HomeMy WebLinkAboutX2021-1548 - Permits.r� City of Newport Beach - Building Division I IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
4 Inspection Requests Phone (949)644-3255
��c3vexa Combination Type - SFP ELEC PLUM
III
COMB Permit :X2021-1548
Project No
Issued Date: 06/16/2021
Inspection Area : 6
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST
BE COMPLETED BY 06/16/2024
OR PERMIT WILL
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
Job Address: 2704 BUNGALOW PL NB
BE INVALID
on Sundays or Holidays
Description: SFR REPLACE MASTER TUB W/FREESTANDING R RETILE MASTER SHOWER
Legal Desc.: TRACT 15829 LOT 1 OF PROJECT 934-61 LOCATED ON AP 458-641-06
Excise Tax:
$0.00
Planning Department-
Fire Department
, • „
Overtime Plan Ck: $0.00
Owner: TUMEWU SUSANNA®e..e
Contractor: S
Address:
Architect:
e e
$0.00
18206 MOONLIT RIVER DR Address: 701 EAST BALL RD #206
701 EAB
Address:
„°,
•
�•
m•.•°o
•
CYPRESS, TX 77433 ANAHEIM, CA 92805
Fair Share :
SJH Trans
� �
Fire Plan Rev
Phone: Phone: 949-734.7800
Phone:
State Lic: ••
•eee
Applicant: ARGENTO DANIEL Con State Lie: 1006655ee.ee
Engineer:
Demolition Fee
°
Address: 701 E BALL RD #206 Lie Expire: 11/30/2021
Address:
p.p�
•' , °
•• o
ANAHEIM, CA 92805 Bus Lic: BT30075602
$0.00
�e.ee
•
WO Insp. Fee
Phone: 562-582-7891 Lie Exp Date: 06/30/2022
Phone:
e i
• e • • ° o
Code Edit : 2019 Worker's Compensation Insurance
Disabled Access : $0.00
State Lie: •
.....
Type of Construction: V -B Carrier: STATE FUND'
Designer:
Address:
• •
.° '
° e o
® •
Occupancy Group: R3/U Policy No: 9156497
.:
Electrical/o
$10.08
.....
Added /New sq.ft. Bldg: 0 Expire: 04/0712022�•
Added /New sq. ft. Garage: 0
Phone:
,
• • • °
m
eee. °
No of Stories: 2 Building Setbacks Rear: /
No of Units : 1
Special Conditions:
San Dist:
NMUSD Fee:
$0.00
$0.00
Front: /
Bldg Height: 0
Plumbing %:
Left: /
Bldg Sprinklers: N R;°tia r
Flood Zone: X
Use Zone:
Parkin S aces:
0
Fire Hazard Zone : N
Construction Valuation: $3.500.00
Building Permit Fee: $144.00
Plan Check Fee: $0.00
Excise Tax:
$0.00
Planning Department-
Fire Department
Overtime Plan Ck: $0.00
Additional Fee :
Grading Bonds Fee:
$0.00
$0.00
Plan check Fee :
$0.00
Fire Inspection:
$0.00
Investigation Fee: $0.00
Gradin PC Consultant:
9
$0.00
Fair Share :
SJH Trans
$0.00
Fire Plan Rev
$0.00
Record management: $0.00
Grading Permit Fee:
$0.00
:
In -lieu Housing Fee :
$0.00
$0.00
Demolition Fee
Energy Compliance: $0.00
Grading PC Fee:
$0.00
Public Works Department -
Building Dept Adm
$0.00
Seismic Safety: $0.00
WO Insp. Fee
$0.00
Park Dedication :
$0.00
General Service
$0.00CA
Disabled Access : $0.00
Refund Deposit
$0.00P/W
Hazardous Mat $0.00
.:
Electrical/o
$10.08
Plan Check :
$0.00
Grading Bond:
$0.00
Building Green Fee : $1.00
Mechanical %:
$0.00
San Dist:
NMUSD Fee:
$0.00
$0.00
Plumbing %:
$12.96
$0.00
$0.00
TOTAL FEE : $168.04
Plan Check Fee
: $168.04
Fee Due at Permit Issuance :
$0.00
PROCESSED BY:
_
Pl1Rl IC WnwllR
e000nveI .
ZONING APPROVAL: PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE: 'L g
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)
ction 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
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
�fessions 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
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 (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
;iness 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
)rovements 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
)roved for the purpose of sale).
uct the project (Section Contractor
Business and Professions Code: The Contractors' State License Law does not
I, as ownerjol tp property, am exclusively contracting with licensed Contractors to constrcts with a licensed Contracto
)ly to an ov%[ r p;property who builds or improves thereon, and who contracts for the projer pursuant to the Contractors' State License Law).
exempt jrpgt licensure under the Contractors' State License Law for the following reason:
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
I astructure that thave 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
)Jq%ions Codd, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Date
Inature of Pappity-Owner or Authorized Agent
ZASED CONTRACTOR'S DECLARATION
e�eby affirm Londerpenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 ) of ivisi fl 3 of the Business and urofe si ode, and my license is in full force
d8ftct. UtensB4lass License No Date 2 Contractor Signature
bVKERS' COMPENSATION DECLARATION PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
4AIN: FAILUR&TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
ST OPCOMPERSJ ION,bAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
Form
affirm u.nder penalty of perjury one of the following declarations:f
....aveand�wll 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, ortance of the work for which this permit is issued. Policy No.
11 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' compensatior
wrance carrier and policy number are:
Policy Number Expiration Date
brier Phone #
Ime of Agent
11 certify that, in the performance of thewy for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensatio laws of California, and agree
it, if I should become ject he w rF rs' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Date 21
onature of Applicant ��
CLARATION REGARp1P.G-CONSTRUCTION LENDINU AUhNcx
:reby affirm under penaj(y of perjury that there is a construction lending agency forLthe ender's Address of the work for which this permit is issued (Section 3097, Civil Code).
Ider's Name
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 co rdin ces and state laws relating to building construction.
I authorize representatives of this city or cold to en eve-ide• fpr`msp on purposes.
mature of Pro erty Owner or Authorized A er r`rint Pr erty Owners or Authorized Agent's Name
TION DATE BY DECLA ION OF COMPLIANCE WITH CODE OF FEDE L FOR OFFICE USE ONLY
REG TIONS PART 61 OF TITLE 40 AND AQMD.RULE
PERMITEXPIRED I SUBMITFED ASBESTOS NOTIFICATION TO
PERMITCANCELLED EPA
PERMIT EXTENDED OMD
PERMITFINAL ASBESTOS TIFI ION IS TAPPLICABLETO
CERTIFICATE OF `� '� PR POSED DEOLI 10
OCCUPANCYISSUED SIGN URE:
U
MEW
Ln a
u
O
n
0
V
N
P
ti
N
O
A
O
O
r-+
S.
w
w
.O
N
A
L
O
O
O
O
+C+ N
G
Lr ,
N O
S3. U
d
� y
O
O
� O
S7
bbn N
N
p
O'
N
O U
co 06
is
Q N
N
y.,
Z
O
O A
NO
T
aa
i
l�
�:
O b
U
w O
N O
o
H
C4 U
- vi
MEW
Ln a
u
O
n