HomeMy WebLinkAboutX2021-0303 - Permitse`�eof City of Newport Beach - Building Division
.'t 100 Civic Center Drive, Newport Beach, CA 92660
N Permit Counter Phone (949)644-3288
u Inspection Requests Phone (949)644-3255
Combination Type - MFP
II1111111111111111111111111111111111111111 II COMB Permit: X2021-0303111111111
Project No: 0320-2021
Issued Date : 04/1312021
Inspection Area : 1
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0411312024 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: 601 LIDO PARK DR NB
Description: MFR REPLACE BALCONY GLASS GUARDRAILS FOR 64 UNITS
Legal Desc.: TR 7695 LOT 1 UNIT 7E G-1-28 OF PROJ LOCTD ON AP 47-021-29
Owner: LIDO HOA Contractor: PCW CONTRACTING SVCS Architect:
Address: 601 LIDO PARK DR Address: 981 W 18TH ST Address:
NEWPORT BEACH, CA 92663 COSTA MESA CA 92627
Phone: Phone: 949-548-9969 Phone: State Lic:
Applicant: ROSALES IVAN Con State Lic: 699611 Engineer: PINHEIROS, JUAN PABLO
Address: 981 W 18TH ST Lic Expire: 12/31/2022 Address: 488 E OCEAN BLVD 708
COSTA MESA CA 92627 Bus Lic: ST00002246 LONG BEACH CA 90802
Phone: 714-733-9375 Lic Exp Date: Phone: 714-632-1865 State Lic:C-078561
Code Edit: 2019 Worker's Compensation Insurance Designer:
Type of Construction: V-B Carrier: CYPRESS INS Address:
Occupancy Group: U Policy No: PCWC228520
Added /New sq.ft. Bldg: 0 Expire: 01/01/2022 Phone:
Added /New sq. ft. Garage: 0
No of Stories: 5 Building Setbacks Rear: I Special Conditions:
No of Units: 54 Front: I
Height:Bldg 0 Left: I
Flood Zone: Use Zone: Parking Spaces: 0 Fire H oZ ®\�
Bldg Sprinklers: Right: I
�.
Construction Valuation: $700,000.00 ((``®e.\ I
Building Permit Fee: $4,789.00 Excise Tax: $0.00 Plannin nt- Fir partment
Plan Check Fee: $4,166.43 Additional Fee: $0.00 Plan checkFee: $0.00 Fir
$0.00
Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share : O:d4 3 kv I Fire Plan Rev $0.00
Investigation Fee: $0.00 Grading PC Consultant: $0.00 SJH Trans : �. 0 Demolition Fee
Record Management: $10.00 Grading Permit Fee: $0.00 In -lieu Housing Fee: ®N $0.00 Building Dept Adm $26.00
Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department- General Service $219.00
CA Seismic Safety: $0.00 WO Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $564.00
Disabled Access : $0.00 PAW Plan Check: $0.00 Grading Bond: $0.00
Hazardous Mat $0.00 Electrical W $0.00 San Dist : $0.00
Building Green Fee : $28.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00
Plumbing W $0.00 $0.00
TOTAL FEE : $9,802.43 Plan Check Fee : $4,166.43 Fee Due at Permit Issuance : $5,636.00
PROCESSED BY: PUBLIC WORKS APPROVAL:
ZONING APPROVAL: PLAN CHECK BY: I
GRADING APPROVAL: APPROVAL TO ISSUE:
I V 01 -I w' 1;�3 , °1315
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
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
'rofessions 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 five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
Wsiness 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 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).
1 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 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
ell a structure that I have built as an owner -builder if it has not been constructed in its entirely by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
signature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of p ury that I am licensed under provisions of Chapter 9 (commencing with Section 70 0) of Division 3 of the Business and Pr ass' o 1 de, and f full force
nd effect. License Class �7 3L C3e1 License No G94IE C1 Date Contractor Signature
VORKERS' COMPENSATION DECLARATION
ARNING: 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
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS 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 thI
erformance 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 Code, for the performance of the work for which this permit is issued. My workers
carrier and policy number are: y�
40✓WS�l IIAGdaAQPA&_ CDPolicy Number Pcc o`i�5 1 Expiration Date 1a I3\ I�L�� 1
of Agent
I certify that, in the performance of the work for hich 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
that, if I should become subje o th workers' o n provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant Datg,,<_
DECLARATION REGASTRUCT19tKE G AGENCY V
I hereby affirm under pens 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).
Lender's Name Lender's Address
By 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.
I authorize representatives of this city or county to enter the inspection purposes.
Signature of Property Owner or Authorized Agen abo - e fi proper Print Property Owner's or Authorized Agent's Name _,,, �t' Date klt.5,4675A
ACTION DATE BY ,/J DE - IRATION OFICOMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART Gl OF TITLE 40 AND AQMD RULE
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