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Home My WebLink AboutX2019-3902 - Permits (2)tvtr, City of Newport Beach - Building Division .� 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 q'�trsnu`' Combination Type - MFP ELEC MECH PLUM COMB Permit: X2019-3902 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II Project No: 2695-2019 Issued Date : 12109/2019 Inspection Area : 5 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. 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: 421 POINSETTIA AVE NB Description: , MFR DRYWALL/FRAMING REPAIR IN KITCHEN AND BATHROOM 150 SF Legal Desc.: CORONA DEL MAR BLK 442 LOT 15 Owner: MOSICH GINA & NICHOLAS Address: 421 POINSETTIA AVE NEWPORT BEACH, CA 92625 Phone: 714-812-6818 Applicant: ALLENSWORTH SAM Address: 26021 PALA ST#160 "---- MISSION VIEJO, CA 92691 Phone: 949492-1161 Code Edit : Type of Construction: Occupancy Group: Added /New sq.ft. Bldg: Added /New sq. ft. Garage: No of Stories: 1 No of Units : 2 Bldg Height: 0 Bldg Sprinklers: Construction Valuation Contractor: DRYMASTER Address: 26021 PALA #160 MISSION VIEJO CA 92691 Phone: 949492.1100 Can State Lic: 959916 Lie Expire: 04/30/2021 Bus Lie: BT300613173 Lie Exp Date: 0513112020 2016 Worker's Compensation Insurance V-B Carrier: STATE COMP. INS R3/U Policy No: 9217814 0 Expire: 09/24/2020 0 Building Setbacks Rear: I Front: I Left: I Right: I Building Permit Fee: $526.00 Plan Check Fee: $467.62 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $6.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access: $0.00 Hazardous Mat $0.00 Building Green Fee : $2.00 TOTAL FEE: $1,136.82 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Architect: 9NSPEC • . Address: ° Phone: e es State Lie: • m Engineer: WICKSTROM ERIC e. o Address: 28581 VIA PRIMAVERA ° • • • • e . • . �. SAN JUAN CAPISTRANO CA 92675 e • ° - ° ° ° Phone: 949-454-8045 State Lic:S-003989 ° e ° ° e ...... Designer: Address: 9 V �,J I V ! dN N® CQNSTRuun6N eeeoo Nei Br:-., I V a.r Phone: m o m e ommmoo • o e o omme oo•oo Special Conditions: ON THE WEEKEND Excise Tax: $0.00 Planning Department - Fire Department Additional Fee : $0.00 Plan check Fee : $40.00 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 %: $36.82 San Dist: $0.00 Mechanical %: $21.04 NMUSD Fee: $0.00 $0.00 Plumbing %: $47.34 $0.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $1,136.82 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: / 1 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) 1 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 L) all of or L) 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 irovements 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 dges not fly 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 kertiNicensure 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) 'ariftalcture tr2t 61?*e 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 fesgsions Cod0, 1s available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. mature of Property Owner or Authorized Agent Date :EMSED COA1.T.BACTOR'S DECLARATION yeby affirm dndeGpdnalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 00) of ivi ton 3 of the Business and Professio ode d is in full force I dMct. Licegsg Class License No Da Contractor Signature )VK9RS' CQMPFTJSATION DECLARATION MM& 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 405 COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. rebyeffirm Aer penalty of perjury one of the following declarations: I fiAV and wjl 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 (Ommance of th�en orltt for which this permit is issued. Policy No. 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 I4ance carrier and policy number are: Policy Number of Agent Date certify that, in the performAhce of1he 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 1, if I should become subj ct to a rkers' o sation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant Date l2 n CLARATION REGAR NG C TRUCTION LENDING AGENCY :reby affirm under pen Ity 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). Ider'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.��v _ I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county yfdInancg&@nd state laws relating to building construction.,'9 I authorize representatives of this city or county to nter ab e-ideptifi operty for inspection purposes. o/(//� d7 / L L' nature of Prooertv Owner or Authorized ADent Z� Print Property Owner's or Authorized Agent's Name ate ACTION DATE BY /I REGUUTATIONS PPA T0MPLIANCE WITH CODE OF 61 OF TITLE 40A D AQMD RULE AL FOR OFFICE USE ONLY PERMIT EXPIRED I I / U I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT FINAL PROPOSED DSTOSFjM TIF 1O 10 IS NOT APPLICABLE TO CERTIFICATE OF �f �4i'ZCi / OCCUPANCY ISSUED SIGNATURE: LO H z \ / ) �)_ a 2® H �§\\ z2a) f _/ o=e§ W k)) �k\L O «` \W \ 0)/ 2a)3/ LLA \\\02 E k� �� 0a) 0LU LU m$ yE. 52°\/e -00E0__ k« ca 6666°/ w_ t §� 5/EXEC �m o= =�<(p 2� =3\:�>/ o ocu CU � r)C3 0 =I \\=e"/ e� = o 2�Ida= c N e = 2 « _� t K\ \f \/ $/E 0 2 G f \ o = o 2 O R g 2 2 \o ®r°)E\/ o 7 £o3—� 022\\o = z0 « /\ §� _ &_ ® M e § M0 c m E/ Lu \U /»/ISb E�G /� E ==E oz $Ea / / Et§rG~ a &CJ0 u 3/? 0CUz�2 @ & 00< 0 22g$/S 0 a 0 I �5 \ � : / �v � . � � s J } k � � / & k � �