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Home My WebLink AboutX2021-3297 - Permitsw�f City of Newport Beach - Building Division *X2021-3297* COMB Permit: X2021-3297 i:. 100 Civic Center Drive, Newport Beach, CA 92660 p Project No : 7873-2021 Permit Counter Phone (949)644-3288 u.. Inspection Requests Phone (949)644-3255 ,v� tsi „cam Combination Type - GRAD ELEC PLUM i A `'� .S Issued Date : 12/0712021 Yp i LZ,,4a I Inspection Area : 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 12/07/2024 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: 2315 HEATHER LN NB Description: DELTA 4 EXTERIOR ELEC, GAS AND DRAINAGE Legal Desc.: N TR 3138 LOT 35 Owner: WELLS CORINNE & MICHAEL Contractor: J M 1 AND ASSOCIATES INC/GABINO Architect: ° Address: 2315 HEATHER LN Address: 2046 MEYER PLACE Address: o ... ° ° NEWPORT BEACH, CA 92660 COSTA MESA CA 92627 Phone: Phone: 714-350-9527 Phone: State Lic: • ' ' ++ • ' Applicant: FLORJOSE Con State Lic: 951957 Engineer: MORAN TIMOTHY ° + '®•• Address: 5364 VIA MARIA Lic Expire: 09130/2022 Address: 23802 HUMPHREY CT ' •' ,°, YORBA LINDA, CA 92886 Bus Lic: BT30069739 MURRIETA CA 92562 ° .... ' • Phone: 714-457-9177 Lic Exp Date: 11130/2021 Phone: 714-920-7680 State Lic:C-071701 a++ a ® °' ° ew ea Code Edit: 0 Worker's Compensation Insurance Designer: FLORJOSE Type of Construction: Carrier: SIRIUS AMERICA INS Address: 5364 VIA MARIA Occupancy Group: U Policy No: WC74001 YORBA LINDA, CA 92886 Added/New sq.ft. Bldg: 0 Expire: 0412912022 Phone: • °•• Added /New sq. ft. Garage: 0 No of Stories: 0 Building Setbacks Rear: I Special Conditions: LIQUEFACTION B. No of Units : 0 Front: I LANDSLIDE AREA Bldg Height: 0 Left: I WATER QUALITY ZONE Bldg Sprinklers: Right: 1 Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $0.00 Building Permit Fee: $0.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $0.00 Additional Fee : $17.60 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: $4.00 Grading Permit Fee: $237.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 Energy Compliance: $0.00 Grading PC Fee: $199.00 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 PAN Plan Check: $50.75 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist: $0.00 Building Green Fee : $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $562.35 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $562.35 PROCESSED BY: 35 PUBLIC WORKS APPROVAL: AA n ZONING APPROVAL: Qn PLAN CHECK BY: GRADING APPROVAL: __. APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION 1 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) action 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 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 )fessions 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 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, siness 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 )rovements 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 )roved 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 fly 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). I am exempt from Iicensure under the Contractors' State License Law for the following reason: my signaturL-L"&R tacknowledge 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 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 IPesKns Code`, iSa4ulable upon request when this application is submitted or at the following Web site:http:/Aw .leginfo.ca.gov/calaw.html. natgre of PropETty Owner or Authorized Agent Date lE1J9ED CONTRACTOR'S DECLARATION I reby affirm urdsppenalty of perjury{y that I//am licensed under provisions of Chapter 9 (commencing with Section 7000: of Division 3 of the Business and Prof sl�ns ode, and my license is in full force j,eftect. Lice`wo.Qass 52.>_ dyfOh* License No Date )"��-r q Contractor.Sig naturQ B Ll �RIZERS' OOMP€AISATION DECLARATION I iNING,FAILURBBO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEN4LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS I$100,0001, IN ADDITION TO THE 5T'5PCOMPENSAT19N, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. bgpffimt under p�epalty of perjury one of the following declarations have and will.r6otain a certificate of consent to self -insure for workers' compensation, issued by the Director TiTE11ce of the worlGfor which this permit is issued. Policy No. ev ... eve and will.main,.tain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the tote carrier and policy number are: ar Policy Number I of Agent 0 certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any , if I should become subject to IN workers' compensation provisions of Section 3700 of the Labor Code, I shall iature of Applicant (2� Industrial Relations as provided for by Section 3700 of the Labor Code, for of the work for which this permit is issued. My workers' Date so as to become subject to the workers' compensation laws of California, and h comply with those provisions. Date162_— r�-q - � ` 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). -enders 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 ordina��A(((ces and state laws relating to building construction. I authorize representatives of this city or countyr t�bove-identified property for inspection purposes. iignature of Property Owner or Authorized Print Property Owner's or Authorized Agent's Name ACTION DATE BY DECLARATION OF II REGULAT ONS PA T061 OF IIT E 40 AND AQMD RULE CE WITH CODE OF AL FOR OFFICE USE ONLY PERMITEXPIRED LIISUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED EPA PERMITFINAL �S�Z6�z TIh�iOBT APPLICABLE TO OSEDD,%OCCUPANCYSUED ^� Date