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Home My WebLink AboutX2020-1781 - PermitswrDy City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIII�IIIIIIII�IIIIIIjlllll II COMB Permit: X2020-1781 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 0 N 7 Project No : 1427-2020 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - MFP Issued Date : 2021 Inspection Arearea : 4 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0311712024 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: 300 AVENIDA CARLOS NB Description: MFR-BDRMWINDOW(2) i V �q l Legal Desc.: TR 6435 (L.L.84-214024) PA PAR 61 rii��'r Owner: HELLGREN LARS Address: 300 AVENIDA CARLOS Record Management: NEWPORT BEACH CA 92660 Phone: 949-219.0828 Applicant: HELLGREN LARS Address: 300 AVENIDA CARLOS Hazardous Mat NEWPORT BEACH CA 92660' Phone: 949-219.0828 Code Edit: 2019 Type of Construction: VB Occupancy Group: R3/U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 2 Bldg Height: 0 Bldg Sprinklers: Flood Zone: Valuation: $12,000.00 Building Permit Fee: $280.00 Plan Check Fee: $309.60 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $14.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access: $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTALFEE: PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Contractor: OSAMA NANAH Address: 601 PARKCENTER DR # 204 SANTA ANA, CA 92705 Phone: 949.771.6659 Con State Lie: 1067869 Lie Expire: 0813112022 Bus Lie: BT300074666 Lie Exp Date: 03/3112022 Worker's Compensation Insurance Carrier: .EXEMPT Policy No: Expire: Building Setbacks Rear: I Front: I Left: / Right: I Excise Tax: -- Additional Fee: Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ insp. Fee: Electrical %: anical %: Plum 'nq %: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.90 $0.00 Plan Check Fee Architect: Address: Phone: State Lie: Engineer: BADAIWI MUSTAFA Address: 601 PARKCENTER DR #204 SANTA ANA CA 92705 a Phone: 714-673-6611 Slate Lic:C-033953 o no Designer: Address: 00 0 Phone: O°°6160 0 0 °00 0 000 Special Conditions: eo a 0000« Planning Department - Plan check Fee Fair Share : 0 0 0 000000 0000 SJH Trans: Fire Department In -lieu Housing Fee: $46.25 Public Works Department - Park Dedication: $0.00 PAN Plan Check ; $0.00 San Dist: $0.00 NMUSD Fee: $0.00 $0.00 PUBLIC WORKS PLAN CHECK Bl APPROVAL TO t 3rd Zone:N tfailLD 00 0 0 0 0 n )oc 0 0 0 000000 0000 Fire Department 0 $46.25 Fire Inspection: $0.00 $0.00 Fire Plan Rev $0.00 $0.00 Demolition Fee $0.00 Building Dept Adm $0.00 General Service $0.00 Refund Deposit $0.00 Grading Bond: $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $650.85 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 ie 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 'rofessions 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 of 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, lusiness and Professions Code: The Contractors' Slate 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 n roved 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 p ly 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: ly 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 ell 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 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.govtcalaw.html. lignature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm undeL Beynalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 000) of Division 3 of the Business and Prof s& si s Cide end-my�llcense Is in full force nd effect. LicenseClass License No i O (c�- k� cam_ Date (! ( ( Contractor Signature >�C GL7� ' mums, CQMPEflSATION DECLARATION UPRNING: FAILURE� SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (4100,000), IN ADDITION TO THE OSJ OF C.OMPENBRI N'LIAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. *re* alfirm undeFpenalty of perjury one of the following declarations: } rate and will, Inuinlain 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 Erformarice of the work Tor which this permit is issued. Policy No. A •s 31'Hade�nd wiljrl�in.tain workers' compensation insurance, as required by Section 3700 of the Labor Cade, for the performance of the work for which this permit is issued. My workers' compensaticr IDuranc•a carrier and policy number are: If101 .. Policy Number Expiration Date IA OfAgent �- ' • Phone # ... I c rt�fp that, In the pe�ormance 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( is T should bgeoVeCubject to the wor rs' mpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. y y/ signature of Applicant Date) IECLARATION 1, ARDING CONSTRUCTION LENDING AGENCY —v 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). ender'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. Iagree to comply with all applicable city and county ordinances and state laws relating to building construction. 3% 1 authorize representatives of this city or county to enter the above-iS�ntlfied property for inspection purposes. DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL 11 FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED PERMIT EXTENDED III UAQMD PERMIT FINAL iZ S ASBESTOS NOTIFICATION IS NC'4'APPLICABLE TO CERTIFICATE OF PROPOSED DIMOL OCCUPANCYISSUED SIGNATURE: