HomeMy WebLinkAboutX2021-0888 - PermitsCity of Newport Beach - Building Division II�IIIIIII�IIIIIIIIIIIIIIilllllllll COMB Permit: X2021-0888
�'- 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 1 0 8 8 8 Project No : 0477-2020
µ •,. d Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
t'9 irriu*ry4Y Combination Type - SFP MECH ELEC PLUM Issued Date : 0412712021
0
Inspection Area : 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 04/27/2024 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: 1323 SANTIAGO DR NB
Description: SFR DELTA 5, REMODEL 689 SF (BATHROOMS, KITCHEN, LAUNDRY RM & RE-WIREIADD LIGHTING (E) DWELLING) REV21.00490
Legal Desc.: N TR 3851 LOT 49=_q,��f"/�
Owner:
PAYNE MARK
Contractor:
J M I AND ASSOCIATES INC
Address:
1323 SANTIAGO DR
Address:
2046 MEYER PLACE
NEWPORT BEACH, CA 92660
COSTA MESA CA 92627
Phone:
Phone:
714-350-9527
Applicant:
FLOR JOSE
Con State Lie:
951957
Address:
5364 VIA MARIA
Lie Expire:
09130/2022
YORBA LINDA CA 92886
Bus Lie:
BT30069739
Phone:
714-457-9177
Lie Exp Date:
11130/2021
Code Edit : 2019
Type of Construction: VB
Occupancy Group: R3/U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units : 1
Bldg Height: 0
Bldg Sprinklers: N
Construction Valuation: $66,000.00
Building Permit Fee: $929.00
Plan Check Fee: $808.23
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$10.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$3.00 l
TOTAL FEE: $1,681.03
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Worker's Compensation Insurance
Carrier: EXEMPT
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: /
Front: /
Left: I
Right: /
Parking Spaces
$0.00
($255.00)
$0.00
$0.00
$0.00
$0.00
$0.00
$65.03
$37.16
$83.61
Plan Check Fee
Architect
Address:
Phone:
State Lie:
Engineer:
••••
MORAN TIMOTHY °•°°,'
Address:
23802 HUMPHREY CT ....
MURRIETA CA 92562
Phone:
714-920-7680 State Lic:C-071701 ....
Designer: FLORJOSE
Address: 5364 VIA MARIA
YORBA LINDA CA 92886
Phone:
Special Conditions
Fire Hazard Zone : N
Planning Department -
Fire Department
Plan check Fee:
$0.00
Fire Inspection:
Fair Share :
$0.00
Fire Plan Rev
SJH Trans :
$0.00
Demolition Fee
In -lieu Housing Fee :
$0.00
Building Dept Adm
Public Works Department-
General Service
Park Dedication :
$0.00
Refund Deposit
PAN Plan Check:
$0.00
Grading Bond:
San Dist:
$0.00
NMUSD Fee:
$0.00
$0.00
Fee Due at Permit Issuance
PUBLIC WO S APPROVAL:
PLAN CHE BY:
APPROVAL TOI
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$1,681.03
• •
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Doom•
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• •
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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 itenlfs,k,
(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 applicanti3
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 ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions ofithe work, and the structure is not intended or offered for sale (Section 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, throughli employees' or personal effort, builds or improves the property, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
improved for the purpose of sale).
❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason:
3y my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year
;ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I under,
)rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.c
Signature of PropprZy,pwner or Authorized Agent
_ICENSED COWNAtTOR'S DECLARATION
%rgpy affirm ugUer penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 00 Dh
rnd effect. License CE ass License No Date
y0$K%RS' COPQPENSATION DECLARATION
9ARNIRC: FAILURE TQ BE�tjRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMIN PENALTIES
)OST OF•GCMPENS(QIOy, bbMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
to completion or the Improvements covered Dy mis permit, I cannot
that a copy of the applicable law, Section 7044 of the Business and
Date
r 3 of the Business and Pro ��essJ�J��•�od and my license is in fu force
-,� Contractor Signature'
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000(, IN ADDITION TO THE
$erep,4 affirm under penalty of perjury one of the following declarations:
• •••
�g and willhrlaintain 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
ce of the work for which this permit is issued. Policy No.
$'aJ and will,maiptain 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' compensal
le r n
nSuran carrier �rdpo�icy number are: i
Policy Number
Agent ......
certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manr
t, if I should become subject to t�la workers' compensation provisions of Section 3700 of the Labor Code, I shall forth,
nature of Applicant
CLARATION REG RDING CONSTRUCTION LENDING AGENCY
:reby affirm under enalty of perjury that there is a construction lending agency for the performance of the work for wl
tder's Name Lenders Address
my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owners behalf.
I have read this application and the information I have provided is correct.
I agree to comply with all applicable city and county ordinances and state laws relating to building construction.
I authorize representatives of this city or county to ant r the a e-identified Property for inspection purposes.
mature of Prooertv Owner or Authorized Agent -c1'-� & Print Property Owner's or
ACTION
PERMIT EXPIRED
PERMIT CANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCYI55UED
DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
111 SURMITTED ASBESTOS NOTIFICATION TO
IS NOT APPLICABLE TO
Date
o as to become subject to the workers' compensation laws of California, and agre
comply with those provisions. �
this permit is issued (Section 3097, Civil Code).
USE ONLY