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Home My WebLink AboutX2019-4112 - Permitssw Ir City of Newport Beach - Building 100 Civic Center Drive, Newport Beach, CA 92660 rv. Permit Counter Phone (949)644-3288 a Inspection Requests Phone (949)644-3255 trz a Combination Type - SFP ELEC MECH PLUM Division *X2019-4112* GRAD COMB Permit: X2019-4112 Project No: 2840-2019 Issued Date : 05124/2021 Inspection Area : 2 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0512412024 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: 322 AMETHYST AVE NB Description: SFR - DEMO & REBUILD GAR 478, DEMO 946 SF OF 1ST AND 2ND FLOOR LIVABLE AND ADD 1109 SF Legal Desc.: BALBOA ISLAND SEC 3 BLK 18 LOT 12 Owner: PENCE MELISA Contractor: OWNERIBLDR Architect: PENCE MELISA Address: 322AMETHYSTAVE Address: MELISA PENCE Address: 322 AMETHYST AVE NEWPORT BEACH, CA 92662 NEWPORT BEACH CA 92662 Phone: 949-370-6037 Phone: 949-370-6037 Phone: 949-370-6037 State Lic:C29539 Applicant: PENCE MELISA Con State Lic: O/B Engineer: Address: 322AMETHYSTAVE Lic Expire: Address: NEWPORT BEACH CA 92662 Bus Lic: Phone: 949-370-6037 Lic Exp Date: Phone: State Lic: Code Edit: 2016 Worker's Compensation Insurance Designer: Type of Construction: V-B Carrier: Address: Occupancy Group: R3/U Policy No: Added /New sq.ft. Bldg: 1109 Expire: -. Phone: Added /New sq. ft. Garage: -12 No of Stories: 2 Building Setbacks Rear: 5 Special Conditions: OWNER/BLDR ATTACHED No of Units : 1 Front: 10 - DEMO CREDIT FOR SCHOOL Bldg Height: 0 Left: 3 - FEES Bldg Sprinklers: Right: 3 Flood Zone: Use Zone: Parking Spaces:. 0 nr. Fire Hazard Zane : N Construction Valuation: $220,330.00 Building Permit Fee: $3,037.00 Excise Tax: $0.00 Planning Department- Fire Department Plan Check Fee: $2,252.00 Additional Fee : $66.00 Plan check Fee: $185.00 Fire Inspection: Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev Investigation Fee: $0.00 Grading PC Consultant: $928.24 SJH Trans : $0.00 Demolition Fee Record Management: $38.00 Grading Permit Fee: $952.00 In -lieu Housing Fee : $0.00 Building Dept Adm Energy Compliance: $154.23 Grading PC Fee: $203.76 Public Works Department- General Service CA Seismic Safety: $28.64 WO Insp. Fee: $120.00 Park Dedication : $0.00 Refund Deposit Disabled Access: $0.00 PNV Plan Check : $344.00 Grading Bond: Hazardous Mat $0.00 Electrical %: $212.59 San Dist: $945.00 Building Green Fee : $9.00 Mechanical %: $121.48 NMUSD Fee: $0.00 Plumbing %: $273.33 TOTAL FEE: $10,679.27 PROCESSED BY: ZONING APPROVAL: livE •°'a°. $0.00 $0.00 $26.00 $219.00 $564.00 $0.00 $0.00 $0.00 Plan Check Fee : $1,275.23 Fee Due at Permit Issuance : $9,4044..04 PUBLIC WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: 1 ( A.� I APPROVAL TO ISSUE: 00i I 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 is 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 'rofessions 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 of 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, lusiness 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 nprovements 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 m oved 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 pply,loi 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: ly my signature below I acknowledge that, except for y personal residen I which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall, ell a structure that J Jlave built as an owner -builder if' has not been t uct d in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7f44 of the Business and 'rofessions CodEiisa vailable upon request whe applic i is r9ii or at the following Web site:http://www.leginfo.ca.govlcalaw.html. l gnatura of Proper{y Owner or Authorized Al Cat MEW&D CdAWLTOR'S DECLAIR I N hereby affirm under pianalty of perjury that I am !ranged under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Co e, a d my license is in full force Dd fagt& Licens@ Class License No Date Contractor Signature 1M1LRKERS' COMVISISATION DECLARATION a RIZIdG:'�AILURE Tb%ECIIhE 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 DST OF COMPENMWO1 , DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. heresy affirm underpeaalty of perjury one of the following declarations: • •I•FJavV and will lmaintain a certificate of consent to self -insure for workers' erfermafi ce of the wo A for which this permit is issued. Policy No. • 167aue•and will•maintam 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' 1 Wpd carrier.,W pjicy number are: me of Agent compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for Date I certify that, in the performance of th o f w Ilion ermit is issued, I shall not employ any person in any manner so as to become subject to the workers' co pensation laws of California, and ogre it, if I should become su,]�t to tf�'e w ke IT, pr isi/p�ns of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. mature of Applicant / \ I/ �-- Date !CLARATION REGARD G C�UCTION LENDING AGENCY ereby 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, ivil ode). rider'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. I have read this application and the information I have provid d is corre I agree to comply with all applicable city and county inan s a d st a relating to building construction. I authorize representatives of this city or county , to The bov -lden 'fi property for inspection purposes. ��/9 , ��Yl V A, c� `/ mature of Prooertv Owner or Authorized Aoent 1 ^� Print Property Owner's or Authorized Anent's Name A H-PLIM l D X Z Data \ 157 -10 ACTION DATE BY `j DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMIT EXPIRED SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED EPA PERMIT EXTENDED AQMD PERMITFINAL CERTIF OCCUPANCYISSUED BSEESTD((((OSTIFI1C0ATIONnNO O NN SIGFr PUCABLE TO