HomeMy WebLinkAboutX2019-1189 - PermitsCity o NewDport Beach
achBuilding DivisionIIII�IIIIpII�IIIIIIII�IIIIIIII�IIIIiIIIIIIIIIIII�II COMB Permit X2019-1189
100 Project No
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
a�sxxig�.a Combination Type - SFP ELEC PLUM MECt! Issued Date: 04/1512019
- 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 or Holidays
Job Address: 1107 BERKSHIRE LN NB
Description:. SFR MASTER BATHROOM REMODEL (135 SF) "CTY STD"
Legal Dese.: N TR 3031 LOT 10
Owner: JEFFREY B: ANDREA BELLITTI Contractor: SIEMONSMA CONST Architect
Address: 1107 BERKSHIRE LN Address: 1048 IRVINE AVE #430 Address: `+ I .,
NEWPORT BEACH, CA 92660 NEWPORT BEACH CA 92660
Phone:
Applicant: SIEMONSMA CONST
Address: 1048 IRVINE AVE #430
NEWPORT BEACH CA 92660
Phone: 949-722-0628
Code Edit : 2016
Type of Construction:. VIB
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:
Construction Valuation: 10
Building Permit Fee:
$248.00
Plan Check Fee: $215.76
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$2.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access ;
$0.00.
Hazardous Mat
$0.00
Building Green Fee ;
$1.00
TOTALFEE:
PROCESSED BY:
v
ZONING APPROVAL:
GRADING APPROVAL: -
Phone:
949-722-0628
Con State Lie:
536498
Lie Expire:
0713112020
Bus Lie:
BT30046476
Lie Exp Date:
03/31/2020
- Workers Compensation Insurance
Carrier:
EXEMPT
Policy No:
NO. EMPLOYEES
Expire:
Building Setbacks
Rear: /
Front: I
Left: /
Right: I
Use Zone: Parkina Spaces: 0
Excise Tax:
$0.00
Additional Fee,
$0.00
Grading Bonds Fee:
$0.00
Grading PC Consultant:
$0.00
Grading Permit Fee:
$0.00
Grading PC Fee:
$0.00
WQ Insp. Fee:
$0.00
Electrical %:
$17.36
Mechanical %:
$9.92
Plumbing %:
$22.32
Planning Department -
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
Special Conditions:
Plan check Fee,
Fair Share :
SJH Trans:
In -lieu Housing Fee:
Public Works Department -
Park Dedication :
$0.00
PAN Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Plan Check Fee
State Lie:
State Lie:
Fire Department
$40.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
• •••
• •
••°
$0.00
$0.00
•
eooa°•
° $0.00
o SO.BQ
•$@.00
$0.00
$0.00
$0.00
$0.00 Fee Due at Permit Issuance : $556.36
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE: -
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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).
111, as owner of the property, or my employees with wages as their sole compensation, will do ( j 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 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 legall)
sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. � 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.html.
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 Sectio f Div' ion 3 of the Busrandprofe"ons Code, and ense i In full force
and effect. License Class License No q to ContraWORKERS'COMPENSATION DECLARATION(\aNARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI AL PINALTIES AND CIVIL FINES UP ND 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.
hereby affirm under penalty of perjury one of the following declarations:
1 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 thl
)erformance ofilie work for which this permit is issued. Policy No.
...Vyg and v(jllggnintain 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' compensatior
asuranoe carrier and eolicy number are: -
..
;aver Policy Number
Kily
Agent
•• ••.
that, IntAe performance of the work for whi h this permitis issued, I shall not employ any person in any man
should act to the rkers' cD nsation provisions of Section 3700 of the Labor Code, I shall forth
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)ECLARATI STRUCTION LENDING AGENCY
.. ..
ilerebyeffirm under penalty of pe ury that there is a construction lending agency for the performance of the work for w
2nder's'Name • • • • •: Lender's Address
Date
so as to become subject to the
h comply with those provisions.
this permit is issued (Section
compensation laws of California, and
Civil Code).
Br^rny signature below,1 certify to each of the following:
• tat the propggt goner 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 cit W cc to a the ove-Id tified property for inspection purposes.
Signature of Property Owner or Aut Print Property Owner's or Authorized Age 's ame d 1 D
ACTION DATE/ BY CLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED
LU I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED
0EPA
PERMIT EXTENDED
UAQMD
PERMITFINAL
CERTIFICATE OF
OCCUPANCY ISSUED
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