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Home My WebLink AboutX2020-2468 - Permits�yy:wt>cy; City of Newport Beach - Building Division *X2020-2468* COMB Permit: 100 Civic Center Drive, Newport Beach, CA 92660 Project No E �. Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - SFP ELEC MECH PLUM Issued Date: Inspection Arearea :2020 5 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 10/28/2023 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: 18 ARCHIPELAGO DR NS Description: SFR - KITCHEN AND BATHROOM REMODEL1050 SF (STANDARD PLAN) NON STRUCTURAL Legal Desc.: N TR 15817 LOT 4 Owner: Address: DEMIA INVESTMENT GROUP LLC Contractor: 43 BRIDGEPORT RD Address: MATT WHITE CUSTOM HOMES INC Architect: ��` 3090 PULLMAN ST Address: q, NEWPORT BEACH, CA 92657 COSTA MESA CA 92626 V Phone: Phone: 714-557-1325 Phone: State Lic: Applicant: MATT WHITE CUSTOM HOMES INC Con State Lie: 940163 Engineer: Address: 3090 PULLMAN ST Lie Expire: 11130/2021 Address: COSTA MESA CA 92626 Bus Lie: BT30030932 Phone: 9491274-2771 Lie Exp Date: 02128/2021 Phone: State Lie: Code Edit : 2019 Worker's Compensation Insurance Designer: Type of Construction: VB Carrier: STATE COMP INS FUND Address: Occupancy Group: R3/U Policy No: 9063837 - Added /New sq.ft. Bldg: 0 Expire: 0710112021 Phone: Added /New sq. ft. Garage: 0 No of Stories: 1 Building Setbacks Rear: / Special Conditions: a No of Units : 1 Front: / Bldg Height: 0 Left: / . . Bldg Sprinklers: Right: I Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $95 000.00 Building Permit Fee: $1,169.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $1,017.03 Additional Fee : $0.00 Plan check Fee : $46.25 Fire Inspection: $0.10 Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev ' , Sn,.gd 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 PAN Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $81.83 San Dist: $0.00 Building Green Fee : $4.00 Mechanical %: $46.76 NMUSD Fee: $0.00 $0.00 Plumbing %: $105.21 $0.00 TOTAL FEE : $2,470.08 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $2,470.08 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: Y PLAN CHECK BY: GRADING APPROVAL: 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 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 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 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 -Builder will 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 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). ❑ 1 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 legall) 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://www.leginfo.ca.gov/calaw.htmi. 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 700) o Divisi n 3 of the Business and Profess' s Co t and y-license is in full force and effect. License Class License No Date O Contractor Signature INORKERS' COMPENSATION DECLARATION NARNING: FAILURE Tn SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOU D'DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENS,'P.CN, nF MAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. f.ereby cflum 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 the MIformance of the work for which this permit is issued. Policy No. and willmairtnin 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 po:.icy number are: ie of Agent_ cer ifv that, in the p if I s)ould become Policy Number Date 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 agre he workers' compensat Rn provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 'ign"u-€ of Applicant ICOI- ARATION,REO R ING NS IO NDINGA NCY Dated 1,21 �2620 I hereby affirm un6cr'panalt f 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, certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. 1 have read this application and the information I have provided is correct. I agree to comply with all applicable city and cougWordinances and state laws relating to building construction. - I authorize representatives of this city or coo en the ve-identif' d property for inspection purposes. Signature of Propertyunt Owner or Authorized Age Print Property Owner's or Authorized Agent's Name &aCw0wat ACTION DATE BY C RA COMPLIANCE WITH E OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED LJEPA PERMIT EMENDED QM D PERMIT FINAL ^t / y n, SBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF ` l• w` POSED pEMOUTION �� OCCUPANCYISSUED SIGNATURE: / 1