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HomeMy WebLinkAboutX2021-2516 - Permits,tlo City of Newport Beach - Building Division z T 100 Civic Center Drive, Newport Beach, CA 92660 w Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - SFP 'I IIII�� 0�II� II III �I1 6II II COMB Permit: X2021-2516 Project No: Issued Date: Inspection Area : 1 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED OR PERMIT WILL BE INVAL 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. NoCyrk on Sundays or Holidays Job Address: 1133 W BALBOA BLVD NB - Description: MFR - R/R ALL WINDOWS & DOORS, SAME SIZE/LOCATION %,rt, Legal Desc.: N TR 234 BLK 11 LOT 16 Owner: SISCO GEORGE WILLIAM Contractor: J P T CONSTRUCTION INC Address: 1133 W BALBOA BLVD Address: 409 62ND ST NEWPORT BEACH CA 92661 NEWPORT BEACH CA 92663 Phone: Phone: 714-336-1966 Applicant: J P T CONSTRUCTION INC Con State Lic: 879360 Address: 409 62ND ST Lic Expire: 06/30/2022 NEWPORT BEACH CA 92663 Bus Lic: BT30014788 Phone: 714-336-1966 Lic Exp Date: 01/31/2022 Code Edit : 2019 Type of Construction: V-B Occupancy Group: R3IU Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 2 Bldg Height: 0 Bldg Sprinklers: Flood Zone: Building Permit Fee: $501.00 Plan Check Fee: $0.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $0.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTALFEE: PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Worker's Compensation Insurance Carrier: WESCO Policy No: WWC3520405 Expire: 04/07/2022 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: / Front: I Left: / Right: / 3arkinc Spaces $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Plan Check Fee oV "" o o Architect: Address: Phone: �5te_Lic: Engineer: Address: Phone: ! State Lic:o Designer: Address: Phone: Tg Special Conditions: HIGH DENS[ Iy®® E y U Fire Hazard Zone : N Planning Department - Plan check Fee Fair Share: SJH Trans : In -lieu Housing Fee Public Works Department - Park Dedication : $0.00 PAN Plan Check : $0.00 San Dist: $0.00 NMUSD Fee: $0.00 Fire Department $0.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: $0.00 Fee Due at Permit Issuance PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $502.00 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,fs) (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 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). ❑ 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 legally 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 Professions Code, is available upon request when this application is submitted or at the following Web site:hftp://www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 7000 f ivisi n 3 of the Business and Professions Co Icense is in full force and effect. License Class License No Date 2U Contractor Signatur WORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNG ED 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. hereby affirm under penalty of perjury one of the following declarations: I 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 (ormance of the work for which this permit is issued. Policy No. 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' carrier and policy number are: Number 7e of Agent certify that, in the performance of the , if I should become subject to the wo iature of Applicanc"A Date issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre is of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. \ / /f DaIF�, � / � z� areby affirm underpenalty that there is a construction lending agency for 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 certMy 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 provide is co I agree to comply with all applicable city and county ordinanc s a at aws relay o building construction. c n T I authorize representatives of this city or county to enter th e-Id ntified prop rty for inspection purposes. mature of PmDerty Owner or Authorized AaenN/ Print Propertv Owner's or Authorized Aqent's Nall ACTION PERMIT EXPIRED PERMITCANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFICATEOF OCCUPANCYISSUED DATE BY— ECLARATION OF COMPLIANCE WITH CODE OF FEDERAL REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE I SUBMITTED ASBESTOS NOTIFICATION FOR OFFICE USE ONLY s •• • •• eee es 0 0 °•O °1e •• e • eee ee•