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HomeMy WebLinkAboutX2021-0900 - Permits1t City of �:Tiiort Beach - Building Division " 100 Cwic Center Drive, Newport Beach, CA 92660 k: Permit Counter Phone(949)644-3288 E1 Inspection Requests Phone (949)644-3255 `a 1Yi5A * Combination Type - SFP ELEC MECH PLUM II I IIIII IIIII 0IIII II I II I IIIII 0�II� IIIII IIIII0 III COMB Permit: X2021-0900 Project No : 0831-2021 Issued Date: 04123/2021 Inspection Area : 2 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0412312024 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: 424 ANGELITA DR NB Description: SFR ADD 160 SF AND REMODEL 62 SF, CREATE (2) BDRMS FROM MASTER CLOSET ���® Legal Desc.: N TR 2813 LOT 50 INSP Owner: HOTLZJACLYN Contractor: PROJEKTAINC Architect: Address: 424 ANGELITA DR Address: 1215 N RED GUM ST#F Address: CORONA DEL MAR, CA 92625 ANAHIEM CA 92806 Phone: Phone: 714-292-0236 Phone: State Lic: Applicant: RICHART JASON Con State Lic: 1010761 Engineer: GHAZLANI ANDY • • ° ° Address: 1041 W 18TH ST Al06 Lic Expire: 01131/2022 Address: 4202 ATLANTIC AVE #204 .... COSTA MESA, CA 92627 Bus Lic: BT30064942 LONG BEACH CA 90807 .... Phone: 949-422-9191 Lic Exp Date: 10/31/2021 Phone: 562-253-2385 State Li¢C-060867 ..:. Code Edit: 2019 Type of Construction: VB Occupancy Group: R3IU Added /New sq.ft. Bldg: 160 Added /New sq. ft. Garage: 0 No of Stories: 1 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Flood Zone: X Construction Valuation: $60,260.00 Building Permit Fee: $1,407.00 Plan Check Fee: $1,143.77 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $24.00 Energy Compliance: $61.00 CA Seismic Safety: $7.83 Disabled Access: $0.00 Hazardous Mat $0.00 Building Green Fee: $3.00 11 TOT FEE: PROCESSED BY: ZONING APPROVAL: _ GRADING APPROVAL: _ Workers Compensation Insurance Carrier: STATE COMP. INS. Policy No: 9160128 Expire: 06/03/2021 Building Setbacks Excise Tax: Additional Fee: Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: 10 Front: 10 Left: 4 Right: 4 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $98.49 $56.28 $126.63 Plan Check Fee Designer: Address: Phone: Special Conditions: AUTH LTR ATTACHED Planning Department - Plan check Fee Fair Share: SJH Trans : In -lieu Housing Fee Public Works Department - Park Dedication : $0.00 PAN Plan Check : $43.00 San Dist: $0.00 NMUSD Fee: $0.00 $1,294.02 PUBLIC WORK/ PLAN CHECK I APPROVALTO Fire Department $231.25 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $1,908.23 moo •mc o . • o c om m m m o 0 mm m 0 •e000 00000 e o.000 0 0 0 0 mmm.mm 0 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 th✓3 applicable item(s) action 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, siness 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 3rovements 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 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: 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! 1 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 Ifessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Inature of Property Owner or Authorized Agent Date TENSED DONTFACTOR'S DECLARATION sreby affirmunder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 7000 Di is to 3 of the Business and Prof Ions de d 71r ire 16I force i e!ect. Qwse Class License No Date ?'a Contractor Signatur :)RKERS' C(DWENSATION DECLARATION Rt T; FAILURE i0 SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THO SA DOLLARS ($100,000), IN ADDITION TO THE yp COMPENSATI041•DAMAGES AS PROVIDED FOR IN SECTION 370; OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. mloy, affirm• finder aerially of perjury one of the following declarations: h Piave 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 th 3 ance ottpe yv lk for which this permit is issued. Policy No. Phil a 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' compensatioi IRS qe carrierand�oolicy number are: r r • . • Policy Number Expiration Date itAttAgent • Phone# 1 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 agre t, if I should become suba orke comp sate rovis' s of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 11'' nature of Applicant Dat %>�_— CLARATION REG ' ON U ION" G NCY 3reby affirm under penalty o perjy that here i construct on -I ding agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). ider's Name �e Lender's Address my signature below, I certify to each of the following: I am the properly 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 an ;tat la I authorize representatives of this city or county n e ,ab v � 1 qti iignalure of Property Owner ACTION PERMIT EXPIRED PERMIT CANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFICATE OF �I OCCUPANCY ISSUED g to building construction. v lA for inspection purposes. 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