HomeMy WebLinkAboutX2021-1216 - Permitswtrs City of Newport Beach - Building Division
x; 100 Civic Center Drive, Newport Beach, CA 92660
[.. �. Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
urnx' Combination Type - SFP ELEC MECH PLUM
COMB Permit: X2021-1216 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II
Project No : 1074-2021
Issued Date : 0811212021
Inspection Area : 1
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 08/12/2024 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: 3706 PARK LN NB
Description: SFR CONVERT DUPLEX TO SFR BY REMOVING KITCHEN @ 1ST FL APPROX 100 SF
Legal Desc.: P BK 51 PG 3 PAR 1
Owner: WOODALL NEIL
Contractor:
OWNER/BLDR
Architect:
Address: PARK LN
Address:
WOODALL NEIL
NO ps8(' TR CTIOAt WORK
WORK
NE
NEWPORT BEACH, CA
��a7! IIIJV i tV
Phone:
Phone:
949-280-4228
Phone: State Lic:
Applicant: RICHART JASON
Con State Lie:
CIE
Engineer: ' (''
Address: 1041 W 18TH ST STE At 06
Lie Expire:
Address:
COSTA MESA CA 92627
Bus Lie:
ON SATURDAYS
Phone: 949-422-9191
Lie Exp Date:
Phone: State Lie:
Code Edit : 2019
Worker's Compensation Insurance
Designer: RICHART JASON
Type of Construction: V-B
Carrier:
Address: 1041 W 18TH ST
Occupancy Group: R3/U
Policy No:
COSTA MESA CA 92626
Added /New sq.ft. Bldg: 0
Expire:
Phone:
Added /New sq. ft. Garage: 0
A
No of Stories: 2
Building Setbacks
Rear: /
Special Conditions: HIGH DEN
No of Units : 1
Front: /
FORM SIGN
GN D
Bldg Height: 0
Left: I
Bldg Sprinklers:
Right: /
rlooa Lone:
Use Zone:
Parking Spaces:
0
Fire Hazard Zone : N
Construction Valuation:
$5,000.00
Building Permit Fee:
$161.00
Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee: $140.07
Additional Fee :
$0.00
Plan check Fee :
$156.00
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:
$8.00
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
P/W Plan Check :
$50.75
Grading Bond:
$0.00
Hazardous Mat
$0.00
Electrical %:
$11.27
San Dist :
$0.00
Building Green Fee :
$1.00
Mechanical %:
$6.44
NMUSD Fee:
$0.00
$0.00
Plumbing %:
$14.49
$0.00
TOTAL FEE: $549.02
Plan Check Fee
: $183.07
Fee Due at Permit Issuance :
$365.95
PROCESSED BY:
ZONING APPROVAL:
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL: 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)
(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 f&r
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 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
not more than five hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U 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).
tYms 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
o 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).
m exempt from licensure under the Contractors' State License Law for the following reason:
signature below I acknowledge that, except for my personal residence in which I must have sided for at least one year prior to completion of the improvements covered by this permit, I cannot legally
tructure that 1 have built as an owner -builder if it has not een constructe in its a fret b Icensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
Professions Code, is available upon request whe is appli n is bm' rat thy Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agen ° Dated
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed rider provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
and effect. License Class License No Date Contractor Signature
WORKERS' COMPENSATION DECLARATION
WARNING: 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
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
111 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 th
performance of the work for which this permit is issued. Policy No.
❑I 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' compensatiol
insurance carrier and policy number are:
Carrier Policy Number Expiration Date
e of Agent Phone #
I ertify that, in the performance of the war or which this permit is is Lied, I all not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
at, f I should become subject to the r s' com ns ti rovisi s tion 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant Date
DECLARATION REGARDING C UCTI L NDING A ENCY
I �=reb affirm under enalt
y
of per' ry that t re is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
y P Lender's Address
Ker'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 county or nance and s to la re In o building construction.
I authorize representatives of this cityor count r the ntitifie for inspection purposes. ,,/��
nature of Pro ertv Owner or Authorized Agegt�//s�*'/Ar/ Print Property Owner's or Authorized Agent's Nam9.i"
ACTION
ACTION
DATE
BYY,7
DE01°ARATION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED
0 1 SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED
LIEPA
PERMIT EXTENDED
LJAQMD
PERMITFINAL
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ASBESTOS NOTIFICAT109 IS NOT APPLICABL TO
CERTIFICATE OF
PROPOSED DEMOUTI N
OCCUPANCYISSUED
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