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HomeMy WebLinkAboutx2022-1211 - Permits>, City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 n'rTrarviu�'' , Combination Type - MFP ELEC MECH PLUM *X2022-1211* COMB Permit: X2022-1211 Project No : 1113-2022 Issued Date: 04/2712022 Inspection Area : 2 PERMIT EXPIRES 180 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 6:00 a.m. to 6:00 p.m. No work on Sundays or Holidays Job Address: 260 CAGNEY LN NS St: 1 FI: 3 Unit: 300 Description: MFR KITCHEN/BATHROOM REMODEL 200 SF - Legal Desc.: TR 8336 LOT 4 UNIT 218 OF PROJECT LOCATED ON AP 423-011-22 TOGETHER Owner: SIKORSKI DAVID Contractor: SIKORSKI CONSTRUCTION LLC Architect: ©coo Address: 5000 MICHELSON DR Address: 124 MELODY LN Address: .... IRVINE CA 90056 COSTA MESA, CA 92627 Phone: 7731578-7963 Phone: 773-578-7963 Phone: State Lie: Bcoa Applicant: PETERS WILLIAM Con State Lie: 1058853 Engineer: KHAEF ESMAIL Address: 33662 BRIDGEHAMPTON Lie Expire: 10131/2023 Address: 4005 CALLE SONORA #2B DANA POINT CA 92629 Bus Lie: BT30061790 LAGUNA BEACH CA 92637 ... ° Phone: 94914124428 Lie Exp Date: 01/31/2023 Phone: 714-504-8260 State Lic:C-045870 Code Edit : 2019 Type of Construction: V-A- SPR Occupancy Group: R2/U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 3 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Y Flood Zone: X Construction Valuation: Building Permit Fee: $331.00 Plan Check Fee: $287,97 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 TOTAL FEE : $786.51 PROCESSED BY: ZONING APPROVAL: S C Worker's Compensation Insurance Carrier: EXEMPT - NO EMPLOYEES Policy No: Expire: 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 %: Rear: I Front: / Left: / Right: / irking Spa $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $46.34 $36.41 $29.79 0 Designer: PETERS WILLIAM Address: 33662 BRIDGEHAMPTON DANA POINT CA 92629 Phone: Special Conditions: Planning Department - Plan check Fee Fair Share SJH Trans In -lieu Housing Fee Public Works Department - Park Dedication : $0.00 PNV Plan Check : $0.00 San Dist: $0.00 NMUSD Fee: $0.00 Fire Department $52.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: Plan Check Fee : $339.97 Fee Due at Permit Issuance PUBLIC WORKS APPROVAL: PLAN CHECK BY: ' l T GRADING APPROVAL: APPROVAL TO ISSUE: • $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $446.54 oco.aa • o 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). - ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) 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). .. �� �m. exempt fro.m licensure under the Contractors' State License Law for the following reason: Qy my. Sgnature NNW 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 s4l a %tructure that PlVve 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,As available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. signature of PropertyQwner or Authorized Agent Date OGEASED CDA-FRQCTOR'S DECLARATION rher86y affirm yndep penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0 ) f i n 3 of the Business and Profession and my ice e I full for 31MEf%t. Lic:n9e Class License No Date Contractor Signature �iC, ,✓ O�lIr IkKERS' COMPENSATION DECLARATION YAFAILURE 10 SF�CT,RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000(, IN ADDITION TO THE COST OFGOMPEN$ATI , AMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LWabXaffinn udder p€nalty of perjury one of the following declarations: �-I L7.. �`Ifave and wil�mafitain 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 performance of the work 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' ranee carrier and policy number are: Policy Number Date me of Agent 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 ogre t, if I should become subject to the ewworkers' compensatiZr+provisions of Sec n 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant x /��� ,�� Date Z Z CLARATION REGAL CONSTRUCTION LENDING AGENCY :reby 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). rder's Name Lenders Address 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. authorize representatives of this city or county a ab e- ntii5 d propert for inspection purposes. �J i mature of Property Owner or Authorized Agent K/=-: = /s G-2' Print Property Owner's or Authorized Agent's Name ��Wn%.6Y✓ter Date I ACTION PERMIT EXPIRED PERMIT CANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCY ISSUED DATE I BY I DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE TO NOTIFICATION IS NOT APPLICABLE TO