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HomeMy WebLinkAboutX2022-0578 - PermitsCity of Newport Beach - Building Division 'X2022-0578' COMB Permit: X2022-0578 (G) 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 2905-2019 Permit Counter Phone (949)644-3288Inspection Requests Phone (949)644-3255 `a Yp 1 1 Issued Date : 03/04I2022 Combination Type - SFP ] • �y 1 Inspection Area : 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0310412025 OR PERMIT WILL BE INVALID Construction Hours: Monday- Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays Job Address: 1500 GALAXY DR NB Description: DELTA 4- `ADDITIONAL SCOPE' ADDITIONAL FRAMING AND FOUNDATION WORK AT THE KITCHEN & GARAGE Legal Desc.: N TR 4224 LOT 67 Owner: GOULD JOHN & JANICE Contractor: LOS TRANCOS DEVELOPMENT INC Architect: OATMAN HOMER C Address: 1500 GALAXY DR Address: P O BOX 982 Address: 412 31ST ST NEWPORT BEACH, CA 92660 LAGUNA BEACH CA 92653 NEWPORT BEACH CA 92663 ' Phone: Phone: 949-400-0002 Phone: 949-675-1755 State Lic:C018254 - ... Applicant: OATMAN HOMER C Con State Lic: 753556 Engineer: BURKE THOMAS - Address: 412 31ST ST Lic Expire: 04/30/2023 Address: 151 KALMUS OR #140 NEWPORT BEACH CA 92663 Bus Lic: ST30000898 COSTA MESA CA 92626 Phone: 949-675.1755 Lic Exp Date: 08/31/2022 Phone: 949-494-0776 State Lic:S-005088 Code Edit : 2019 Worker's Compensation Insurance Designer: Type of Construction: V-B-SPR Carrier: WICEXEMPT Address: • , ,. occupancy Group: R3/U Policy No: NO EMPLOYEES , Added /New sq.ft. Bldg: 0 Expire: Phone: Added /New sq. ft. Garage: 0 No of Stories: 1 Building Setbacks Rear: / Special Conditions: REV22-0345 No of Units: 1 Front: I Bldg Height: 0 Left: I Bide Sorinklers: Y Right: I Flood Zone: X Use Zone: Parkin S aces: 0 Fire Hazard Zone : N Construction Valuation: $35 000.00 Building Permit Fee: $619.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $538.53 Additional Fee : $0.00 Plan check Fee : $52.00 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: $8.00 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 $0.00 Building Green Fee : $2.00 Mechanical %: $0.00 NMUSD Fee: $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $1,219.53 Plan Check Fee : $590.53 Fee Due at Permit Issuance : $629.00 PROCESSED BY: 3,5 PUBLIC WORKS APPROVAL: Q ZONING APPROVAL: t ©A PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: /W K 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 app(ica t for to 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 U 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). D 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 projgith a licensed Contractor pursuant to the Contractors' State License Law). 1 am exempt from licensure under the Contractors' State License Law for the following re ly my signature below I acknowledge that, except for my personal residence in which I musresided 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 no been constructed in its ant' ecensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and 'rofessions Code, is available upon request when this a lication s b oat oeb site:http://www.leginfo.ca.gov/calaw.html. ;ignature of Property Owner or Authorized Agent Date .ICEN.SED CONTRACTOR'S DECLARATI hereby affirm unde, penalty of perjury that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, ynse' orce no effect. Licen<e Class License No Date z-Contractor Signature PORKERS' CO.✓FENSATION DECLARATION DARNING: FAILURE o JLCURE 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 DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY's FEES. hereby affirm under oenalty of perjury one of the following declarations: I I have and wi I 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 e,fornance of tie work for which this permit is issued. Policy No. ' i­e 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' "ance carrie, and policy number are: ;ertify that, in the performance of the work if I should become subject to the workers' of Policy Number Expiration Date A Phone # 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. / Date .��3'(ZaDZL DECLARATION REGARDING MNSTRUCTION LEND]YU AGENCY hereby affirm under penalty of perjury that there is a c'?j6struction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). -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 count an r d state el Ling to building construction. ,d authorize representatives of this city or county to ente a e-I pr party for inspection purposes.11 Signature of Pro art Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name i�/r 4_ f�'�'t.�� Date 7[ ACTION DATE BY DECLARATION OF COMPUA CE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMIT EXPIRED LJ I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED DEPA PERMIT EXTENDED QM D PERMITFINAL CERTIFICATE OF OCCUPANCY ISSUED (�r��(� V ( S ESTOS NOTIFICATION IS NOTAPP CABLE TO PROPOSED DEMOUTI e ��,y jZ sirNATIIRE '<