HomeMy WebLinkAboutX2021-2805 - PermitsW ryr City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - SFP ELEC MECH PLUM
111111111111111111111111111111111111p1111111111111111 COMB Permit: X2021-2805
Project No :
Issued Date: 10115/2021
Inspection Area : 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 1011512024 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: 2372 AZURE AVE NB
Description: SFR INTERIOR BATHROOM REMODEL 56 SF *"CITY STANDARD"*
Legal Desc.: N TR 1501 LOT 38
Owner: GORING WILLIAM A
Contractor:
TARGET HOME DESIGN INC
Architect:
Address: 2372 AZURE AVE
Address:
12439 MONGOLIA BLVD #122
Address:
NEWPORT BEACH, CA 92660
NORTH HOLLYWOOD, CA 91607
Phone:
Phone:
(866) 355-7723
Phone:
State Lic:
® ,
Applicant: TARGET HOME DESIGN
Con State Lic:
973379
Engineer:
,
Address: 12439 MAGNOLIA BLVD
Lic Expire:
09130/2022
Address:
NORTH HOLLYWOOD, CA 91607
Bus Lic:
BT30076951
Phone: 866-355-7723
Lic Exp Date:
10/31/2022
Phone:
State Lic:
Code Edit : 2019
Worker's Compensation Insurance
Designer:
TARGET HOME DESIGN
Type of Construction: V-B
Carrier:
STATE COMP INS
Address:
12439 MAGNOLIA BLVD
Occupancy Group: R3/U
Policy No:
9244152
NORTH HOLLYWOOD, CA 91607
, ..
Added /New sq.ft. Bldg: 0
Expire:
0111112022
Phone:
,
Added /New sq. ft. Garage: 0
,
No of Stories: 1
Building Setbacks
Rear: /
Special Conditions:
CITY STANDARD ATT TO
No of Units: 1
Front: /
PERMIT
Bldg Height: 0
Left: /
Bldg Sprinklers: N
Right: /
-
Flood Zone: X
Use Zone: Parking Spaces:
0
Fire Hazard Zone :
N
Construction Valuation: $25,000.00
Building Permit Fee: $501.00
Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee: $435.87
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: $2.00
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 %:
$35.07
San Dist:
$0.00
Building Green Fee : $1.00
Mechanical %:
$20.04
NMUSD Fee:
$0.00
$0.00
Plumbing %:
$45.09
$0.00
TOTAL FEE: $1,092.07
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Plan Check Fee :
$0.00 Fee Due at Permit Issuance : $1,092.07
PUBLIC WORKS APPROVAL:
PLAN CHECK BY: y!
APPROVAL TO ISSUE: V
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-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 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).
❑ I 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 priorto 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://www.leginfo.ca.gov/calaw. html.
Signature of Property Owner or Authorized Agent Date
LICENSED CON) KACTOR'S DECLARATION
hereby affirm under oenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 O) o Div on of the Business and Profes o n my Fcens in full force
and effect. Lieanse Ciass License No Date. Contractor Signature
WORKERS' COMPENSATION DECLARATION
.JARNAG: 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 1$100,0001, IN ADDITION TO THE
COST O� COMPENSCT'PN ^AMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
j her?hy affirm under penalty of perjury one of the following declarations:
❑ I have and wil'. mawtain 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 thi
Y o-mance of the work for which this permit is issued. Policy No.
havw 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' compensatior
Oanca carrier anu policy number are:
ul_
le of Agent'
certify that, in the performance
if I should become U c e
Iature of Aoolica7
Policy Number
Date
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
rkers' compensat' ro ' ' ns of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Date/L7��,JZ/11
hereby 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, Civil Code)
antler'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 a Be to comply with all applicable city and countyprdinances d state laws relating to building construction.
I authorize representatives of this city or countyvto nt t id 'rfleT�� o�-fo p�ction purposes.
iionature of Prooertv Owner or Authorized Agent not Property Owners or Authorized Agent's ame
ACTION DATE BY DECLARATION OF COMPLIANCE WOR CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
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PERMITEXPIRED I LJ I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITEXTENDED
PERMITFINAL
CERTIFICATE OF
1
b
OCCUPANCY ISSUED