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Home My WebLink AboutX2021-1972 - PermitsCity of Newport Beach - Building Division *X2021-1972* COMB Permit: X2021-1972 r 100 Civic Center Drive, Newport Beach, CA 92660 /� � � � ( N ' Project No : 1484-2020 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 , �/� C IR �� Issued Date : 2D21 Combination Type - SFP ELEC PLUM MECH Area : Inspection Area : 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 1110212024 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: 1620 KINGS RD NB Description: SFR *ADDITIONAL SCOPE* CONVERT GARAGE TO ACCESSORY DWELLING UNIT 608 SF (REV21-1176) Legal Desc.: N TR 1221 LOT 12 Owner: FOROUTAN Contractor: BURKHART BROTHERS CONSTR Architect: Address: 1620 KINGS RD Address: 12 BALBOA COVES Address: NEWPORT BEACH, CA 92663 NEWPORT BEACH CA 92663 Phone: Phone: 949-375-6725 Phone: State Lic: ' Applicant: RICHART JASON Con State Lic: 905510 Engineer: GHAZLANI ANDY - ' Address: 1041 W 18TH ST A-106 Lic Expire: 10131/2023 Address: 4202 ATLANTIC AVE #204 COSTA MESA CA 92627 Bus Lic: BT30026859 LONG BEACH CA 90807 Phone: 949-422-9191 Lic Exp Date: 03131/2022 Phone: 562-253-2385 State Lic:C-060867 - Code Edit : 2019 Worker's Compensation Insurance Designer: - Type of Construction: V-B Carrier: SECURITY NATIONAL INS Address: - - - Occupancy Group: R3 Policy No: SWC1325229 Added /New sq.ft. Bldg: 0 Expire: 02/01/2022 Phone: ; Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear: I Special Conditions: No of Units : 1 Front: I Bldg Height: 0 Left: / Bldg Sprinklers: Right: I Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $26,000.00 Building Permit Fee: $511.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $444.57 Additional Fee: ($1,055.77) Plan check Fee : $0.00 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 PAN Plan Check : $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $35.77 San Dist: $0.00 Building Green Fee : $2.00 Mechanical W $20.44 NMUSD Fee: $0.00 $0.00 Plumbing %: $45.99 $0.00 TOTAL FEE : $4.00 Plan Check Fee : $0,00 Fee Due at Permit Issuance : $4.00 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: 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 L) all of or L) 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). 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 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 Cone, is available upon request when this application is submitted or at the following Web site:http:11wWw.leginfo.ca. govlcalaw.html. Signature of Property Owner or Authorized Agent Date ;'LICENSED CONTRACTOR'S DECLARATION (lhereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0) o Division 3 of the Business and Pro a ions C e and my ' nse is i ull force and effect. Licer, se Class License No Date t Contractor Signature IIWORKERS' CCP.I9ENSATION DECLARATION I PRNINI: FAILURE -E FECURE 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 I'COS� OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. iI S.t:Eby affirm und,r penalty of perjury one of the following declarations: I nave and w'II 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 IN ,pa.,fmc,.ance of the work for which this permit is issued. Policy No. and w.!I mai.itain 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 I 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 Californi , and agrei It, if I should become subject to the/yrork s' compen/s�t�n/provlsions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. )nature of Applicant`\I // /�----d // Dat _ Z Z iCLARATION REGARY1`11"ONIRTRUCTION LENDING AGENCY ereby 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 I Code). nder's Name Lender's Address 3y 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 an Ste laws relating to builds -construction. I authorize representatives of this city or cou t enter the abo -id ified propert for' Dealt purposes. signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Ag ACTION DATE BY DEC RATION OF COMPLIAN W H CODE OF FEDERAL I FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED EPA PERMIT EXTENDED AQMD PERMITFINAL fpA SBESTOS NOTIFICAT N IS NOT AP LE TO CERTIFICATE OF OP EDSNOTIRI OCCUPANCY ISSUED T!p {M IGNA7URE. A� Name