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Home My WebLink AboutX2018-0735 - Permits (3)�wro�r City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII� II COMB Permit: X2018-0735 .�� 100 Civic Center Drive, Newport Beach, CA 92660 x 2 0 1 8 0 7 3 6 Project No : 0608-2018 F + Permit Counter Phone (949)644-3288 s. Inspection Requests Phone (949)644-3255 Issued Date : 06/2612018 Combination Type - SFP ELEC MECH PLUM GRAD Inspection Area : 6 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 or Holidays Job Address: 1106 SEA LN NB tt t+�� Description: NEW SFR 3328 SF W/ATTACHED GARAGE 593 SF t ^ Legal Desc.: N TR 2202 LOT 9 Owner: KIESSELBACH MARK Contractor: BURKHART BROTHERS CONSTR Architect: WALZ JOHN ROBERT O 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 Phone: Phone: 714-350-3892 Phone: 949-836-5977 State Lic:C031388 Applicant: WALZ JOHN ROBERT Con State Lic: 905510 Engineer: TOAL ADAM Address: 510 LARKSPUR AVE Lic Expire: 1013112019 Address: 139 AVENIDA NAVARRO CORONA DEL MAR CA 92625 Bus Lic: BT30026859 SAN CLEMENTE CA 92672 Phone: 949-836-5977 Lic Exp Date: 03/31/2019 Phone: State Lic:C.059275 Code Edit: 2016 Worker's Compensation Insurance Designer: Type of Construction: V-B-SPR Carrier: STATE COMP Address: Occupancy Group: R3/U Policy No: 9041905 Added /New sq.ft. Bldg: 3328 Expire: 0210112019 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 Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $800,000.00 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 : $0.00 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: $580.56 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 Plumbin Do: $410.67 $0.00 TOTAL FEE: $14,249 Plan Check Fee : $4,213.00 Fee Due at Permit Issuance : $10,032.12 PROCESSED BY: PUBLIC WORKS APPROVAL: O 9 c Z ZONING APPROVAL: A4 PLAN CHECK BY: J 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 J all of or L) 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 Iicensure 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 legal1 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:hftp://www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 f i 's'o 3 f the Business and Professi ns o e, a d 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 THOUSA dD DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DPMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. I : rereby cffirm under penalty of perjury one of the following declarations: 111 have and will mail.tain 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 r__K rmance of the work for which this permit is issued. Policy No. and will mainfgin 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' carrier and policy number are: Policy Number IS, of Agent Date ,ertify that, in Vie perforrhance 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 agrer t, if I .,hould bccome subj t 9b the workers' mpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Lct::re of Applicant Date CI.ANATION kF.arZ r" STRUCTION LENDING AGENCY )reby affirm unde, penalty o 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 owners behalf. I have read this application and the information I hale provided is correct. I agree to comply with all applicable city and county rdi noes and state laws relating to building construction. I authorize representatives of this city or county to er heJayr�o -Identified property for inspection purposes. n �n n nature of Pmnertv Owner or Authorized Agent / / � i Print Prooertv Owner's or Authorized Aoent's Name,/ W ' V V V DATE I BY DRA4'ION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY Ell3ULATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMITEXPIRED U SUBM ITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED EPA PERMITEXTENDED I LJAQMD NOTIFICATION IS NOTAPPLICABLE TO CERTIFICATE OF la��.. ,„s PROPOSED SIGNATURE DEMOLITION OCCUPANCYISSUED