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Home My WebLink AboutX2022-1024 - Permitsw„� City of Newport Beach - Building Division *X2022-1024" COMB Permit: X2022-1024 s �m 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 0944-2022 �:. 'r�', Permit Counter Phone (949)644-3288 ti, "4Y. Inspection Requests Phone (949)644-3255 -`a'w,�,>a*`� Combination Type - MFP MECH ELEC PLUM Issued Date : 04/07/2022 Inspection Area : 2 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0410712025 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: 260 CAGNEY LN NS St: 1 FI: 3 Unit: 313 Description: MFR REMODEL KITCHEN & (2) BATHROOMS 1317 SF REPLACE FIREPLACE HEARTH. Legal Desc.: TR 8336 LOT 4 UNIT 218 OF PROJECT LOCATED ON AP 423-011-22 TOGETHER •ao Owner: HOFFMAN NEAL Contractor: POLAND J R CONSTRUCTION INC Architect: a• a a W a Address: 260 CAGNEY LN #218 Address: 4195 CHINO HILLS PARKWAY #138 Address: .... NEWPORT BEACH, CA 92663 CHINO HILLS CA 91709 • •"° Phone: 760-275-3765 Phone: 949.241-5533 Phone: State Lic: ` Applicant: POLAND SCOTT Con State Lic: 647916 Engineer: TRUONG PRONG 40aa ••„°,° Address: 4195 CHINO HILLS PKWY Lic Expire: 0613012022 Address: 20754 TIMBERLINE LN CHINO HILLS, CA 91709 Bus Lic: BT30059313 WALNUT CA 91789 Phone: 949-241-5533 Lic Exp Date: 0513112013 Phone: 949-254-2751 State Lic:C-070784 a ° Code Edit: 2019 Worker's Compensation Insurance Designer: ° Type of Construction: V-B Carrier: EXEMPT Address: Occupancy Group: R2/U Policy No: a a• Added /New sq.ft. Bldg: 0 Expire: - Phone: J o a••a Added/New sq. ft. Garage: 0 No of Stories: 3 Building Setbacks Rear: / Special Conditions: No of Units : 60 Front: / Bldg Height: 0 Left: / Bldg Sprinklers: N Right: / Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $105,360.00 Building Permit Fee: $1,273.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $1,107.51 Additional Fee : $0.00 Plan check Fee : $52.00 Fire Inspection: $0.00 Overtime Plan Ck: $0.00 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: $12.00 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 PM Plan Check : $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $178.22 San Dist: $0.00 Building Green Fee : $5.00 Mechanical %: $140.03 NMUSD Fee: $0.00 $0.00 Plumbing %: $114.57 $0.00 TOTAL FEE : $2,882.33 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $2,882.33 PROCESSED BY: 4 I3 J PUBLIC WORKS APPROVAL: ZONING APPROVAL: rvi K IV PLAN CHECK BY: S GRADING APPROVAL: APPROVAL TO ISSUE: ' �ocaoa • o a.�aa aaoaaa • a V a c ooWa• UILDER 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 -Builder will have the burden of proving that it was not built or improved for the purpose of sale). ❑ I, as owner of �igeproperty, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not �aplply 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). �.,.4WC exempt from licensure under the Contractors' State License Law for the following reason: By my agnature bebw 1 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 thalT Me 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 Prdfegslons Code, -is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Sjgnalure of ProportyOwner or Authorized Agent Date �19ENGED e6NT A.CTOR'S DECLARATION I hereby affirm,und%r ppnalty of perjury that I am licensed under provisions of Chapter 9 (pommencing with Section 7000 of ivi '6n 3 of the Business and Prof> es�iol n ise is in full force sand effect Lijygte Class License Now v Date x i Contractor Signaturee WbWERS' COMPENSATION DECLARATION 0.... WARNING: FAILURF.TO WURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000(, IN ADDITION TO THE COST OP COMPEMSATYON.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. K"eb: affirm under penalty of perjury one of the following declarations: JThave anC p4l' 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, performance of the work for which this permit is issued. Policy No. have 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' rance carrier and policy number are: Na of Agent x 1 certify that, in the performance that, if I should become subject to of Policy Number Date 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 agre, I provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. fJ e Lf1/y/do- IECLARATION REGARDING C-ONSTRUCTION LENDING AGENCY hereby 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). ender's Name Lender's Address ly 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 correct. I agree to comply with all applicable city and county ordina an sta laws relating to building construction. I authorize representatives of this city or county to enter o Ified property for inspection purposes. Iionature of Prooertv Owner or Authorized Agent x r / Print Property Owner's or Authorized Agent's Name. S D JI ACTION DATE BY REGCARATIO S OF COMPLIANCE LIANCE 40 WITH CODE OF FEDERAL I FOR OFFICE USE ONLY T 61 PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED EIEPA PERMIT EXTENDED QMD PERMITFINAL ASBESTOS NOTIFI TION I N APPLICABLE TO CERTIFICATE OF PROPOSED DEMOLI OCCUPANCYISSUED jj 1AI27, J SIGNATURE:X..