HomeMy WebLinkAboutX2022-1201 - PermitsCity of Newport Beach - Building Division *X2022-1201* COMB Permit: X2022-1201
100 Civic Center Drive, Newport Beach, CA 92660 _ Project No : 1106-2022
r. nPermit Counter Phone (949)644-3288
> 's Inspection Requests Phone (949)644-3255 i li L_ Issued Date : 06/16/2022
Combination Type - MIFF MECH ELEC PLUM Inspection Area : 4
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 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: 2715 VISTA UMBROSA NB
Description: MFR ADD 367 SF, REMODEL 1,674 SF . .
Legal Desc.: N TR 6905 LOT 49
Owner:
CORCORAN BEVERLY
Contractor:
OWNER/BLDR
Address:
2715 VISTA UMBROSA
Address:
CORCORAN BEVERLY
NEWPORT BEACH, CA 92660
O/B FORM ATTACHED
Phone:
Phone:
949-310-3758
Applicant:
LA ROCHE DENIS A
Con State Lic:
O/B
Address:
PO BOX 3708
Lic Expire:
TUSTIN CA 92781
Bus Lic:
Phone:
949-939-3047
Lic Exp Date:
Code Edit : 2019
Type of Construction: VB
Occupancy Group: R3/U
Added /New sq.ft. Bldg: 367
Added /New sq. ft. Garage: 0
No of Stories: 1
No of Units: 2
Bldg Height: 0
-food 2
M
Worker's Compensation Insurance
Carrier:
Policy No:
Expire:
Building Setbacks Rear: 0
Front: 0
Left: 0
Riaht: 0
Architect:
LA ROCHE DENIS A
Address:
PO BOX 3708
TUSTIN CA 92781
Phone:
949-939-3047
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
State Lic:C013756
State Lic:
Special Conditions: HAULER: WASTE MGMT
nazam
Construction Valuation: $300 000.00
Building Permit Fee:
$3,165.00
Excise Tax:
$0.00
Planning Department -
$208.00
Fire Department
Fire Inspection:
Plan Check Fee: $2,578.19
Additional Fee :
$0.00
$0.00
Plan check Fee :
Fair Share:
$0.00
Fire Plan Rev
Overtime Plan Ck:
$0.00
$0.00
Grading Bonds Fee:
Grading PC Consultant :
$0.00
SJH Trans :
$0.00
Demolition Fee
Investigation Fee:
Record Management:
$30.00
Grading Permit Fee:
$237.00
In -lieu Housing Fee :
$0.00
Building Dept Adm
General Service
Energy Compliance:
$210.00
Grading PC Fee:
$199.00
$0.00
Public Works Department-
Park Dedication : $0.00
Refund Deposit
CA Seismic Safety:
$39.00
WQ Insp. Fee:
PNV Plan Check :
$50.75
Grading Bond:
Disabled Access :
Hazardous Mat
$0.00
$0.00
Electrical %:
$221.55
San Dist:
$0.00
Building Green Fee :
$12.00
Mechanical %:
$126.60
NMUSD Fee:
$0.00
Plumbing %:
$284.85
TOTAL FEE: $8,217.94
Plan Check Fee : $3,046.94 Fee Due at Permit Issuance
PROCESSED BY: J3 S PUBLIC WORKS APPROVAL:
ZONING APPROVAL: D L PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
e
C ho
$0.00
$0.00
$27.00
$265.00
$564.00
$0.00
$0.00
$0.00
$5,171.00
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
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 Iicensure 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 p"alty of
not ore 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 (_) 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-Builderwill 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 ownar 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 an. exempt from Iicensure under the Contractors' State License Law for the following reason:
3y my signature oelow 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,
sFll a structure chat , Iave 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
aroiess.ons Code, is available upon request when this ap ation is sub itte or at the fo owing Web site:http://www.leginfo.ca.gov/calaw.htmi.
Signature of Property Owner or Authorized Agent %�1iJ'2 E 6./%?i g2.r—,I Date
_ICEN-SED CONl'k4CTORB DECLARATION
hereby affirm unrier oenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
and effect. Llpende Cass License No Date Contractor Signature
NORKERS' COMPENSATION DECLARATION
NARNINIP: 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 COMPErSATION,oAMAGES 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:
:1 1 nave ano 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 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 Expiration Date
of Agent
ertify 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
if I should become subject to workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
of
Date' �
hereby affirm under penalty of perjury that thYre 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
ly 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 th^5above-identified property for inspection purposes.
ignature of Property Owner or Authorized Agart
%S� Print Property Owner's or Authorized Agent's Name
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMITEXPIRED I LJ I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITFINAL (D/Zi �yVS �Q SOBESTOS NOTIFICATION IS NOTAPPLICABLE TO
CERTIFICATE OF (( (( ��IV//J 'PROPOSED DEMOLITION
OCCUPANCYISSUED SIGNATURE: