HomeMy WebLinkAboutx2022-1051 - Permitseh`�$ City of Newport Beach - Building Division
i 100 Civic Center Drive, Newport Beach, CA 92660
iy Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - SFP ELEC MECH PLUM
IIIIIIIIIIIIIIII�IIIIIIIIIIIIIIII� II COMB Permit: X2022-1051
Project No :
Issued Date : 04/11/2022
Inspection Area : 2
PERMIT EXPIRES 160 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0411112025 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: 203 VIA MENTONE NB
Description: SFR REMODEL 98 SF (2-BATHROOMS) •"
Legal Desc.: TR 907 LOT 602 NELY 20 FT THEREOF(AND SWLY 20 FT LOT 603 e"
Owner:
DSK3 FAMILY FOUNDATION
Address:
9591 JAMES CIR
VILLA PARK, CA 92861
Phone:
Applicant:
SHEPERD DONALD
Address:
327 S CENTER ST
ORANGE CA 92866
Phone:
949-444-1992
Code Edit :
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 1
No of Units : 1
Bldg Height: 0
Bldg Sprinklers:
Flood Zone:
Contractor:
SHEPHERD CONSTRUCTION
Address:
327 S CENTER ST
ORANGE CA 92866
Phone:
949-444-1992
Con State Lic:
479977
Lic Expire:
04130/2023
Bus Lic:
BT30078366
Lic Exp Date:
03131/2023
2019 Worker's Compensation Insurance
V-B Carrier:
NORGUARD INS CO
R31U Policy No:
DOWC290901
0 Expire:
08/12/2022
0
Building Setbacks
Rear: /
Front: /
Left: /
Right: /
Use Zone:
Parkino Snsrnw n
Building Permit Fee: $619.00
Plan Check Fee: $538.53
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$2.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat $0.00
Building Green Fee : $2.00
TOTAL FEE: $1,337.33
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Architect:
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State Lic:
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Engineer:
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Special Conditions:
CITY STANDARD
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Excise Tax:
$0.00
Planning Department -
Fire Department
Additional Fee :
$0.00
Plan check Fee :
$52.00
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 %:
$43.33
San Dist: $0.00
Mechanical %:
$24.76
NMUSD Fee: $0.00
$0.00
Plumbing %:
$65.71
$0.00
Plan Check Fee:
$0.00 Fee Due at Permit Issuance :
$1,337.33
PUBLIC WORKS APPROVAL:
A
PLAN CHECK
�7
BY:
APPROVAL' 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 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-Builderwill 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).
I 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 legal
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 Codeiis available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of Property iMmer or Authorized Agent D to , /
LICENSED COAIYThi'ACTOR'S DECLARATION
l efebfr affirm CHIAC'penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0) of Division 3 of the Business and Pro ons o an, }3 fcev full force
aryl effect. Licensie-ftss License No Date �///02 Contractor Signature / i
0.1.
ERS COMPENSATION DECLARATION
: FAILURF.'I WDRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
:061PENSATION, WMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
affirm uWer penalty of perjury one of the following declarations:
IN ADDITION TO THE
Se and will malhtain 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
ance of thework for which this permit is issued. Policy No.
and v4lr mplIn$ain 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'
carder9Ad p6licy number are:
Policy Number
me of Agent 0 '
Date
I certify that, in t6perjury
of work for hit isWtrs I shall not employ any person in any manner so as to become subject to the workee111rrs'' ccompensation laws of California, and agre
lat, if should bece orkers' co ensafection 3700 of the Labor Code, I shall forthwith comply with those provisions Da
ignature of Applic
DECLARATION RST 1. AGENCY
hereby affirm undthat there on ction lendin ency for the performance of the work for which this permit is issued (Section 3097; Ivil Code).
ender's Name _._tender's Address
3y my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owner's beh
I have read this application and the information I have p d is cor ct.
I agree to comply with all applicable city and county dinanc sand tate s
I authorize representatives of this city Or county to nter.Che ove d le a
Signature of Property Owner or Authorized Agent = y'ct
ACTION DATE BY RATIO Cr MPLIANCE
REGULATIONSCAR lOFTITLI
1403
PERMITEXPIRED 1 ISUBMITTE ASBESTOSNO-
PERMIT CANCELLED EPA
PERMIT EXTENDED AQM D
PERMIT FINAL n� BESTS�T[F�T�IONIICERTIFICATE OF ^ PROP SED
OCCUPANCY ISSUED V U SIGNATURE
wilding construction.
inspection purposes.
Print Property Ownel
CODE OF FEDERAL I FOR OFFICE USE ONLY
IDAQMD RULE
Name