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Home My WebLink AboutX2021-0328 - Permits0.r City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2021-0328 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 1 0 3 2 8 Project No : 0337-2021 F„ _ Permit Counter Phone (949)644-3288 u Inspection Requests Phone (949)644-3255 1r;+rna" Combination Type - MFP ELEC PLUM MECH Issued Date: 02/1612021 -- - t�> Inspection Area : 6 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0211712024 OR PERMIT WILL BE INVALID Use Zone: 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 Fire Hazard Zone : N Job Address: 34 DAUPHINE NB Construction Valuation: $2.800.00 - Description: MFR REPLACE TUB WITH SHOWER @ THE MASTER BATHROOM (20 SF) Legal Desc.: Excise Tax: $0.00 Planning Department - Owner: FRANCINE FOROUGHI Contractor: 12:24 CONSTRUCTION Architect: MAXWELL GARY COLIN $0.00 Plan check Fee : Address: 34 DAUPHINE Address: 2831 E 69TH ST Address: 6941 ATLANTA AVE #365 Overtime Plan Ck: $0.00 Grading Bonds Fee: NEWPORT COAST CA 92657 Fair Share : LONG BEACH CA 90805 HUNTINGTON BEACH CA 92646 Fire Plan Rev $0.00 Phone: Phone: 714-450.2367 Phone: 949-632-6018 State Lic:C013785 • • $0.00 Applicant: JOHNSON MICHAEL Con State Lie: 971758 Engineer: $0.00 In -lieu Housing Fee: Address: 2831 E 69TH ST Lie Expire: 04/30/2022 Address: e e • • : ° LONG BEACH CA 90805 Bus Lic: BT30074276 General Service $0.00 CA Seismic Safety: $0.00 Phone: 714.450-2367 Lie Exp Date: Park Dedication : Phone: State Lie: Refund Deposit Code Edit : 2019 Worker's Compensation Insurance Designer: PAN Plan Check: Type of Construction: V-8 Carrier: STATE COMP Address: Hazardous Mat $0.00 Electrical %: Occupancy Group: R211J Policy No: 9269243 ooe�s Added /New sq.ft. Bldg: 0 Expire: 01/31/2022 Phone: ° ° ° • ° Added./New sq. ft. Garage: 0 $0.00 Plumbing %: $11.43 No of St' -or, Is: 2 Building Setbacks Rear: / Special Conditions: TOTAL FEE : $314.14 No of Units : 6 : $156.74 Front: / $157.40 • ° ° Bldg Height: 0 Left: I 000eoo Bldg Sprinklers: Right: I ...... °°O° Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $2.800.00 - Building Permit Fee: $127.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $110.49 Additional Fee : $0.00 Plan check Fee : $46.25 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 %: $8.89 San Dist: $0.00 Building Green Fee : $1.00 Mechanical %: $5.08 NMUSD Fee: $0.00 $0.00 Plumbing %: $11.43 $0.00 TOTAL FEE : $314.14 Plan Check Fee : $156.74 Fee Due at Permit Issuance : $157.40 PROCESSED BY:yl'�1 PUBLIC WORKS APPROVAL: PLAN CHECK BY: - APPROVAL TO ISSUE:`\\ .�f V(/� ��-�� ZONING APPROVAL: SIV V V�--a �/ GRADING APPROVAL: 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 therBusiness 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). - 4 ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do L) 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 im 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 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' 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. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code,il ayailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Signature of Property Owner or Authorized Agent Date L410ENSED COATAACTOR'S DECLARATION I aereiry affirm u0erpeaalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section OV=5 5 $ Of the Business and Pro sions COc and my license is in full force anq effect. Licen9d Class License No Date d ®° / Contractor Signature IISORK IRS' CONDE-�NLSATION DECLARATION NARNING, FAILUREJ06G4riE 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 COSPOF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. II�hh+,erebyaffirm under penalty of perjury one of the following declarations: L.,101049 o 9 and will 9alntain 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 lh oQ(fgrgWUce of the Puork for which this permit is issued. Policy No. I have:and wig 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' compensatioJ grinige carrier dhfl poky number are: ;e c. Policy Number Expiration Date Jame of Agent • • Phone # :1I certify that, in the performance of the work for which this permit eeei��soo issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre hat, if I should becotOdsubject to the w s' co p anon ro ' ' s.of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. signature of Applicant /�'y(t // Date9 )ECLARATION REG41RRD G CONSTRUCTION LWINDING 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, 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 owners 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 an ate lating to building construction. I authorize representatives of this city or couty t enter the b -i died property for inspection purposes. / 3i nature of Property Owner or Authorized Agent Print PropertOwner's or Authorized Agent's Name Da ACTION DATE I BYECLl�ATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY R TIONS PART 61 OF TITLE 40 AND AQMD RULE PERMITEXPIRED LJISUBMITTED ASBESTOS NOTIFICATION PERMIT CANCELLED EPA CERTIFICATEOF �^_ u Dl-. ITFINAL ASBES NOTIFICATION OSED EMOLIT��IO.N// OCCUPANCYISSUED SIGNATUR : X/ o SZ fn v o- �� W nx n 9'-I r- 0- p o'm `' '�^`'3 N �' o s c�i�� c m CD `� s. 2� m�� s go CO N m CD 0 3 m a N O Cl) cn n v CD a o? mm v ms O n'< Z D ?y d 3 3 QO_ O O_N N k ,2 Q.N CD c Q CD .. N m m m fn °° c4 C7 t -° 0 m m m M S 7 CD N 0=r CD CD 0 N N d O i (O Q Nq to CL (D N y m N (D f7 Q C n' M 7 N CON �. 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