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Home My WebLink Aboutx2021-2027 - Permitswt - City of Newport Beach = Building Division a 100 Civic Center Drive, Newport Beach, CA 92660 ' Permit Counter Phone (949)644-3288 A Inspection Requests Phone (949)644-3255 Combination Type - SFP ELEC MECH PLUM IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIII COMB Permit: X2021-2027 Project No : Issued Date : 08/03/2021 Inspection Area : 2 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 09/03/2024 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: 221 VIA EBOLI NB Description: SFR -REPLACE (3) WINDOWS (2) DOORS AND REMODEL MASTER BATH 80 SF Legal Desc.: N TR 907 LOT 998 Owner: DELGADO DELIA Contractor: OWNER/BLDR Architect: cy�!'i Address: 221 VIA EBOLI Address: DELGADO DELIA Address: d� NEWPORT BEACH, CA 92663 OIB AUTH ATT Phone: 9491400-4600 Phone: Phone: State Lic: Applicant: DELGADO DELIA Con State Lic: O/B Engineer: !�°® Address: 221 VIA EBOLI Lic Expire: Address: NEWPORT BEACH, CA 92663 Bus Lic: Phone: 9491400-4600 Lic Exp Date: Phone: State Lic Y9®• Code Edit: 2019 Worker's Compensation Insurance Designer: Type of Construction: V-B Carrier: Address: Occupancy Group: R3/U Policy No: •tl®=-:. �:- Added /New sq.ft. Bldg: 0 Expire: Phone: Added /New sq. ft. Garage: 0 No of Stories: 1 Building Setbacks Rear: / Special Conditions: No of Units : 1 Front: / Bldg Height: 0 Left: / ° Bldg Sprinklers: Right: / Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $21,000.00 Building Permit Fee: $433.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $376.71 Additional Fee : $0.00 Plan check Fee : $52.00 Fire Inspection: $0.00 Overtime Plan Ck: Koo 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: $2.00 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 %: $30.31 San Dist : $0.00 Building Green Fee : $1.00 Mechanical %: $17.32 NMUSD Fee: $0.00 $0.00 Plumbing %: $38.97 $0.00 TOTAL FEE : $951.31 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $961.31 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: ( / y e s es OWNER -BUILDER DECLARATION I hereby afITM 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 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 U 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 I�mpp'rp, ved 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 licensure 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 legalh sell a structure that I have built as an owner -builder if it has t bee structed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the sin ss and Professions Cods,.is available upon request when this Ica Itted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Signature of Pr31aWV,6wner or Authorized Agent Date c 64RNSED CQNJ; ACTOR'S DECLARATIOO�� j hereby affirm %der�lenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force a11iI efftct. License Class License No Date Contractor Signature WORKERS' CQf1PENSATION DECLARATION tNIRC,: FAILURE TO SE6URE 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 iv 9F COMPEN&AIMA, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. iiaby affimyuntleelaenalty of perjury one of the following declarations: T .. T?lave 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 the ibtrrn ante of the work for which this permit is issued. Policy No. have and%4 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. Srblce carrier and policy number are: vier • • .... Policy Number Expiration Date of Agent My workers' 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 if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant Date_ CLARATION REGARDING 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). Ider's Name Lenders 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 a is cnrr I agree to comply with all applicable city and c y ordina .es -I d st9te la relating to building construction. I authorize representatives of this city or cou to ter ov -Id ified r.inspection purposes. �1�--'jg(X� nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMITCANCELLED PERMITEXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCYISSUED SUBMITTED ASBESTOS NOTIFICATION TO )S NOTIFICATION IS NOT AIC/SLE TO DEMOLITION �}