HomeMy WebLinkAboutX2019-2415 - Permits (2)„r.alfop City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
,t.,.;" ..,•r Inspection R!,, a -s-
r,<,.,,w+`' Combinatlgla:YyH
ELEC MECH PLUM
ate: �2-9- 2 Z
Job Address: 123 JASMINE C
Description: SFR-CONV 44
Legal Desc.: N TR 7967 LOT
Owner:
Address:
Phone:
Applicant:
Address:
Phone:
BENTROTT BR
123 JASMINE
CDM CA 92625
BISHOP ALEX
23183 LA CADE
LAGUNA HILLS
949-677-2484
Code Edit: 2016(�
Type of Construction: V-13' a
Occupancy Group: R31U1,
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 1 1`
No of Units : 1
Bldg Height: 0
Bldg Sprinklers:
Flood Zone:
COMB Permit: X2019-1116
Project No : 0792-2019
Inspection Aria : 4
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
- Fri 00 aam. to 6*40 at .frgm 8:00 0 n S da 0 Holidays
rn rr. arias fl'$� /0 81"d101 tYP re`iunY� r
REMODEL (E) 1600 SF ar --
s
to whom:
Contractor:
OW N E RIBLD R
Architect:
Address:
BENTROTT BRYAN s�
Address:
Phone.
-
Phone:
State Lie:
Cori Mate C-c. - O/B Engineer: WILSON KALEN
'E 101 Lie Expire: Address: 1371 WARNER AVE #A
I Bus Lic: TUSTIN CA 92780
Lie Exp Date: Phone: 714-576-6524 State Lik
CarriYeN'pICI - - Ce ® ®i g40 ca ' ""`l3JE HILLS CAD92653E 1
(worrPjnii�d) (no wi �: starUll -2484
Expire:
n
N oten : Building Setbacks Rear: 15 Special Conditions: CR & R TO i
HAUL DEBRIS
Left: 5
Construction Valuation: $150,000.00
Building Permit Fee:
$1,348.00
Excise Tax:
$0.00
Planning Department -
Plan Check Fee: $1,172.76
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:
$34.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee:
Energy Compliance:
$105.00
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
PM/ Plan Check :
$82.50
Hazardous Mat
$0.00
Electrical %:
$94.36
San Dist:
$0.00
Building Green Fee :
$6.00
Mechanical %:
$53.92
NMUSD Fee:
$0.00
Plumbing %:
$121.32
TOTAL FEE : $3,802.86
PROCESSED BY:
ZONING APPROVAL:
initiills: PZ L_
Zone:
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:
Plan Check Fee : $2,086.01 Fee Due at Permit
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
,pEC ® ►
$0.00
$0.00
$24.00
$197.00
$564.00
$0.00
$0.00
$0.00
$1,716.85
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)
ction 7031.6, 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
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
fessions 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,
more than five hundred dollars ($500).
LI I, as owner of the property, or my a I.
Business and Professions Code: The CYi
improvements are not intended or offereA,11
improved for the purpose of sale). fl. ;
I, as owner of the property, am exclp"iv
a 0 an owner of property who built
I am exempt from licensure under ti-(
By signature below I acknowledge trat,
structure that I have built as an ol''
Professions Code, is available upon reques
Signature of Property Owner or Authori%d
LICENSED CONTRACTOR'S DECLA
I hereby affirm under penalty of perjury.thal
and effect. License Class
WORKERS' COMPENSATION DECL
NARNING: FAILURE TO SECURE WORKERS' COMPE
COST OF COMPENSATION, DAMAGES AS PROVIDED
their sole compensation, will do (_) all of or
of the work, and the structure is not intended or offered for sale (Section 7044,
h em loyees' or personal effort, builds or improves the property, provided that the
ale. If, however, the building or improvement is sold within one year of comp a Io , YJL9 that it was not built or
Date: �2-at-2-Z
contracting with license tion 7044, Businef ¢ e$ss p4ade: The Contractors'
)roves thereon, and who contracts for the projects with a licensed Contractor pursuan to FFdd�tll'' State License Law).
;e Law for the following Ygasglg� - -_
residence in which I mudf'have rAS _ddedvYor at least",
IT constructed in its entirety by licensed contractors.
that a copy of the
under pro VISIons -'of"Chapter 9 commencing with, Section 7000), of Division 3 of the Business and Professions Code,
License No Date Contractor Signature
AGE IS UNLAWFUL, ANO"SHALISI JECT AN16PLOYER TO CRIMINAL PENALTIES AND CIVIL FINE$ UP TO ONE HUNDRED THOUSAND DOI
3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. -
hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate
ormance of the work for which this pe
have and will maintain workers' com
trance carrier and policy number are:
of Agent
rtify that, in the performance of the
I should become subject tqt*w.Q
of Applicant
selkiirIiiiijure for workers' compipirsation, Issued by the Director of Industrial Relations as provided for by Section
oli
anae a b Se n f e Labor CoWe e®r j&Co a +prr f I wl'rc� f Ern is iE
work started)��n�����v��A v�! �{' e
Policy tuber
compensation prgyj lqu of Section
IIreby affirm under penalty of perjury that there is a construction lending agency for the pe for
in any manner so as to become subject to the workers'
-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 this city or count o v-identifie f 'Section purposes.
signature of PropertyOwner or Authorized Agent Pont Property Owner's or Authorl Ag
ACTION DATE BY ;DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE
1403
PERMIT CANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCYISSUED
NOTIFICATION TO
NOTIFICATION IS NOT APPLICABLE
I License Law does not
this permit, I cannot legally
of the Business and
7fZl/lf'
my license is in full force
($100,000), IN ADDITION TO THE
of the Labor Code, for the
My workers' compensation
X,I
aiiAtof California, and agree
7