTA MESA CA 92627
949-698-3148
993326
06/30/2018
BT30055316
06/30/2017
Worker's Compensation Insurance
Carrier: STATE FUND
Policy No: 9137767
Expire: 07/16/2017
Building Setbacks Rear: /
Front: !
Left: /
Right: !
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
State Lic:
State Lic:
Special Conditions: LANDSLIDE AREA
0 Fire Hazard Zone : N
Building Permit Fee:
$835.00
Excise Tax:
$0.00
Planning Department -
Plan Check Fee:
$726.45
Additional Fee :
$0.00
Plan check Fee
Overtime Plan Ck:
$0.00
Grading Bonds Fee:
$0.00
Fair Share
Investigation Fee:
$0.00
Grading PC Consultant:
$0.00
SJH Trans
Record Management :
$2.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee
Energy Compliance:
$0.00
Grading PC Fee:
$0.00
Public Works Department -
CA Seismic Safety:
$0.00
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Disabled Access :
$0.00
P/W Plan Check:
$0.00
Hazardous Mat
$0.00
Electrical %:
$58.45
San Dist:
$0.00
Building Green Fee :
$3.00
Mechanical %:
$33.40
NMUSD Fee:
$0.00
Plumbing %:
$75.15
TOTAL FEE: $1,733.45
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Plan Check Fee
Fire Department
$0.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
$0.00 Fee Due at Permit Issuance
PUBLIC WORKS APPROVAL:
PLHH CHECK BY:
APPROVAL TO ISSUE:
w�®
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$1,733.45
OWNER -BUILDER DECLARATION '-
1 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(sl, W ve placed next to the applicable IL ,-,
(Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure `Z 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 (commence action 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 subjectsthe 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-Builderwill 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 11egall1
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/mlaw.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 0 o Di ' is } of the Business and Prof lions C e, Yf�iy license is in full force
and effect. License Class License No Dat AM / Contractor Signatu
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 THOUSA OLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'$ 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 the
PeOmance of the work for which this permit is issued. Policy No.
have and will m In In workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the worts for which this permit is issued. My workers'
rance carrier and illy number are: n �1
toofAgents J N;`" j
certify that, in the performance of the work
if I should become subject to the workers'
of Applicant
Date
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
ions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /
ate /0 �f
CLARATION REGARDING CONSTRUCTION LEr'{DIfJG AGENCY
areby affirm under penalty of perjury that there is I nstruction lending agency for the performance of the work for which this permit is issued (Section 3097
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 slat relating to building construction.
I authorize representatives of this city or county lo�enter the aboQft d property for inspection purposes. A
of Procertv Owner or Authorized
ACTION
PERMIT EXPIRED
PERMIT CANCELLED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCY ISSUED
I DATE I
REGULATIONS
1403
Print Property Owner's or Authorized Ag
ILIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
OF TITLE 40 AND, RULE
I SUBMITTED ASBESTOS NOTIFICATION TO
Civil Code).
hn;z-yv:f 9I
EpA All requireo ala•ns, latches gates and fences which serve as part of a pool/spa barrier, shall
L_JAQMD to in place prior to approval to fill pool/spa & shall remain in place & be maintained for the
forN ASBESTOS NOTIFIC ION I5 NOTA (CABLE TO life of the pool.
PROPOSED DEM ON