HomeMy WebLinkAboutX2021-3404 - PermitsCity of Newport Beach - Building Division
' 100 Civic Center Drive, Newport Beach, CA 92660
a'. Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - SFP ELEC PLUM
II iiiiiii3 4 0 4 II
COMB Permit: X2021-3404
Project No : 2971-2021
Issued Date : 03/25/2022
Inspection Area : 4
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 03/25/2025 OR PERMIT WILL BE INV)
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: 23 CHATHAM CT NB
Description: MFR ATT/TRELLIS 312 SF, FIREPLACE, BBQ, ELEC & GAS W/YARD DRAINAGE
Legal Desc.: TR 11451 LOT 1 UNIT 51 OF PROJECT LOCATED ON AP 442-371-05 TOGETHER
Owner:
HASMAN ROBERT
Contractor: OWNER/BLDR
Architect:
Address:
23 CHATHAM CT
Address:
Address:
NEWPORT BEACH CA 92660
Phone:
702-769-2725
Phone:
Phone:
State Lic:
Applicant:
HASMAN ROBERT
Con State Lic: O/B
Engineer:
SHERAFATI ARDALAN
Address:
23 CHATHAM CT
Lic Expire:
Address:
17901 VON KARMAN AVE 9600
NEWPORT BEACH CA 92660
Bus Lic:
IRVINE, CA 92614
Phone:
702-769-2725
Lic Exp Date:
Phone:
949-522-5001 State Lic:C-085331
Code Edit : 2019
Type of Construction: VB
Occupancy Group: U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 0
No of Units : 0
Bldg Height: 0
Bldg Sprinklers:
Construction
Building Permit Fee: $389.00
Plan Check Fee: $267.00
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$14.00
Energy Compliance:
$0.00
CA Seismic Safety:
$3.90
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$2.00
TOTAL FEE: $1,487.14
PROCESSED BY:
ZONING APPROVAL:
Worker's Compensation Insurance
Carrier:
Policy No:
Expire:
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: 0'
Front: 5'
Left: 0'
Right: 0'
'arking Spac
$0.00
$261.00
$0.00
$0.00
$237.00
$199.00
$0.00
$27.23
$0.00
$35.01
Designer:
HASMAN ROBERT
Address:
23 CHATHAM CT
NEWPORT BEACH CA 92660
Phone:
702-769-2725
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
$52.00
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 : $319.00 Fee Due at Permit Issuance : $1,168.14
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_ PURUC W!OLKS APPROVAL:
PLANCHECKBY:
GRADING APPROVAL: „" „APeROV:AL.TO ISSUE:
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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
1 It 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
Ions Code) or that he or she is exempt from licensure and fhe 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
ore than five hundred d011ars ($500).
a owner of the property, or my employees with wages as their sole he
will do all of or (, portions of the work, and the structure is not intended or offered for sale (Section 7044,
'4aSi ss and Professions Code: The Contractors' State License Law does not apply to an own roperty who, through employees' or personal effort, builds or improves the property, provided that the
pr9vements are not intended or offered for sale. If, however, the building or improvement is old within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
roved for the purpose of sale).
J l*as and
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 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:
Iy my signature below I acknowledge that, except for my personal rI jdence in 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 I have built as an owner -builder if it has not ee constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
'rofessions Code, is available upon request wh t s appi ti, Is s bmi or at t lowing Web site:http://www.leginfo.ca.gov/calaw.htm]. ee��
signature of Property Owner or Authorized Agent i1, , D
.ICENSED CONTRACTOR'S DECLARATI N
hereby affirm under penalty of perjury that I am lic sed `der provisions of Chapter 9 (commencing with Section 1f Division 3 of the Business and r s Code, and my license is in full force
nd effect. License Class License No Or . Contractor Signatl
NORKERS' 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
:OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3716 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
1 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
)erformance of the work for which this permit is issued. Policy No.
:1I 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' compensatiol
nsurance carrier and policy number are:
:artier Policy Number Expiration Date
game of Agent Phone #
I certify that, in the performance of the for which this permit is is , I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
ha if I should become subject to th o rs' compWsation DpovTsions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. - a/
Signature of Applicant Date[ ?
7ECLARATION REGA CO T TION LENDING AGENCY _ T
hereby affirm under p nal of rjury 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
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 behalf.
I have read this application and the information I have provided is correct.
I agree to comply with all applicable city and county ordmanc nd stat s relating to building construction.
I authorize representatives of this city or count to er above-i 01ed ro spection purposes.
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name % a
ACTION DATE BY D RATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
EGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403 ^+ ••- • •••
PERMITEXPIRED I SUBMITTED ASBESTOS N !IFICATION 10+ o • •° • �•,
PERMITCANCELLED EPA °�" • ° �* " • • • s
!9•
PERMIT EXTENDED QMD
PERMITFINAL ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF PROPOSED DEMOLITION ••i °•� •°• i°• •°•
OCCUPANCYISSUED SIGNATURE:
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