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Home My WebLink AboutX2019-0865 - Permitsa City of Newport Beach - Building Division IIIIIIIIIII�III�III�III�III�IIIIIIII�II COMB Permit: X2019-0865 100Civic Center Drive, Newport Beach, CA 92660 x 2 0 1 9 0 8 6 5 Project No: 0585-2019 Permit Counter Phone (949)644-3288 Inspection Requess PhJi _ (949)644-3255 Combination Type - SFP MECH ELEC PLUM Issued Date: 0312512019 Inspection Area : 3 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. 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; 1601 DOROTHY LN NB Description: SFR ALT 1,127 SF (REMODEL REDUCE(E) BEDRM TO CREATE OFFICE SPACE & REMODEL LIVING, DINING & ENTRY) Legal Desc.: N TR 1973 LOT 23 Owner: LANDY DARYUJILL Contractor: M C M Architect: C ' Address: 1601 DOROTHY LN .Address: 2238 PORT CARLISLE PIL Address: 4 NEWPORT BEACH, CA 92660 NEWPORT BEACH CA 92660�,..® Phone: Phone: 714-803-9204 Phone:. State Lie: Applicant: SANTA MARIA ANDREW Con State Lie:. 869498 Engineer: CROSBY PAUL Address: 2333 PORT CARLISE PL Lie Expire: 12131/2019 Address: 13190 MUGU CT NEWPORT BEACH CA 92660 - Bus Lie: BT30042113 APPLE VALLEY CA 92308 Phone: 949-533-8138 Lie Ezp Date: OV31/2020 Phone: 760-2175900 State Lic:S-005635 Code Edit: 2016 Worker's Compensation Insurance Designer: SANTA MARIA ANDREW Type of Construction: VB - Carder: WIC EXEMPT .Address: 2333 PORT CARLISLE PL _ Occupancy Group: R3/U Policy No: (NO EMPLOYEES) NEWPORT BEACH CA 92660 � Added /New sq.ft. Bldg: 0 Expire: Phone: 949-533-8136 Added /New sq. ft.. Garage: 0 No of Stories: 1 Building Setbacks Rear: / Special Conditions: No of Units : 1 Front: / Bldg Height: 0 Left: / Bldg Sprinklers: N Right: / Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone: N Construction Valuation: $90,160.00 Building. Permit Fee: $1,050.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $913.60 Additional Fee : $0.00 Plan check Fee : $40.00 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:. $0.00 Grading PC Consultant: $0.00 SJH Trans : $0.00 Demolition Fee Record Management: $24.00 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 WO 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 Electricals%: $73.50 San Dist: $0.00 Building Green Fee: $4.00 Mechanical %: $42.00 : NMUSD Fee: $0.00 $0.00 Plumbing.%: $94.50 $0.00 TOTAL FEE : $2,241.50 Plan Check Fee : $913.50 Fee Due at Permit Issuance ; $1,328.00 PROCESSED BY: e. e. a ` a PUBiLC Y116'RH,S APPROVAL: APPROVAL: aG� `"" PLAN CHECK BY:y mxZONING GRADING APPROVAL: APPROVAL TO ISSNEe v a a 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 7b00) 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). 111, 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 im roved 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). ❑ 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, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (Commencing with Section 7 0 of Qivisi n 3 of the Business and Pr a ions-2yde nd ram, g is in full force and effect. License Class License No Date ?" Contractor Signature-�A�+�/,�� WORKERS' COMPENSATION DECLARATION ' NARNING: 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 COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. I hereby affirm under penalty of perjury one of the fallowing declarations: ❑ 1 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 performance of the work for which this permit is issued. Policy No. have and Agent 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' Number Expiration Date Phone # ]I 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 tat, if I should become subject to the rkers' �cfo ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 1-7 ignature of ApplicantO�ZP..t.il,1. Da t " DECLARATION REGA DING CONS RUCTION LENDING AGENCY hereby affirm under p nalty 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 y my signature below, I certify to each of the fallowing: 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. I authorize representatives of this city or county toe he abov = entified property for inspection purposes. , %�? % .innate lre of Pmnerty Owner nr Authorized ADent � S /� %7/a�I Print Prooertv Owner's or Authorized Acent's Nam Date J1u l ACTION DATE BY 'DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED I SUBMI ASBE5TOS NOdiFyCAYR�J TO PERMITCANCELLED EPA • • •• •• PERMIT EXTENDED 4 0ACtIVID • • • • • • • : • • • _ PERMIT FINAL TIL7t19 ' ASBESTOS NOTIFICATION IS NOT APrrBLE TO CERTIFICATE OF OCCUPANCYISSUED PRCPOSE D / SIGNATUR • • { ` C OO G O • O O O O O O O O ^C 000 6 p p00 0j0 070