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Home My WebLink AboutX2020-0869 - Permits (3)c1`e City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2020-0869 a' t 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 0 0 8 6 9 Project NO : 0603-2020 Permit Counter Phone (949)644-3288 H m Inspection Requests Phone (949)644-3255 Issued Date : 06115/2020 Combination Type - MFP MECH ELEC PLUM Inspection Area : 4 PERMIT EXPIRES 18O DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY Ofr/ld/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: 12 VIENNA NB Description: REMODEL MASTER BATHROOM & CHANGE ROOF LINE 117 SF `-'� TMFRR 9 Legal Desc.: TR 859 LOT 1 UNIT 19 OF PROJECT LOCATED ON AP 461-121-07 TOGETHER 'NSPE^") (� J'-f0R Owner: LITTLEFIELDISERVATI Contractor: PACIFIC LANDMARK INT. Architect: Address: 3343 LONE PINE RD Address: 415 N TERMINAL STREET Address: WEST BLOOMFIELD MI 48323 SANTA ANA CA 92701 „ Phone: Phone: Phone: State Lic: Applicant: HASHEMI ABBY Con State Lic: 660149 Engineer: ALSON KEN ' Address: 415 N TERMINAL ST Lic Expire: 05131/2022 Address: 9744 MAPLE ST#101 SANTA ANA CA 92701 Bus Lic: BT30067106 BELLFLOWER CA 90706 Phone: 714-981-2000 Lic Exp Date: 04130/2021 Phone: 562-866-3625 State Lic:C-041697 ' Code Edit : 2019 Worker's Compensation Insurance Designer: Type of Construction: V-B Carrier: OAK RIVER Address: ' Occupancy Group: R21U Policy No: FLWC013313 o Added /New sq.ft. Bldg: 0 Expire: 1111812020 Phone: ' �+ Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear: I Special Conditions: SOME LANDSLIDE AREA No of Units : 4 Front: I Bldg Height: 0 Left: I Bldg Sprinklers: Right: I Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $20,000.00 Building Permit Fee: $395.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $343.65 Additional Fee : $0.00 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: $10.00 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 P/W Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $27.65 San Dist: $0.00 Building Green Fee : $1.00 Mechanical %: $15.80 NMUSD Fee: $0.00 $0.00 Plumbing %: $35.55 $0.00 TOTAL FEE: $828.65 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Plan Check Fee $341.04 Fee Due at Permit Issuance : $487.61 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: d �^ OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indic ed 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, demc fish, 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 LI w (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 Sectic n 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) portions of th 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 ei nployees' 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 ri-m-roved for the purpose of sale). u I, as owner of the property,_ am exclusively contracting with licensed Contractors to construct the project (Section 7044, E usiness 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 I ursuant to the Contractors' State License Law). ❑ 1 am exempt from licensure under. the Contractors' State License Law for the following reason: ar prior to completion of the improvements covered by this permit, I cannot legal) By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one ye sell a structure t1 tat I nave built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I and rstand that a copy of the applicable law, Section 7044 of the Business and :F..cf I-sions Coda. ;a available upon request when this application is submitted or at the following Web site:http://w .1 inf .ca.gov/calaw.html. (Signature of Proper'y Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION heteoy affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 00) of ivision 3 of the Business and Profes ns Co , a d Ijc Rse is in full force a'od effect. License :.,ass License No Date Contractor Signature WORKERS' COMPENSATION DECLARATION 4AHNING: FAILURE TO SFCURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUB.IECT AN EMPLOYER TO CRIMINAL PENALT S AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE ^O-T OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hPwhy affirm under penalty of perjury one of the following declarations: 1 have and'will na,ntain a certificate of consent to self -insure for workers' compensation, issued by the Director of ndustrial Relations as provided for by Section 3700 of the Labor Code, for th rance of the work for which this permit is issued. Policy No. ve and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the pe k ormance of the work for which this permit is issued. My workers' compensatioce carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # as to become subject to the workers' C pensation laws of California, and agre I certify that, in the perfor nce of the work for which this permit is issued, I shall not employ any person in any manners that, if I should become sub' ct to the orkers' compen tion provisions of Section 3700 of the Labor Code, I shall forthwith omply with those provisions. Signature of Applicant DECLARATION REGAR ING CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which his permit is issued (Section 309 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 hav provided is correct. I agree to comply with all applicable city and county rdinances and state laws relating to building construction. I authorize representatives of this city or county to nte[-t bov nlified property for inspection purposes. Signature of Property Owner or Authorized Agent Print Property ert Owner's or Au& orized Agent's Name 0 ACTION DATE BY DEC RATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE I ISE ONLY ULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED El I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED EPA PERMIT EXTENDED LJAqM D PERMITFINAL ASBESTOS N TIFICATION IS NOT APPLI TO CERTIFICATE OF V P DIED DE O TIO OCCUPANCYISSUED SIGNATURE• C2