HomeMy WebLinkAboutX2016-1207 - Permits�$teaogT
City of Newport Beach - Building Division
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100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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Inspection Requests Phone (949)644-3255
Combination Type - SFP ELEC PLUM MECH
COMB Permit: X2016-1207
Project No :
Issued Date : 04/08/2016
Inspection Area : 3
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
INSTALL OR VERIFY SMOKE/CARBON, MONOXIDE DETECTORS /PLUMBING FIXTURES TO BE UPGRADED
Job Address:
1807 COMMODORE RD NB
Description:
SFR - KITCHEN REMODEL *CITY STANDARD* 108 SF -
Legal Desc.:
N TR 3763 LOT 10
Owner:
HO KWOH-I
Contractor: OWNERIBLDR
Address:
2626 33RD ST
Address:
SANTA MONICA, CA 90405
Phone:
310-452-7729
Phone:
Applicant:
SEAN/OLD GUARD FABRICATION INC
Con State Lic: O/B
Address:
3505 CHARTER OAK DR
Lic Expire:
CARLSBAD CA 92008
Bus Lic:
Phone:
Lic Exp Date:
Code Edit: 2013
Type of Construction: V-B
Occupancy Group: R3/U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 1
No of Units : 1
Bldg Height: 0
Bldg Sprinklers:
Flood Zone:
Worker's Compensation Insurance
Carrier:
Policy No:
Expire:
Building Setbacks Rear: I
Front: I
Left: I
Right: /
Architect
Address:
Phone: State Lic:
Engineer:
Address:
Phone: State Lic:
Designer:
Address:
Phone:
Special Conditions: O/B AUTH FORM ATTACHED
Building Permit Fee:
$278.00
Excise Tax:
$0.00
Planning Department -
Plan Check Fee:
$241.86
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:
$0.00
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
PAN Plan Check :
$0.00
Hazardous Mat
$0.00
Electrical %:
$19.46
San Dist:
$0.00
Building Green Fee:
$1.00
Mechanical %:
$11.12
NMUSD Fee:
$0.00
Plumbing %:
$25.02
TOTAL FEE: $61
PROCESSED BY:
ZONING APPRA
GRAD]
it A
i d
Plan Check Fee:
pMCI^r
' L
Fire Department
$37.50
Fire Inspection:
$0.00
$0.00
Fire Plan Rev
$0.00.
$0.00
Demolition Fee
$0.00
Building Dept Adm
$0.00
General Service
$0.00
Refund Deposit
$0.00
Grading Bond:
$0.00
$0.00
$0.00
$0.00 Fee Due at Permit Issuance : $613.96
PUBLIC WORKS APPROVAL:
PLAN CHECK BY: 1(1 1
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).
❑ 1, 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,
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
ibky to an owner of property who builds or improves thereon, anti who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
in exempt from licensure under the Contractors' State Li rise Law for the following reason:
signature below I acknowledge that, except for my pers al resid rice in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legalh
ell structure that I have built as an owner -builder if it has n bee structed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 o th usiness and
rofessions Code, is available upon request when hi appli ion s mitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. D A R ry
signature of Property Owner or Authorized Agent (�Il``. 3
.ICENSED CONTRACTOR'S DECLARA B
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cod and my license is in full force
rid effe^t. License Glass License No Date Contractor Signature
YORKCRS' COM'3ENSATION DECLARATION
IARNIN3: 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
OSi OF �OMPENSAT,ON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm urid_�I penalty of perjury one of the following declarations:
7 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
e' onmance of the wurk for which this permit is issued. Policy No.
�l Lade 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' compensatiol
Iannce carrier and policy number are:
Policy Number
ad o Agent
Date
certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and
if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
ignature of Applicant Date_
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY
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 prIer's b half.
I have read this application and the information I haveis corr ct.
I agree to comply with all applicable city and county orasa ate laws relating to building construction.
I authorize representatives of this city or county to t-i entified property for inspection purposes. Iry
ignature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name Date
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FEDERAL REGULd rIONS PART 6 f OF TITLE40 AND
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❑ EPA
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❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
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