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Home My WebLink AboutX2019-2522 - Permits�vrt City of Newport Beach -Building Division zip 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288. Inspection Requests Phone (949)644-3255 rxe xs Combination Type - MFP ELEC PLUM COMB Permit: X2019-2522 x 2 0 1 9 2 5 2 2 Project No: 1797-2019 Issued Date : 08/114/2019 Inspection Area : 8 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: 95 OCEAN VISTA NB Description: MFR - BATH REMODEL 45 SF Legal Desc.: TR 9676 LOT 13 UNIT 129 OF PROJ LOCATED ON AP 442-361-31 e .... e n Owner: STEWART MICHAEL & VICKI Contractor: SIEMONSMA CONST Architect: BEAUCHAMP DANIEL Address: 95 OCEAN VISTA Address: 1048 IRVINE AVE #430 - Address: 470 WALD ° • • , o NEWPORT BEACH, CA 92660 NEWPORT BEACH CA 92660 IRVINE CA 92618 ° ° • ° Phone: 949-249-3863 Phone: 049-722.0628 Phone: 949-727-3840 State Li¢C014593 e e e• n Applicant: SIEMONSMA DAVID Con State Lie: 536498 Engineer: ° Address: 1048 IRVINE AVE #430 - Lie Expire: 0713112020 Address: NEWPORT BEACH CA 92660 Bus LIc: BT30046476 ... Phone: 949.289.3863 Lie Exp Date: 0313112020 Phone: State Lic: • ..... 0 m o Code Edit: 2016 Worker's Compensation Insurance Designer: e ° °. e e e m ° . o Type of Construction: V -B - Carrier: EXEMPT Address: ° • • • ° ° ° Occupancy Group: R2/U Policy No: NO EMPLOYEES Added /New sq.ft. Bldg: 0 Expire: Phone: .... Added /New sq. ft. Garage: 0 °' ? •,,'e �.. '1'x'6 No of Stories: 2 Building Setbacks Rear: I Special Conditions: �B -�� No of Units: 4 Front: I V Bldg Height: 0 Left: I Bldg Sprinklers: Right: / Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $8,600.00 Building Permit Fee: $216.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $187.92 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: $4.00 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 %: $15.12 San Dist: $0.00 Building Green Fee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $19.44 $0.00 TOTAL FEE : $483.48 Plan Check Fee : $187.92 Fee Due at Permit Issuance : $295.56 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 checkrnark(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 ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale). ❑ I, as owner of thep$operty, 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 ownef 9�prgaerty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ®.I.ac»exempt from.Ncensure under the Contractors' State License Law for the following reason: B)S my sil;rhature Bgby J 9cknowledge 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 legal[) SO[%st%cture 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:http://www.leginfo.ca.gov/calaw.html. Sigoatu$e of PropE'I,y.Qvsner or Authorized Agent Date LICEWSED CONTRACTOR'S DECLARATION I W%reby� affirm uMd'er enalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 o i ision of the Business and Prof ions Cod nd nse is ' full force agd ef: ect. License lees License No Date Contractor Signature N(QVr,ARS' COMPENSATION DECLARATION / 4RMNG: ¢tAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMIN PENALTIES AND CIVIL FINES UP TO ONE HUN ED THOUS 11 DOLLARS ($100,000), IN ADDITION TO THE COST OF CBMPENSA'hdrf, OBMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 16ert6J$ffirm ungW pegalty of perjuryone of the following declarations: ha ... . . . I ve and wiM rtnaintain 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. :11 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 nsurance carrier and policy number are: mer Policy Number Expiration Date pa of Agent I Phone # certify that, in the pert mance of the wo 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 agre 'I(I should become s ' t to the o e ' co ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applica Date CLARATION REG R NGC RUCTION LENDING AGENCY 3reby affirm under enalty of p ry that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). lder's Name Lender's Address 3y 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 an state laws relating to building construction. I authorize representatives of this city or county niter th ov =fifi d property for inspection purposes. Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Age ACTION DATE BY DE RATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY RE LATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMITEXPIRED A LIISUBMITiED ASBESTOS NOTIFICATION TO PERMITCANCELLED EPA CERTIFICATE OF II�ZD OCCUPANCYISSUED