HomeMy WebLinkAboutX2022-0102 - Permits (2)66
�Le� City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2022-0102
.'t 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 2 0 1 0 2 Project No:
µ Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
CIssued Date : 01/14/2022
Combination Type - MFP
NO CONSTRUCTION NOISE Inspection Area : 1
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0111412025 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: 109 35TH ST NB �y t^�
Description: MFR REMOVE (E) 22 SQ, INSTALL TORCH DOWN, CLASS'B'MIN. ON THE WEEKEND Legal Desc.: N TR 3813 LOT 14 e
Owner:
POPLET KEITH
Address:
109 35 TH STREET
NEWPORT BEACH, CA 92663
Phone:
Applicant:
POPLET KEITH
Address:
109 35 TH STREET
NEWPORT BEACH, CA 92663
Phone:
949-637-1785
Code Edit : 2019
Type of Construction: VB
Occupancy Group: R3/1.1
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units : 2
Bldg Height: 0
Bldg Sprinklers:
Flood Zone: X
Building Permit Fee: $351.00
Plan Check Fee: $0.00
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$0.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $352.00
PROCESSED BY:
ZONING APPROVAL:
Contractor:
OWNER/BLDR
Architect:
Address:
POPLET KEITH
Address:
Phone:
Phone: State Lic:
Con State Lic:
O/B
Engineer:
Lic Expire:
Address:
Bus Lic:
Lic Exp Date:
Phone: State Lic:
Worker's Compensation Insurance
Carrier:
Policy No:
Expire:
Building Setbacks
Use Zone:
Excise Tax:
Additional Fee:
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WO Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: /
Front: /
Left: I
Right: /
king Spa
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Designer:
Address:
Phone:
Special Conditions: LIQUEFACTION & HIGH
DENSITY AREA
0
Planning Department -
Plan check Fee
Fair Share
SJH Trans:
In -lieu Housing Fee
Public Works Department -
Park Dedication :
$0.00
PNV Plan Check :
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Plan Check Fee : $0.00
Fire Department
$0.00
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
Fee Due at Permit Issuance : $352.00
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
Z
C J
)
:4
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
he 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
Irofessions 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
lot 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,
3usiness 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
mprovements 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
mproved 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
Ipply 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 prior to completion of the improvements covered by this permit, I cannot lega113
;ell a structure that I nave built as an owner -builder if it has not been constructed in its entirety b licensed contractors. I understand that a copy of the applicable law, Section 7044 of he Business and
'rofessions Coda, Is available upon request when,�L/'x' application i jub tit r t thQq/sfV,Ilo ¢sJte: ttp://www. Ieginfo.ca.govlcalaw.html.
3'c.n.3'ce of Property Owner or Authorized Agent /� . Ul///� i�,/ ` ��
_ICENSED CONTRACTOR'S DECLARATION
nPrem, affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
Ind a�iect. License Class License No Date Contractor Signature
vnRKERS' L;UMPFNSATION DECLARATION
IARNING: FAILUR' 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
19FT CF COMPENSATICN, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
her^.by affirm under penalty of perjury one of the following declarations:
7 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.
hav= and will meirtain 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'
ra,Ice carrier and policy number are:
Policy Number
of Agent
Date
01 certify that, in the performance of the wo or which this permit is issue, I shaallll not employ any person in any manner so as to become subject to the workers' compensation lawns of California, and agre
tat, if I should become s blect to the wo� p a ion prwisionX)S�//L of the Labor Code, I shall forthwith comply with those provisions. // g Z
lignature of Applicant ; e
IECLARATION REG R G CONSTRUCTION LENDING AGENCY
hereby affirm under enalty of perjury that there is a construction lending agency for the performance of the work forwhich 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 provided is correct.
I agree to comply with all applicable city and county ordin 9�es and state laws relati g to building construction. —
I authorize representatives of this city or county o ante { � ntIll prop�LnJSfo�J}�spect_ionour ones. �`L � � ���/
'�ionature of Prooertv Owner or Authorized ADe 1 i < C/A=rooertv Owner's or Authorized Aoent's Nam>� � D
ACTION
DATE
BY/
DEC RATION OF COMPLIANCE WITH CODE OPFEDERAL
FOR OFFICE USE ONLY
REG IONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMITEXPIREO
I SUBMiVrED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED
EPA
PERMIT EXTENDED
QM
PERMIT FINAL
CERTIFICATE OF
II
p
ASBESE TIFICATI 15 NOTAPPLICABLE T0�
OCCUPANCYISSUED
D
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