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X2020-1133 - Permits
City of Newport Beach - Building Division IIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIII a e: 100 Civic Center Drive, Newport Beach, CA 92660 COMB Permit :X2020-1133 IIII x 2 0 2 0 1 1 3 3 b III Permit Counter Phone (949)644-3288 Project No: 2782-2019 Inspection Requests Phone (949)644-3255 r tr, yuv.* Combination Type - SFP ELEC MECH PLUM Issued Date: 05112/2020 Inspection Area : 4 PERMIT EXPIRES 100 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 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: 1794 PORT CARLOW CIR NB Description: DELTA 2 ADD'L SCOPE REMODEL 3 BATHS & KITCHEN267 at (REV20.0707), ADD GUARDRAIL (REV20-0590) Legal Desc.: N TR 14533 LOT 12 Owner: AYALA ROBERTO Address: •1794 PORT CARLOW CIR Record Management: 14EWPORT BEACH, CA 92660 Phone: 949-719-0577 Applicant: COUSENS PAUL Address: 6100 SAN FERNANDO RD Hazardous Mat 03LENDALE CA 91201 Phone: 018.522-8080 Code Edit: 2019 Type of Construction: V -B Occupancy Group: R31U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 1 Bldg Height: 0 Bldg Sprinklem: Building Permit Fee: $833.00 Plan Check Fee: $0.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $0.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access: $0.00 Hazardous Mat $0.00 Building Green Fee : $3.00 TOTAL FEE: $1,002.60 PROCESSED BY: ZONING APPROVAL: tel, qi�l Contractor: COUSENS CONSTRUCTION INC Address: 6100 SAN FERNANDO RD #201 Address: GLENDALE CA 91201 Phone: 818-236-3999 Con State Lic: 535683 Lic Expire: 1113012020 Bus Lic BT20062603 Lic Exp Date: 05/31/2020 Worker's Compensation Insurance Carrier: STATE COMP INS FUND Policy No: 1251698 Expire: 09/01/2020 Building Setbacks Excise Tax: Additional Fee: Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WO Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: I Front: / Left: I Right: / Parkino Spaces $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $58.31 $33.32 $74.97 Plan Check Fee Architect Address: Phone: State Lic Engineer: HUSZCZ MARIAN JOHN Address: 8 CORNWALLIS Fair Sham IRVINE CA 92620 Phone: 949-551.3316 State Lic:S-003555 Designer: $0.00 Address: Park Dedication: Phone: Special Conditions: REV20.0707 REV20.0590 Planning Department - Fire Departmed - - Plan check Fee $0.00 Fair Sham $0.00 SJH Trans Fire Plan Rev In -lieu Housing Fee: $0.00 Public Works Department - Park Dedication: $0.00 PAN Plan Check: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $1,002.60 ° SUBLJCVUGRKS°a4PPROVAL: r' �f. r PLAN CHECK BY: V q} GRADING APPROVAL: APPRQVAIs VO ISSUE: ©z eu ooc ° " eoo Fire Departmed - - $0.00 Fire Inspection: $0.00 $0.00 Fire Plan Rev $0.00 $0.00 Demolition Fee $0.00 Building Dept Adm $0.00 General Service $0.00 Refund Deposit $0.00 Grading Bond: $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $1,002.60 ° SUBLJCVUGRKS°a4PPROVAL: r' �f. r PLAN CHECK BY: V q} GRADING APPROVAL: APPRQVAIs VO ISSUE: ©z eu ooc ° " eoo 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 foi' .he 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 Irofessions 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 iot more than five hundred dollars ($500). :11, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) 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 i�m roved 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 licensure under the Contractors' Stale 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 legally sell a structure that I havebuilt 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. 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 Sec(jon 7000) of Division 3 of the Bus' as and 1rofessjan d':`AckmylipeFlse_is-in-fyll force ._..__._._ -_s _.., and effect. License Class License No ; to .2— w�i O Cont or SignaCu78' _ INORKERS' 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 uradb? p6r),alty of perjury one of the following declarations: -Iwhavr, 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, o rformatice of the wNik'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' compensatiol insurance carrier and policy number are: 11 Lawier „ Policy Number Expiration Date 11, redify that, in the=pepformancg 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 agre t Ra ,„if (, should benome subject to e"Drker qqm ens0aet, ovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. p 3ignatlare micont - � Pie—' '” / ��— S> 91 0LARA N"NEGAR�' ING CONSTRUCTION LENDING AGENCY .heraby affirm undeFpenalty 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). -ender'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 county ordinances and state laws relating to building construction. I authorize representatives of this ity or cop e e a 'fled-property-foc.itl action purposes. 3i nature of Property Owner or Autho A ant - t Pro arty Owner's or Authorize is Name , VVZ Co✓ �1 Date U see ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE O REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED[JISUBMITrEDASBESTPINOTIiICATIOUIQ PERMITCANCELLED EPA : • : • :`• PERMITEXTENDED QMD ` • •• . • �• ` PERMIT FINAL `` A58EST05 NOTIPIC', NOT APPLICABLE' TO • ` CERTIFICATE OF 1 1 _ ROPOS D DE[v�L1T N. , OCCUPANCYISSUED 5 RE: _.,