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x2020-1939 - Permits
w.e City of Newport Beach - Building Division II III IIIIIIIIIIIII�IIIIIIIIII�IIIIIIIII II COMB Permit: X2020-1939 p 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 0 1 9 3 9 Project No : 1550-2020 F Permit Counter Phone (949)644-3288 u. Inspection Requests -Phone (949)644-3255 `1�irn,cw Combination Type - MFP ELEC MECH PLUM Issued Date :11110/2020 9 Inspection Area : 2 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 11/11/2023 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: 204 DIAMOND AVE NB Description: MFR ADD *STOP WORK* ENCLOSE PATIO COVER (208 SF) CONVERT CLOSET INTO BATHROOM & LAUNDRY Legal Desc.: BALBOA ISLAND SEC 2 BLK 9 LOT 16 0 Owner: PIE CT 0%, PHAN ANH & MIMI Contractor. OWNERIBLDR Architect: + `i Address: 204 DIAMOND Address: PHAN ANH Address: C 0 NEWPORT BEACH CA 92662 Phone: 408-460-8046 Phone: Phone: State Lie: a o • (fig Applicant: PHAN ANH Con State Lic: OIB En ineer: 9 • AX ° '•rya°• Address: 204 DIAMOND AVE Lie Expire: Address: • ya ° • ° NEWPORT BEACH CA 92662 Bus Lie: ° ° Phone: 714-604.5673 Lie Exp Date: Phone: State Lie: �y • ° Code Edit, 2019 Worker's Compensation Insurance Designer: NGUYEN LIEM I 9 •®' ° ° Type of Construction: VB Carrier: Address: 6061 LARCHWOOD DR . ° Occupancy Group: R3/U Policy No: HUNTINGTON BEACH CA 92647 ,,,' to ° . Added /New sq.ft. Bldg: 97 Expire: Phone: ... Added /New sq. ft. Garage: 0, ® No of Stories: 2 Building Setbacks Rear: 5' Special Conditions: HIGH DENSITY AREA, a ° No of Units: 2 Front: 8' LIQUEFACTION . ® ° BldgHeight: 3 9 Left: 3' OIB ATTACHED o ° Bldg Sprinklers: Right: 3 Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $14.160.00 - Building Permit Fee: $1,031.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $816.65 Additional Fee : $0.00 Plan check Fee: $185.00 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: $1,031.00 Grading PC Consultant: $0.00 SJH Trans : $0.00 Demolition Fee Record Management: $18.00 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: $86.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $72.17 San Dist: $0.00 Building Green Fee : $1.00 Mechanical %: $41.24 NMUSD Fee: $0.00 $0.00 Plumbing %: $92.79 $0.00 TOTAL FEE : $3,374.85 Plan Check Fee: $1,001.65 Fee Due at Permit Issuance : $2,373.20 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: �.I \.J 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 checkmark(s) I have placed next to the applicable items) 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 ie 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 t more than five hundred dollars ($500). rL! `as owner of the property, or my employees with wages as their sole compensation, will do L) all of or �t portions of the work, and the structure is not intended or offered for sale (Section 7044, ',usiness and Professions Code: The Contractors' State License Law does not apply to an owner of property�wjfe, through employees' or personal effort, builds or improves the property, provided that the nprovements 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 nproved 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 pply 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). 7 I am exempt from licensure under the Contractors' State License Law for the following reason: ly my signature below I acknowledge that, except for y 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 Iegall) ell a structure that I have built as an owner -builder if has not be n ce 'tied in its entirety by licensed contractors. 1 understand that a copy of the applicable law, Section 7 t4 of the Business and 'rofessions Codepis available upon request whe h' application tted or at the following Web site:http:/Aw .leginfo.ca.gov/calaw.html. _ 99 signature of Pro0erTy(5,&ner or Authorized Agent s Date / 1© Z O ZA :GEOIS1=13 CONTRACTOR'S DECLARATI ° °I Iv Tereby Affirm utid& Pially of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Co , and my license is in full force nd effect. License Class License No Date Contractor Signature ;ORKERS' COJNPEVSATION DECLARATION 1`AyIN(IJAILURE-M-ASURE 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 ;PST pF• OMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. ber"ll affirm upd&*Apalty of perjury one of the following declarations: -1-hl9aue 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 erfer6Rance of the work for which this permit is issued. Policy No. • • •. ' I havE and w111•rpainpin 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 :Mlr" carver and policy number are: :dF11Er' • • Policy Number Expiration Date dame of Agent Phone # 3 certify that, in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the workers' ompensation laws of California, and agre hat, if I should becomes sect to the workers' o I ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. signature of Applicant Da )ECLARATION REG DI ONSTRUCTI L"EENDING 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 309 R Code). .enders Name Lenders Address , )y 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 a ordinances and stating to building construction. I authorize representatives of this city or county ente h a Le -identified property for inspection purposes. ,/ey�w� //�l�/ ;kmature of Prooertv Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name r I ° Date V f I ACTION DATE BY I REEdLAq f ION OF COMPUANT 61 OF TITCE E WITH CODE OF FEDEFEDERAL I FOR OFFICE USE ONLY PERMIT EXPIRED V I SUBMITTED ASBESTOS NOTIFICATION PERMITCANCELLED EPA CITIFI '/) A^PPLIAS CABLE TO / OOL�MITI GOCFANCYSUD I�/%Z T