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Home My WebLink AboutX2018-0735 - Permitsr�wrogr City of Newport Beach - Building Division II11111111119�IIIIIIIIIIIIIIIIIIII��I�IIII II COMB Permit: X2018-0735 ¢ 100 Civic Center Drive, Newport Beach, CA 92660 x 2 0 1 a 0 7 3 5 Project No : 0608-2018 F _ Permit Counter Phone (949)644-3288 v @ inspection Requests Phone (949)644-3255 Issued Date : 0612612018 Combination Type - SFP ELEC MECH PLUM GRAD Inspection Area : lb y PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. 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 a] HaNsheAs Job Address: 1106 SEA LN NB f Description: NEW SFR 3328 SF WIATTACHED GARAGE 593 SF Legal Desc.: N TR 2202 LOT 9 � Owner: KIESSELBACH MARK Contractor: BURKHART BROTHERS CONSTR Architect: WALZ JOHN ROBERT ZIP ,�� Address: PO BOX 2373 Address: 12 BALBOA COVES Address: 510 LARKSPUR AVE - "+. LA HABRA CA 90632 NEWPORT BEACH CA 92663 CORONA DEL MAR CA 92625 -AD"0 Phone: Phone: 714-350-3892 Phone: 949-836-5977 State Lic:C031388 Applicant: WALZ JOHN ROBERT Con State Lie: 905510 Engineer: TOAL ADAM Address: 510 LARKSPUR AVE Lie Expire: 10131/2019 Address: 139 AVENIDA NAVARRO CORONA DEL MAR CA 92625 Bus Lie: BT30026859 SAN CLEMENTE CA 92672 Phone: 949-836-5977 Lie Exp Date: 03/31/2019 Phone: State Lic:C-059275 Code Edit: 2016 Worker's Compensation Insurance Designer: Type of Construction: V-BSPR Carrier: STATE COMP Address: Occupancy Group: R3/U Policy No: 9041905 Added /New sq.ft. Bldg: 3328 Expire: 02/01/2019 Phone: Added /New sq. ft. Garage: 5593 No of Stories: 1 Building Setbacks Rear: 6 Special Conditions: No of Units : 1 Front: 20 Bldg Height: 0 Left: 6 Bldg Sprinklers: Y Right: 6 Building Permit Fee: $4,563.00 Excise Tax: $698.88 Planning Department - Fire Department Plan Check Fee: $2,846.00 Additional Fee: $0.00 Plan check Fee: $391.00 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 : $680.56 SJH Trans : $0.00 Demolition Fee Record Management : $82.00 Grading Permit Fee: $921.00 In -lieu Housing Fee: $0.00 Building Dept Adm $0.00 Energy Compliance: $268.00 Grading PC Fee: $127.44 Public Works Department - General Service $0.00 CA Seismic Safety: $104.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access : $0.00 PAN Plan Check : $152.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $319.41 San Dist: $734.00 Building Green Fee: $32.00 Mechanical %: $182.52 NMUSD Fee: $1,832.64 $0.00 Plumbing %: $410.67 $0.00 TOTAL FEE : $14,245.12 Plan Check Fee : $14,245.12 Fee Due at Permit Issuance: $0.00 PROCESSED BY: ZONING APPROVAL: PUBLIC WORKS APPROVAL: 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 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). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) 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 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 legally sellB structure that I have buillFas 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://www.leginfo.ca.gov/calaw.htmi. 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 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No Date Contractor Signature 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 THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. I hereby affirm under penalty of perjury one of the following declarations: 111 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 thf performance of the work for which this permit is issued. Policy No. have 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' rance carrier and policy number are: Policy Number of 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. of Date CLARATION REGARDING CONSTRUCTION LENDING AGENCY ereby 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). 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 state laws relating to building construction. I authorize representatives of this city or county to enter the above -identified property for inspection purposes. Date ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED U I SUBMITTED PERMIT CANCELLED Epp PERMITEXTENDED I LJAQMD PERMITFINAL CERTIFICATE OF UASBESTOS SIGNATURE: DEMOLITION ION IS NOT APPLICABLE TO PROPOSEOCCUPANCY ISSUED