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Home My WebLink AboutX2021-0795 - Permits0City of Newport Beach - Building Division 4 100 Civic Center Drive, Newport Beach, CA 92660 r., '; Permit Counter Phone (949)644-3288 i1, Inspection Requests Phone (949)644-3255 c`u;i•dryr+*, Combination Type - MFP ELEC PLUM MECH - ( I 7 I IIIIIIIIIIIIII�IIIUIIIIIIIIIIIII�Illlll�lllll� X 2 0 2 1 0 _ CdV� WcA 1 7 9 5 L r) III COMB Permit: X2021-0795 Project No : 0734-2021 Issued Date: 04/1912021 Inspection Area : 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 04/19/2024 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: CORNWALL LN NB MFR Description: MFR KITCHEN REMODEL 130 SF - EC` R INSP Legal Desc.: TR 5616 LOT 1 UNIT 20 OF PROJECT LOCATED ON AP 425-042-01 TOGETHER •mmm Owner: COE ANDREW Contractor: JAKE DOUGHERTY CUSTOM CON Architect: m a WILKINS KAREN m Address: 1617 CORNWALL LN Address: PO BOX 3182 Address: 785 QUINTANA ROAD #180 • • • • • ... °o • NEWPORT BEACH, CA 92660 RUNNING SPRINGS, CA 92382 MORRO BAY CA 93442 • • o • ° ° Phone: Phone: 410-703-3695 Phone: State Lic:CO27930 . . . ° m m• o Applicant: DOUGHERTY JAKE Con State Lie: 1052766 Engineer: °m m m m e m m o Address: 30656 FERNDALE DR #3182 Lie Expire: 04/3012023 Address: ° • • • ° RUNNING SPRINGS, CA 92382 Bus Lie: BT30074873 m m Phone: 410-703-3965 Lie Exp Date: 04101/2022 Phone: m m m momoo State Lie: omeoo Code Edit : 2019 Worker's Compensation Insurance Designer: m ° • • • • ° Type of Construction: V -B Carrier: NORGUARD Address: ° • • • o Occupancy Group: R2/U Policy No: JAWC138191 Added /New sq.ft. Bldg: 0 Expire: 10/23/2021 Phone: m • • ° ® m • • • • m ° Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear: / Special Conditions: No of Units : 8 Front: I Bldg Height: 0 Left: I Bldg Sprinklers: Right: I Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $60.000.00 Building Permit Fee: $889.00 Excise Tax: $0.00 Planning Department- Fire Department Plan Check Fee: $773.43 Additional Fee : $0.00 Plan check Fee : $46.25 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 : $18.00 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 %m: $62.23 San Dist: $0.00 Building Green Fee: $3.00 Mechanical %m: $35.56 NMUSD Fee: $0.00 $0.00 Plumbing %: $80.01 $0.00 TOTAL FEE: $1,907.48 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Plan Check Fee $819.68 Fee Due at Permit Issuance: $1,087.80 PUBLIC WORKS APPROVAL: PLAN CHECK BY: 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) 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 U 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). 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 ly to an owngr4 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 exemptfiom ricensure under the Contractors' State License Law for the following reason: ,pKsgnature J,Ejpw 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 a sWucture th%t J DIVE 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 fessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. ,gybe of Proprsrly Owner or Authorized Agent Date ZDISED CMIOCTOR'S DECLARATION rgt1f affirm under ptnalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the BusinewLago Professions Co flcense is in full force effect. Li tens a Gass License No 4}aI e4 -1 13 -2021 Contractor Wature e igjC£RS' COMPENSATION DECLARATION NIff�1G: 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 ($100,000), IN ADDITION TO THE YOF2;OMPENSOTIOfy DAMAGES AS PROVIDED FOR IN SECTION 0106 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 8gr(pf pgnalty of perjury one of the following declarations: and Wily a]ntain 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 :e of -121 for which this permit is issued. Policy No. Pewill 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' 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 California, and I, if I should beco subject t orkers' compens 'o provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Appl' Daj� (- q Z O L CLARATION RE AR NG CONSTRUCTION LENDING AGENCY �reby 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). lder's Name Lender's Address 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 and state laws relating to building construction. I authorize representatives of this city or county to ante e a ove-identifie Inspection purposes. [� P nature of Prooertv Owner or Authorized Folli" Print Property Owner's or Authorized Ag�Name S�tl � G �LLO 14L 2 �-�/ D -1 '"r' ACTION DATE BY- DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIREDI SUBMITTED ASBESTOS NOTIFICATION TO - PERMIT CANCELLED EPA CERTIFICATE OF ��2/�(/I 'FRpPOSEDITFINAL OS MOLINOTIFICATION_IS NOT OCCUPANCY ISSUED V SIG NAT yd6L (^/_y