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Home My WebLink AboutX2022-1101 - Permitssr �� City of Newport Beach - Building Division *X2022-1101* a 100 Civic Center Drive, Newport Beach, CA 92660 .. Permit Counter Phone (949)644-3288 v.. - Inspection Requests Phone (949)644-3255 Combination Type - SFP '--%„ 9 COMB Permit: X2022-1101 Project No: 1011-2022 Issued Date : 04/15/2022 Inspection Area : 2 .... P PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LASw-*- PECTION. PROJECTS MUST BE COMPLETED BY 0411512025 OR PERMIT WILL BE INVALl9a a a 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, a % Job Address: 706 PARK AVE NB Description: SFR REFACE (E) FIREPLACE (X2022-0987) P Legal Desc.: BALBOA ISLAND SEC 2 LOT 17 BILK 10 E1/2(AND E112 LOT 18 BLK 10 P Owner: FLEISS MARY Contractor: HOMEKEEP PLUS LLC Architect: Address: 706 PARK AVE Address: 2324 SAN JOAQUIN PLZ Address: NEWPORT BEACH, CA 92662 NEWPORT BEACH CA 92660 Phone: Phone: 9491945-4621 Phone: State Lic: Applicant: GUERIN BRENDON Con State Lie: 1053406 Engineer: Address: 2324 SAN JOAQUIN PLZ Lie Expire: 05/3112023 Address: NEWPORT BEACH CA 92660 Bus Lie: BT30072162 Phone: 949/945-4621 Lie Exp Date: 06130/2022 Phone: State Lic: Code Edit: 2019 Worker's Compensation Insurance Designer: Type of Construction: V-B-SPR Carrier: EXEMPT Address: Occupancy Group: R3/U Policy No: no employees Added /New sq.ft. Bldg: 0 Expire: Phone: Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear: / Special Conditions: No of Units : 1 Front: / " Bldg Height: 0 Left: / Bldg Sprinklers: Y Right: / Flood Zone: A01 Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $1,500.00 Building Permit Fee: $110.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $95.70 Additional Fee : $0.00 Plan check Fee : $0.00 Fire Inspection: Overtime Plan Ck:. $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev Investigation Fee: $0.00 Grading PC Consultant: $0.00 SJH Trans : $0.00 Demolition Fee Record Management: $0.00 Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department- General Service CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit Disabled Access : $0.00 PAN Plan Check: $0.00 Grading Bond: Hazardous Mat $0.00 Electrical °/: $0.00 San Dist: $0.00 Building Green Fee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 Plumbing %: $0.00 TOTAL FEE: $206.70 PROCESSED BY: ZONING APPROVAL: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $206.70 PUBLIC WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: _... APPROVAL TO ISSUE: mK aaaeaa aaa �a a a a oc:aa a aaau• - oeaaoa aaP-P a aaaa Z Z U) M 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 le 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 of more than yIEFRL n. red dollars ($500). I, ay owner ofVe property, or my employees with wages as their sole compensation, will do l_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Ri Inels 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 nprovements are r"Mended 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 %rdgid for the purpose of sale). r 'as owner of the groperty, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not jlply fo,an owner o}'pr`operty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). loam exemptklvrrrlicensure under the Contractors' State License Law for the following reason: 19 Wrignatura` belowl 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 legalll el"etructure 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 loleal6ions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. jigflatuCp of Property Owner or Authorized Agent Date ,ICAIJ5ED COAYRQCTOR'S DECLARATION 'he ruby'affirm w1be604nalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) f Division 3 of the Business and Professions Code, and my license is in full force and effect. LicerisE Cl2ss License No Date ��'��tZ Contractor Signature �C ;>. fy-'i VORKERS' COMPENSATION DECLARATION IARNING: 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 '.OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: I have 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 erformance 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' rance carrier and policy number are: Policy Number of Agent Date �h certify that, in the performance of the work forwhich 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 iat, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Iignature of Applicant X ULicnn (.7"Lfl`) DatX / IS/ZaZZ IECLARATION REGARDING 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, Civil Code). Ender's Name Lender's Address iy 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 and state laws relating to building construction. I authorize representatives of this city or county to enter the above -identified property for inspection purposes. /Z9 Z�LL tignature of ProoertY Owner or Authorized Agent X F?,- m u n G"(`in Print Property Owner's or Authorized Agent's Name )C 127relY}, V y� rl , Date ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 111�403 PERMITEXPIRED I__1I SUBMITTED ASBESTOS NOTIFICATION TO PERMITC4NCELLED PERMIT EMENDED PERMITFINAL CERTIFICATE OF OCCUPANCYISSUED PROPOSED NOTIFICATION IS NOTAPPLICABLE TO o. Ah n