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X2019-4073 - Permits
�"''�e� City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2019-4073 ti4 100 Civic Center Drive, Newport Beach, CA 92660 p X 2 0 1 9 4 0 7 3 Project No :2807-2019 1 � �, � s3 Permit Counter Phone (949)644-3288 ��(( Inspection Requests Phone (949)644-3255 A 201 9 -7 2, - y'� t 26 RANA NEWPORT BEACH, CA 92663 �z. w .*" Combination Type - SFP ELEC MECH PLUM �1 1, s� 1 61 Issued Date: 1211812019 Phone: 714.814-0874 /i� (51 Inspection Area : 3 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 of Holidays Job Address: 231 61ST ST NB Description: SFR BATH ALTERATION 150 SF Legal Desc.: TR 772 LOT 6 BILK 1 ALL (EX SWLY 10 FT) THEREOF ANDSWLY 14 FT LOT 7 BILK Owner: SAVIAN SCOTT Contractor: OWNER/BLDR Architect: MILLER ANDREW Address: 23161 ST ST Address: Address: 26 RANA NEWPORT BEACH, CA 92663 RANCHO SANTA MARGARITA CA 92688 Phone: 714.814-0874 Phone: Phone: 949.246-4167 State Lic:CO27070 Applicant: SAVIAN SCOTT Con State Lic: 011 Engineer: BURKE LEO Address: 231 61ST ST Lic Expire: Address: 34167 PACIFIC COAST HWY #D NEWPORT BEACH, CA 92663 Bus Lic: DANA POINT CA 92629 Phone: 714.814-0874 Lic Exp Date: Phone: 949.226-7130 State Lic:C-067404 Code Edit: 2016 Worker's Compensation Insurance Designer: Type of Construction: V -B Carrier: Address: Occupancy Group: R3IU Policy No: Added /New sq.ft. Bldg: 0 Expire: Phone: Added /New sq. ft. Garage: 0 No of Stories: 1 Building Setbacks Rear: I Special Conditions: LIQUEFACTION AREA No of Units : 1 Front: / Bldg Height: 0 Left: / Bldg Sprinklers: Right: I Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $8.000.00 Building Permit Fee: $200.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $174.00 - Additional Fee : $0.00 Plan check Fee : $40.00 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: $10.00 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 %: $14.00 San Dist: $0.00 Building Green Fee : $1.00 Mechanical %: $B.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $18.00 $0.00 TOTAL FEE: $465.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $465.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: PUBLIC WORKS APPROVAL: PLAN CHECK BY: �. �my mW my my .°- ° APPROVAL TO ISSUE: oG coc O o m oGG O O 00 O O O `O C 4 G O LGO OGO G 4 00 OG OGG iC `i n 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 L) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Cade: 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 app 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). ©I m exempt from licensure under the Contractors' State License Law for the following reason: By signature below I acknowledge that, except for my pers qal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot Iegall) a structure that I have built as an owner -builder if it ha t b en 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 wheQJhis a 'o is submitted or at the following Web site:http:/NAvw.leginfo.ca.gov/calaw.html. +2. f Signature of Property Owner or Authorized Agent' Dat LICENSED CONTRACTOR'S DECLARATIO 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 NARNING: 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 ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: ❑ I 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 the oerformance of the work for which this permit is issued. Policy No. 131 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' compensatiol insurance carrier and policy number are: Policy Number of Agent Date I�rtify that, in the performance the ork 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 agn t, I should becomes bject tot rkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ' L� �� /5 ature of Applicant Dat CLARATION REG �ING CO UCTION LENDING AGENCY :reby 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 oVin ce and state laws relating to building construction. I authorize representatives of this city or county t nt a ove-identified property for inspection purposes. `nature of Prooertv Owner or Authorized Aoent ( Print Property Owner's or Authorized Agent's Name X S L� S"tAIJ Date 1 Z �( ACTION DATE BY PERMITEXPIRED: PERMIT CANCE D PERMIT EXTENDED PERMITFINAL I CERTIFICATEOF ... `S • J (A OCCUPANCY ISSUED ••• 0 •. 0 •. • • ••• •. bECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE I SUBMITTED PROPOSED TO NOTIFICATION 15 NOT APPLICABLE TO 1+��111,11 o ri co=IF f2 a� —a a� m m u warn ma o �a m c mL oY m m — Na OcA .� � 0 a � m m. 0"- �@ o cm c.0 S wv >, oy w°p m m`oN°3o (D o m �a°m m=So mE M 0c E -Q0 3 3 �- a �� 3,0 o m� Eo 'O c' p) m> p ° L o m E 0 y O n N m 'p S m L U - ..f.. ami m€ 'vco- O ��am E40) cc 0 -o cp �a 3mmd. aaiw c c m-_ m ° >w gym° Z eoIK' i mw ay m Uo �aE m(1) mLm a) m a 0 'C o c C U u7 a w mp m c m a m o- O aci nw m n' 3Z .0 m c» E ac o 0 ol.. 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