HomeMy WebLinkAboutX2020-2166 - Permitsxvlrf City of Newport Beach - Building Division
a 100 Civic Center Drive, Newport Beach, CA 92660
E "ny Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - SFP ELEC MECH PLUM
COMB Permit: X2020-2166
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Project No : 1923-2020
Issued.. Date : 10/21/2020 .. ._
Inspection Area : 5
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 1012212023 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 Sunday{ r n�®
Job Address: 4721 CORTLAND DR NB I
Description: SFR INTERIOR REMODEL (KITCHEN, 4 BATHROOMS) DRAINAGE, STUCCO & WINDOWS 500 SF *STOP WORK" 120-2923
Legal Desc.: TR 3519 LOT 4 ALL -EX SWLY 1 FT -
Owner: PSG CAPITAL
Contractor:
OWNERIBLDR
Address: 16411 SCIENTIFIC WAY #250
Address:
AUTH AGNT: KURT KELLER
IRVINE, CA 92618
$0.00
CA Seismic Safety:
Phone: 949-233-4669
Phone:
$0.00
Applicant: BAILEY DAVID
Con State Lic:
O/B
Address: 23183 LA CADENA DR STE 101
Lic Expire:
NMUSD Fee:
LAGUNA HILLS, CA 92653
Bus Lic:
$0.00
Phone: 949.573-1050
Lic Exp Date:
Code Edit : 2019
Worker's Compensation Insurance
Type of Construction: V -B
Carrier:
$0.00
Occupancy Group: R3/U
Policy No:
...
Added /New sq.ft. Bldg: 0
Expire:
° $0.00
Added /New sq. ft. Garage: 0
Refund Deposit
No of Stories: 1
Building Setbacks
Rear: /
No of Units : 1
$0.00
-40.00
0 0 0
Front: I
Bldg Height: 0
Left: I
Bldg Sprinklers:
Right: /
Flood Zone:
Use Zone: Parking Spaces: 0
11 Construction Valuation: $50.480.00
Building Permit Fee: $817.00
Plan Check Fee: $710.79
Overtime Plan Ck:
$0.00
Investigation Fee:
$817.00
Record Management :
$16.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access:
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$3.00
TOTALFEE:
PROCESSED BY:
ZONING APPROVAL:
Excise Tax:
Additional Fee:
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
$0.00
$0.00
$0.00
$0.00
$232.00
$195.00
$0.00
$57.19
$32.68
$73.53
Plan Check Fee:
Architect: BAILEY DAVID
Address: 23183 LA CADENA DR #101
LAGUNA HILLS CA 92653
Phone: 949-573-1050 State Lic:CO27404
Engineer: AS BUILT PERMIT
Address:
Phone: EXPOSE ALk§TRUCTURAL,
Designer: ELECTRICAL, PLUMBING, AND
Address: MECHANICAL COMPONENTS
Phone:
Special Conditions: 120-2923
Planning Department -
Plan check Fee:
Fair Share
SJH Trans
0°0.0°
In -lieu Housing Fee:
Public Works Department -
Park Dedication:
$0.00
P/W Plan Check:
$43.00
San Dist:
$0.00
NMUSD Fee:
$0.00
ab Zone : N
0
°
0000
0°0.0°
Fire Department
$46.25
Fire Inspection:
$0.00
Fire Plan Rev
°.$0.90
$0.00
Demolition Fee
$0.00
Building Dept Adm
E.SQU
...
General Service
° $0.00
Refund Deposit
$0.00
Grading Bond:
$0.00
-40.00
0 0 0
...�
o c
. 00
.$0.00
0°.."..
0$9.98
000°
$995.04 Fee Due at Permit Issuance
PUBLIC WORKS APPROVAL: C_ -
PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
$2,048.40
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)
lection 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
1e 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
It
than five hundred dollars ($500).
, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
Iusiness 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).
1 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, an who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
I am exempt from licensure under the Contractors' Stat Lic 3RLaw for the following reason:
ly my signature below I acknowledge that, except for my pe on idence in which I must have resided for at least one year prior to completion of the improvements cov ed by this permit, I cannot legall}
ell a structure that I have built as an owner -build If has n b e onstruc In Its entirety by licensed contractors. I understand that a copy of the applicable law, c n 7044 of the Business and
'rofessions Code, is available upon re est n this applic 'o i s b ltd or at the following Web site:htlp://www.leginfo.ca.gov/calaw.htmi. ' s 2 / • 20
lignature of Property Owner or Authorize gent ate
.ICENSED CONTRACTORS DEC ATION j
hereby affirm under penalty of perjury' that am licensed u er p A ions of Chapter 9 (commencing with S to 7000) of Division 3 of the Busine§ond Professions Code, and my license is in full force
nd effect. License Class- License o Contracto/��11aC,nature
VORKERS' COMPENSATION DECLARATION _
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjuryone of the following declarations:
I have and wHI maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th
erformance of the work for which this permit is issued. Policy No.
]I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatiol
Isurance carrier and policy nu 2ber are: f .
Policy Number
Date
that, in 44%wrfo rice of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the
ould b2prp
pe 1 C 9 the workprmpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions -
of
ATIOGI�DI N5TRUCTION LENDING AGENCY
affirm u dor pe alty perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section
Name Lender's Address
3y. j),signature{Iek", #certify to each of the following:
t Am the properly owner or authorized to act on the r rty owner's behalf.
• • I, have read this application and the information I he r vided is corr
I agree to complywlfh all applicable city county 'n state I elating to building cons tion.
• • 4 authorize representatives of thi y county to bove= I led property for inspection purpos
iigne$ure of Property•owner or Authori d A Print Pro ert Own s or Authorized Ag
ACTION DATE BY DEL JAJON OF COMPLIANCE WITH CODE OF FEDERAL FO OFFICE USE ONLY
REGU TIONSPART61OFTITLE40ANDAQMDRULE
PERMIT EXTENDED QMD
PERMITFINAL SSEST05 NO FNOT APPLICABLE TO
CERTIFICATEOF PR OL ,✓
OCCUPANCYISSUED v 5 A El /
ers compensation laws of California, and agree
)ate-
17,
ate-17, Civil Code).
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