HomeMy WebLinkAboutX2022-0893 - PermitsCity of Newport Beach - Building Division
.. 100 Civic Center Drive, Newport Beach, CA 92660
r. Permit Counter Phone (949)644-3288
s�..,... Inspection Requests Phone (949)644-3255
Combination Type -,SFP
COMB Permit: X2022-0893
Project No :
Issued Date : 03/29/2022
Inspection Area : 4
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 03/29/2025 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: 3107 CORTE MARIN NB
Description: SFR PEX RE -PIPE (12) FIXTURES
Legal Desc.: N TR 12271 LOT 103
Owner:
MOJDEH BAUDRY
Contractor:
INTEGRITY REPIPE
Architect:
Address:
3107 CORTE MARIN
Address:
927 CALLE NEGOCIO #D
Address:
NEWPORT BEACH, CA 92660
SAN CLEMENTE CA 92673
Phone:
Phone:
877-473-7473
Phone: State Lic:
Applicant:
INTEGRITY REPIPE
- Con State Lic:
993925
Engineer:
Address:
927 CALLE NEGOCIO #D
Lic Expire:.
06/30/2022
Address:
SAN CLEMENTE CA 92673
Bus Lic: - -.
BT30066794
Phone:
877.473-7473
Lic Exp Date:
04/3012022
Phone: State Lic:
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 : 1
Bldg Height: 0
Bldg, Sprinklers:
Construction Valuation:
Building Permit Fee: $161.00
Plan Check Fee: $0.00
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$0.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $162.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Worker's Compensation Insurance
Designer:
Carrier:
CLEAR SPRING PROP & CASUALTY C Address:
Policy No:
CSWK0000050801
Expire:
08/31/2022
Phone:
Building Setbacks
Rear: /
Special Conditions:
Front: /
Left: I
Right: I
Use Zone:
Parking Spaces: 0
Fire Hazard Zone : N
Excise Tax:
$0.00
Planning Department -
Fire Department
Additional Fee :
$0.00
Plan check Fee :
$0.00
Fire Inspection:
$0.00
Grading Bonds Fee:
$0.00
Fair Share:
$0.00
Fire Plan Rev
$0.00
Grading PC Consultant :
$0.00
SJH Trans :
$0.00
Demolition Fee
Grading Permit Fee:
$0.00
In -lieu Housing Fee:
$0.00
Building Dept Adm
$0.00
- Grading PC Fee:
$0.00
Public Works Department-
General Service
$0.00
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Refund Deposit
$0.00
PAN Plan Check :
$0.00
Grading Bond:
$0.00
Electrical %:
$0.00
San Dist :
$0.00
_ Mechanical %:
$0.00
NMUSD Fee:
$0.00
$0.00
Plumbing %:
$0.00
$0.00
Plan Check Fee:
$0.00
Fee Due at Permit Issuance :
$162.00
E PUBLIC WORKS APPROVAL:
4
`nPLAN CHECK BY:
APPROVAL TO ISSUE:
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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 Iicensure 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 (_) 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).
❑ 1 am exempt from Iicensure 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 Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
Signature of Property Owner or Authorized Agent Dale
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 110 'visi of the Business and Pr fes b de, and my license is in full force
and effect. License Class License No Date) Contractor Signatur
INORKERS' COMPENSATION DECLARATION
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED T USAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will 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 thi
Derfyrmance of the work for which this permit is issued. Policy No.
have and will ainta, workers' c�RTpEsTrs,ption insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers'
ranee carrier an olicyllnumber re: 11 r
ier �, 4\ — . i Poli"m er / _ Expiration Date
of Agent
]I certify that, in the performance of the wo for which this permitasued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
rat, if I should become su ject to the worker ' compensation Isions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
ignature of Applicant D
IECLARATION REGA DI CONSTRUCTION LVJWG AGENCY
hereby affirm under p nalty of perjury that there' construction lending agency for the performance of the work for which this permit is issued (Section 30 7, Civil
ender's Name Lender's Address
y my signature below, I certify to each of the following: e_.—tA�e /
I am the property owner or authorized to act on the property owner's behalf. �.( Q/Vf h
I have read this application and the information I have provided is correct. IMl�'/
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I agree to comply with all applicable city and county ordinances and state laws relating to building construction. 3 •? 9 • Z 2
1 authorize representatives of this city or county t enter the above -identified property for inspection purposes.
ionntive deed of Prnn6v Owner or AuthorizAaentW_. Print Proeerty Owner's or Authorized Agent's Name DatekkT//
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ACTION
DATE
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DECU<TION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
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