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Home My WebLink AboutX2021-0576 - Permitsa City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit: X2021-0576 100 Civic Center Drive, Newport Beach, CA 92660 x 2 0 2 1 0 5 7 6 Project No : 0530-2021 Permit Counter Phone (949)644-3288 Inspection Requests FNone (949)644-3255 Combination Type - BLDG Issued Date: 0311012021 Inspection Area : 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 03/1012024 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: 1207 BERKSHIRE LN NB Description: SFR 6' HIGH PIZZA OVEN Legal Desc.: N TR 3031 LOT 16 Owner: LARKIN Contractor: Address: 1207 BERKSHIRE LN Address: Energy Compliance: NEWPORT BEACH, CA 92660 CA Seismic Safety: Phone: Disabled Access: .Phone: Applicant: ELLISON HUNTER Con State Lic: Address: 5228 RESIDENCIA Lic Expire: 0113112022 NEWPORT BEACH, CA 92660 Bus Lic: Phone: 949.683-9861 Lic Exp Date: Code Edit: 2019 Type of Construction: Occupancy Group: U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 0 No of Units : 0 Bldg Height: 0 Bldg Sprinklers: Construction Valuation: $5.000.00 Building Permit Fee: $161.00 Plan Check Fee: $140.07 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 : $1.00 PROCESSED BY: BLUE PACIFIC POOLS SOUTHERN CALIFORNIA Architect 25108 MARGURITE PKWY #A79 Address: Plan check Fee MISSION VIEJO CA 92679 Fair Share: Fire Plan Rev 949-310-3196 Phone: State Lic: 923454 Engineer: SILVA CHRISTINA 10/3112022 Address: 24482 MUELA BT30073923 $0.00 MISSION VIEJO CA 92692 0113112022 Phone: 949-795-6256 State Lic:C-037201 Worker's Compensation Insurance Carrier: STATE COMP INS FUND Policy No: 9126143 Expire: 02128/2022 Building Setbacks Use Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %v: Rear: 6 Front: 20 Left: 6 Right: 6 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Designer: Address: Phone: Special Conditions: Fire Hazard Zone : N Planning Department - Fire Department Plan check Fee Fire Inspection: Fair Share: Fire Plan Rev SJH Trans : Demolition Fee In -lieu Housing Fee Building Dept Adm Publ lc 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 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL FEE :. $.348.32 .,. -_ Fire Department $46.25 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 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL FEE :. $.348.32 .,. -_ Plan Check Fee: $0.00 Fee Due at Permit Issuance : $348.32 PUBLIC WORKS APPROVAL: ZONING APPROVAL: GRADING APPROVAL: PLAN CHECK BY: 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 checkmark(s) I have placed next to the applicable item(s) action 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 permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' Stale License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Ifessions 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 more than five hundred dollars ($500). I, as owner of the property, or my employees with wagesas their sole compensation, will do `) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, >iness 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 )rovements 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 )roved 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 )ly 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: 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 legal) I a structure 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 Ifessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. nature of Property Qwner or Authorized Agent Dale TENSED dewrRACTOR'S DECLARATION )yp p: affirmunderpenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectiono Di ision 3 of the Business and Profes o Code. and y license is in full force I effect. Li'r epgq lass License No Date, D 2 Contractor Signature )R1(ERS' COMPENSATION DECLARATION 2MISG: FAILURE 70 SEOURE 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 IT OF COMPENGA'MOM, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. )1'9b9r�aifirm under genalty of perjury one of the following declarations: t t19,4e and Wil4 cla stain 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 forrRance of thework for which this permit is issued. Policy No. 1,04 and will-malea in 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 urance carrieParri. icy number are: a• Policy Number Date IaffiVoT Agent • 3 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 agre ist, if I should becomsub' dt rk s' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. signature of Applicanf>� DatIb IECLARATION REG(ARDkG CONSTRUCTION LENDING AGENCY hereby 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, Civi Code). ender's Name Lender's Address ly my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owners behalf. I have read this application and the informational 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 city or county to y�nter th ve-I nn i d property for inspection purposes. ........,,.e ..f o.,...va„ n...—,.� A„Ihnd>en Ancn/ I V e�FT l Fl/ ,/�f ! Print Prooertv Owner's or Authorized ADent's Name Datel ACTION DATE BY V DL6lARA1TON OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 14 PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED UEPA PERMIT EXTENDED IJAQMP PERMITFINAL CERTIFICATEOF I� b�(11 �1 BEST OTIFICATION IS NOT APPLICABLE TO ,� ROP ED OUTI(� OCCUPANCYISSUED SIGNATURE: