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Home My WebLink AboutX2022-1115 - PermitsII iii i ii i i i iii iii ii ii ib City of Newport Beach -Building Division COMB Permit: X2022-111 a� 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 2 1 1 1 5II Project No Permit Counter Phone(949)644-3288 Inspection Requests Phone (949)644-3255 rw, Issued Date : 04/18/2022 Combination Type - SFP ELEC MECH PLUM Inspection Area : 5 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0411812025 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: 102 ARCHIPELAGO DR NB Description: SFR INTERIOR ALTERATION @ KITCHEN & POWDER ROOM (APPROX 150 SF) CITY STANDARD Legal Desc.: Owner: MOORE RICK Contractor: BURKHART BROTHERS CONSTR Architect: Address: 102 ARCHIPELAGO DR Address: 12 BALBOA COVES Address: NEWPORT COAST CA 92657 NEWPORT BEACH CA 92663 Phone: Phone: 949-375-6725 Phone: State Lic: Applicant: TSAI SPENCER Con State Lic: 905510 Engineer: Address: 1382 VALENCIA AV STE F Lic Expire: 10/3112023 Address: TUSTIN CA 92780 Bus Lic: BT30026859 Phone: 949-402-5581 Lic Exp Date: 03/31/2023 Phone: State Lic: Code Edit : 2019 Workers Compensation Insurance Designer: TSAI SPENCER Type of Construction: We Carrier: SECURITY NATIONAL INS Address: 1382 VALENCIA AV STE F Occupancy Group: R3/U Policy No: SWC1373426 TUSTIN CA 92780 Added /New sq.ft. Bldg: 0 Expire: 02/0112023 Phone: 949-402-5581 Added /New sq. ft. Garage: 0 of Building Setbacks Rear: / Special Condition ,Yr��q NNo o of Units: �:� �P ECT®R Bldg Height: 0 Left: / Bldg Sprinklers: N Right: / Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $15,000.00 Building Permit Fee: $331.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $287.97 Additional Fee : $0.00 Plan check Fee : $52.00 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 PNV Plan Check : $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical W $23.17 San Dist : $0.00 Building Green Fee : $1.00 Mechanical %: $13.24 NMUSD Fee: $0.00 $0.00 Plumbing %: $29 79 $0.00 TOTAL FEE: $738.17 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Plan Check Fee : $0.00 Fee Due at Permit Issuance : $738.17 PUJ3LIr, W03KS AFPROVAI':q- PLAN CHECK BY: APPROVAL TO ISSUE"." 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). 7 I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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). J 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 entirety 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.html. signature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 ) f Divi n 3 of the Business and Professions , and my license is in full force nd effect. License Class License No Date ZZ Contractor Signature J CORKERS' 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 OST OF COMPENSATION, DAMAGES 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: 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 Code, for the performance of the work for which this permit is issued. My workers' carrier and policy number are: Policy Number of Agent Date 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 L if I should become subject the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant r\x i/>n� Date CLARATION REGA NG N CLARSTRUCTION LENDING AGENCY :reby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Ci it Code). Ider's Name Lender's Address 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 coun to enter/�he�a�bove-identified property for inspection purposes. Signature of Property Owner or Authorized Agent' Print Property Owner's or Authorized Ag ACTION I DATE I BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND ACMD RULE PERMITEXPIRED U I SUBMITTED A'"FSTOS NI,TIFI�ATON TC DEPA PERMIT CANCELLED PERMIT EXTENDED UAQMD PERMITFINAL CERTIFICATEOF OCCUPANCYISSUED 2. J �ZS l• t(�l_ ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO PROPOSED ICIL,TT IV SIGNATIIRR�4l L/iz//L--x Name A l`r". Date