HomeMy WebLinkAboutX2021-1385 - Permits�1+rv�a City of Newport Beach -Building Division
100 Civic CenMr Drive, Newport Beach, CA 92660.
4 Permit Counter Phone (949)644-3288
c: ?r Inspection Requests Phone (949)644-3255
�az,f,a�u,ay Combination Type - SFP ELEC MECH PLUM
II iiiii1 1385i9II
COMB Permit: X2021-138
Project No : 1222-2021
Issued Date : 1012912021
Inspection Area : 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 10/29/2024 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: 1806 BERYL LN NB
Description: SFR ADD 55 SF, NEW ROOF AND RAISE WALLS, KITCHEN/DINING, BEDROOM/BATH REMODEL, RELOCATE LAUNDRY RM AND CHANGE OUT WINDOWS & DOORS 900 SF
Legal Desc.: N TR 1806 LOT 24
Owner:
DEVRIES BERNICE L
Contractor:
OWNER/BLDR
Address:
1806 BERYL LN
Address:
HEYDORFF LEO
NEWPORT BEACH, CA 92660
Phone:
Phone:
714-673-9005
Applicant:
HEYDORFF LEO
Con State Lic:
O/B
Address:
20761 CHAUCER LANE
Lic Expire:
HUNTINGTON BEACH, CA 92646
Bus Lic:
Phone:
714-673-9005
Lic Exp Date:
Code Edit : 2019
Type of Construction: V-B
Occupancy Group: R3/1.1
Added /New sq.ft. Bldg: 55
Added /New sq. ft. Garage: 0
No of Stories: 1
No of Units: 1
Bldg Height: 0
Bldg Sprinklers:
Flood Zone:
Building Permit Fee: $2,913.00
Plan Check Fee: $2,448.99
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management :
$32.00
Energy Compliance:
$175.70
CA Seismic Safety:
$32.63
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$11.00
PROCESSED BY:
Worker's Compensation Insurance
Carrier:
Policy No:
Expire:
Building Setbacks Rear: 6
Front: 20
Left: 6
Right: 6
Architect:
Address:
Phone: State Lic:
Engineer: YAGHI SHUCRI I
Address: 112 E. CHAPMAN #D.
ORANGE CA 92866 r
Phone: 714-997-9120 , State Lic:C-043205
Designer
Address:
SPEZCT
Phone: fN
Special Conditions: CMSD
O/B AUTH FORM ATT
ROBERTS WASTE TO HAUL
Use Zone:
Parking Spaces:
0
Fire Hazard Zane : N
i
Excise Tax:
$0.00
Planning Department -
Fire Department
Additional Fee :
$0.00
Plan check Fee:
$208.00
Fire Inspection:
$0.00
Grading Bonds Fee:
$0.00
Fair Share :
$0.00
Fire Plan Rev
$0.00
Grading PC Consultant :
$0.00
SJH Trans :
$0.00
Demolition Fee
Grading Permit Fee:
$0.00
In -lieu Housing Fee :
$0.00
Building Dept Adm
$27.00
Grading PC Fee:
$0.00
Public Works Department -
General Service
$265.00
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Refund Deposit
$564.00
PAN Plan Check :
$50.75
Grading Bond:
$0.00
Electrical %:
$203.91
San Dist:
$0.00
Mechanical %:
$116.52
NMUSD Fee:
$0.00
$0.00
Plumbing %:
$262.17
$0.00
TOTAL FEE : $7,310.67
ZONING APPROVAL:
Plan Check Fee : $3,331.29 Fee Due at Permit Issuance : $3,979.38
HUHLICWORKS APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL: - APPROVAL TO ISSUE:
Trn
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 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
,no-lt(more than five hundred dollars ($500).
Wrl, 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-Builderwill have the burden of proving that it was not built or
imp oved 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).
WI 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 legally
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:L/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/i ion on 3 of the Business and Professions C es, a Icense is in full force
and effect. License Class License No Date / 2 L��% Contractor Signature'(��C �•
✓✓ORKERS' COMPENSATION DECLARATION \
NARNING: 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
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
haffirm
hereby arm under penalty of perjury one of the following declarations:
1:ihave 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 the
3erformance 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
ertify that, in the performance of the work for whicL.higsperm, t is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree
t, if I should become subjecct tto the workers' comp p Ions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of ApplicanD
CLARATION REGTION LENDING AGENCY
areby 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. ivil 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 ordin ces and fate laws relating to building construction.
I authorize representatives of this city or county to enter a ab entif1'yf party for inspection purposes.
nature of Propertv Owner or Authorized Agent \;, v v Print Prooertv Owner's or Authorized AGent's Name �� / iJ ❑ate
PERMIT CANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCYISSUED
I DATE I BY
_11
N,ECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
I SUBMITTED ASBESTOS NOTIFICATION TO
PROPOSED
SIGNATUR
NOTIFICATION IS NOT, APPLICABLE TO
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