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X2020-2964 - Permits
City of Newport Beach - Building Division IIIIII�IIIIII��IIIIII�IIIIIIII'IIIIIIIIII II COMB Permit: X2020-2964 +� 100 Civic Center Drive, Newport Beach, CA 92660 X $ 0 2 0 2 9 6 4 Project No : 2359-2020 r. Permit Counter Phone (949)644-3288 sr = Inspection Requests Phone (949)644-3255 nr * '`' Combination Type - MFP MECH ELEC PLUM Issued Date: 01104/2021 9<rr ,a Inspection Area : 1 � f"�t"11f\I�'"1'�9 1I�"t'tll'�sa, r a�rryr,r - PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID I S��1TI S OST L - /05/2024 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: 115 42ND ST NB Description: MFR ADD 4 SF, ALT 400 SF, REMOVE/REPLACE DOORSIWINDOWS. REPAIR STRUCTURAL SYSTEM @ GARAGE Legal Desc.: RIVER SECTION BLK 42 LOT 22 N SATURDAYS AT ]D6YS Owner: BARTLETT DANIKERI Contractor: OWNER/BLDR Architect: SMITH BRADFORD Address: 115 42ND ST Address: BARTLETT DANAddress: 425 30TH ST #22 NEWPORT BEACH, CA 92663 NEWPORT BEACH CA 92663 cc Phone: 949-433-7060 Phone: 949.631-3682 Phone: 949-631-3682 State Lic:CO14146 cc 0 Applicant: SMITH BRADFORD Con State Lic: O/B Engineer: GHOULI RAID ASAD Address: 425 30TH ST #22 Lic Expire: Address: 26040 ACERO #100 NEWPORT BEACH CA 92663 Bus Lic: MISSION VIEJO CA 92691 y Phone: 949-631-3682 Lic Exp Date: Phone: 949-855-2300 State Lic:C-070882 UJ Code Edit: 2019 Workers Compensation Insurance Designer: Type of Construction: V -B Carrier: Address: Occupancy Group: R31U Policy No: Added /New sq.ft. Bldg: 4 Expire: Phone: i� J Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear: 5' Special Conditions: HIGH DENSITY s No of Units : 2 Front: 10' LIQUEFACTION AREA Bldg Height: 24 Left: 3' Bldg Sprinklers: N Right: 3' Flood Zone: X Use Zone: R-2 Parking Spaces: 2 Fire Hazard Zone : N Construction Valuation: $41.000.00 Building Permit Fee: $679.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $590.73 Additional Fee: $0.00 Plan check Fee: $92.50 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: $52.00 Grading Permit Fee: $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $0.00 Energy Compliance: $61.00 Grading PC Fee: $0.00 Public Works Department- General Service $0.00 CA Seismic Safety: $5.33 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%:: $47.53 San Dist: $0.00 Building Green Fee : $2.00 Mechanical m/o: $27.16 NMUSD Fee: $0.00 $0.00 Plumbing W $61.11 $0.00 TOTAL FEE: $1,618.36 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Plan Check Fee: $787.63 Fee Due at Permit Issuance : $830.73 ®mm mam m o mmm mmo m m o o c PUBLIC WORKS APPROVAL: m m o 0 0 o t PLAN CHECK BY: mmc oma, omm omm oAee PIkQVAL TO ISSUE: - c o e o m m o c m © m o m< c o 0 o c mm moo m m 00 00 000 I hereby affirm under penalty of perjury that I am exempt from the Contractors' Stale 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 BlPsiness 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 (_) all of or U portions of the work, and the structure is not intended or offered for sale (Sectidn 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). ❑ 1, 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). I 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 legalh sell a structure that I have built as an owner -builder if it ha teenconstructed 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 whe t Is p ication submior at the following Web site:http:!/www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent i� W?4�/ 7 - "L LICENSED CONTRACTOR'S DECLARAT N I hereby affirm under penalty of perjury that I arrillicensed 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 COMPENSATION DECLARATION IARNING: 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 OST 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 th erformance 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 Subiec workers' compensafi_np DA&IDns of Section 37_00 of the Labor Code, I shall forthwith comply with those rov.sions. Signature of ApplicanX /� .� Dat DECLARATION RE R ING C STR CTION LENDING AGENCY I hereby affirm unde enalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 309 , Civil Code). Lender's Name Lender's Address By 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 ordinances and state laws relating to building construction. I authorize representatives of this city or coun ertter above -identified property for inspection purposes. 1 T / Signature of Property Owner or Authorized Agent ( Print Property Owner's or Authorized Agent's Na , j � tJ P I �- / D t! `� l ACTION DATE BYDEC TION OF COMPLIANCE WITH COD OF FEDERAL FOR OFFICE USE ONLY EGULATS PART 61 OFTITLE 40AND AO.MD RULE 1403 • ••• • • ••• ••• PERMITEXPIRED U ISUBMITT D ASBESTOS NbTICICAdON TO PERMIT CANCELLED EPA • • •• • • • •�• •� PERMIT EXTENDED UAQW PERMITFINAL SB OS NOTIFICATION IS NOTAPPLICABLE TO CERTIFICATE OF p SED TION ••• • • • '•� •� OCCUPANCYISSUED SIGNATU —a�2 — r` ••• •• •• • ••• ••