HomeMy WebLinkAboutX2022-0792 - PermitsIs0surxw[�„�; City of Newport Beach - Building Division *X2022-0792* COMB Permit: X2022-0792
100 Civic Center Drive, Newport Beach, CA 92660 Project No : 1810-2021
v n Permit Counter Phone (949)644-3288
4 Inspection Requests Phone (949)644-3255
Combination Type - MFP
ed Date : 03/17/2022
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Inspection Area : 4
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST SE COMPLETED BY 03/17/2025 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: 3000 PARK NEWPORT DR NB St:
1 FI: 1 Unit: 103
Description: MFR (UNIT 103) DRYWALL REPLACEMENT
THROUGHT, ELEC AND PLUM THROUGHOUT 729 SF "CHANGE OF CONTRACTOR (X2021-2090)'
Legal Desc.: N TR 6947 LOT 8
Owner: PARK NEWPORT LAND LTD
Contractor:
R D M WEATHERPROOFING
Architect: GRISAFE MARK
Address: 201 FILBERT ST #700
Address:
PO BOX 130
Address: 5618 E. CONANT ST
SAN FRANCISCO, CA 94133
BEDIAS TX 77831
LONG BEACH CA 90808
Phone:
Phone:
714-404-8739
Phone: 562-480-1035 State Lic:CO28845
Applicant: GRISAFE MARK
Con State Lic: 724244
Engineer:
Address: 5618 E. CONANT ST
Lic Expire:
0613012022
Address:
LONG BEACH CA 90808
Bus Lic:
BT0302449
Phone: 562-480-1035
Lic Exp Date:
0212812023
Phone: State Lic:
Code Edit: 2019
Worker's Compensation Insurance
Designer:
Type of Construction: V-A
Carrier:
STATE COMPENSATION INS FUND Address:
Occupancy Group: R2
Policy No:
9210606
Added /New sq.ft. Bldg: 0
Expire:
05/16/2022
Phone:
Added/New sq. ft. Garage: 0
-'
No of Stories: 3
Building Setbacks
Rear: /
Special Conditions: CHANGE, OF -CONTRACTOR FOR
No of Units : 1
Front: /
X2021-2090
Bldg Height: 0
Left: /
FIRE HAZ REDUCTION ZONE
Bldg Sprinklers:
Right: /
Flood Zane: X
Use Zone:
Parking Spaces:
0 Fire Hazard Zone : N
Construction Valuation: $0.00
Building Permit Fee: $0.00
Excise Tax:
$0.00
Planning Department - Fire Department
Plan Check Fee: $0.00
Additional Fee :
$38.00
Plan check Fee: $0.00 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: $0.00
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 %:
$0.00
San Dist : $0.00
Building Green Fee : $0.00
Mechanical %:
$0.00
NMUSD Fee: $0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE : $38.0,
Plan Check Fee
: $0.00 Fee Due at Permit Issuance : $38.00
q00
PROCESSED BY: �J
PUBLIC W'JPKF APPRO /A'_:
ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
APPROV.NLTO ISSUE:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) 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
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).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do U 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).
❑ I 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 legalh
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 7000) of ivision 3 of the Business and Professions In loans is in full force
and effect. License Class License No Date Contractor Signature
NORKERS' COMPENSATION DECLARATION
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUWECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND D LARS (E1D0,00(, IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNETS 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
ormance of the work for which this permit is issued. Policy No.
and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Cade, for the performance of the work for which this permit is issued. My workers'
carrier and policy number are:
Policy Number
Date
ie of Agent Ti ivav I. I Phone #
certify that, in the performa a 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
if I should become subji the wgr�cers_compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
of Applicant
Date 3-ZZ-ZZ
IECLARATION REGA DI COPOSTRUCTION LENDING AGENCY
hereby affirm under pens y of p r' ry 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 following:
I am the property owner or authorized to act on the proper(?) owner's behalf.
I have read this application and the information I have pr Ided is correct.
I agree to comply with all applicable city and co ty o ances nd state laws relating to building construction.
I authorize representatives of this city or count nt e o e-i ntified property for inspection purposes.
ianature of Prooertv Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name IlMif U �r l
ACTION
PERMITEXPIRED
PERMIT EXTENDED
PERMITFINAL
CERTIFICATE OF
OCCUPANCY ISSUED
DATE I BY
OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
PART 61 OFTITLE 40AND, DRULE
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