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Home My WebLink AboutX2021-3000 - Permitswtv City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 a Permit Counter Phone (949)644-3288 V. Inspection Requests Phone (949)644-3255 Combination Type - SFP ELEC 111111111111111111111111111111111111111111p11lil JillCOMB Permit: X2021-3000 Project No : 0617-2021 Issued Date : 11/1512022 Inspection Area : 4 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 1111512025 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: 2621 ALTA VISTA DR NB Description: DELTA 3 - (ADD'L SCOPE) ADD 48 SF @ 2ND FL BEDROOM (REV21-1730) - - -- Legal Desc.: N TR 4893 LOT I l l Owner: CNQST LLC Contractor: BRYAN PACIFIC BUILDERS Architect: Address: PO BOX 11176 Address: 413 CALLE DELICADA Address: NEWPORT BEACH, CA 92658 SAN CLEMENTE CA 92672 Phone: Phone: 714-360-4488 Phone: Applicant: KENT ART Con State Lic: 585047 Engineer: Address: 619 16TH ST Lic Expire: 02/28/2022 Address: HUNTINGTON BEACH, CA 92648 Bus Lic: BT30066161 Phone: 714-272-1624 Lic Exp Date: 11/30/2021 Phone: Code Edit : 2019 Type of Construction: V-B Occupancy Group: R3/U Added /New sq.ft. Bldg: 48 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: N Flood Zone: X 11 Construction Valuation: $E Building Permit Fee: $836.00 Plan Check Fee: $642.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $14.00 Energy Compliance: $0.00 CA Seismic Safety: $1.12 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $1,643.39 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Worker's Compensation Insurance Carrier: SIRIUS AMERICAN INS CO Policy No: WC61613 Expire: 12/18/2021 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: 6 Front: 20 Left: 6 Right: 6 $0.00 ($117.25) $0.00 $0.00 $0.00 $0.00 $0.00 $58.52 $0.00 $0.00 Designer: Address: Phone: State Lic AZARIAN BEHROOZ 24182 LA HERMOSA LAGUNA NIGUEL CA 92677 949-495-8822 State Lic:C-041732 Special Conditions: 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 $208.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $1,643.39 o e oc PUBLICNQtKS APPROVAL: u c o ooa PLAN CHECK BY: •o APP:iOVAVW ISSUE: 0 0 0 o a ovo un uo a .,moo 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 (_) 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). ❑ 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 legalll 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 Code, is available upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.htmi. Signature of Property Owner or Authorized Agent Date 4 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 000 f f iv i 3 the Business and Professi0 � ' tsa is in full force and effect. License Class License No Date f ontractor Signature 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 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: ❑ 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 th per,(ermance of the work for which this permit is issued. Policy No. �r�fi—P'yI+have and I� 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 s'.= came aid policy nu r re: % Carrier {{{{{ k Number Expiration Date Name of Agent Phone # ❑I certify that, in the performance he wor which this per "t 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 that, if I should become su ject to the or ' c pens. to ovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. n Signature of Applicant Date DECLARATION REGA ING N UCTION LEN NG AGENCY I hereby affirm under p alty of p rjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 7, Civil Code). Lender's Name Lender's Address By my signature below, I certify to each of the following: _ t-- 1 am the property owner or authorized to act on the property owner's behalf. n rt we",. rr- I have read this application and the information I have provided is orrect. (k a-1 I agree to comply with all applicable city and cc n ordinance d tat I w Iating to building construction. I authorize representatives of this city or county nter the v operty for inspection purposes. 44q Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Nam 1 D ACTION DATE BY I I brF_CfANAT1nN OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY ULATIONS PART 61 OF TITLE 40 AND AOMD RULE PERMITEXPIRED I SUBINITTED ASBESTOS N@TIFIC4_nON TQ PERMIT CANCELLED EPA • • • •: • �• .• PERMIT EXTENDED QM • • �. PERMITFINAL , / ae2- IMPM ASBEST SNOTIFICATIO N APPLICABLE TO CERTIFICATE OF ROPOSE M UTI)N •• • • • ••s OCCUPANCYISSUED SIGNA RE: e e e s • ,•i 0 0 0 0 0 00 oco 0 0 00 00 000