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HomeMy WebLinkAboutX2021-0877 - Permitsn•rt,- City of.-N wport Beach - Building Division II IIII�III IIIIIIII IIIIII IIIIIIIII IIIIII II COMB Permit: X2021-0877 UQq_'o-'."mQ 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 1 0 8 7 7 Project No : 0811-2021 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Issued Date: 0411412021 Combination Type - SFP Inspection Area : 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0411412024 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: 2290 LA LINDA CT NB Description: REMOVE 300 SOS OF VENEER, REPLACE WISTUCCO w n , S '��6G Legal Desc.: N TR 9353 LOT 7 , i Owner: NGOC PHAM Contractor: BAUM CONSTRUCTION & DEVELOPMENT Architect: Address: 20120 ORCHARD MEADOW DR Address: 2900 FIDLER AVE Address: SARATOGA, CA 95070 LONG BEACH, CA 90815 Phone: Phone: 562-424-2286 Phone: State Lic: Applicant: BAUM CONSTRUCTION & DEVELOPMENT Con State Lic: 1003379 Engineer: Address: 2900 FIDLER AVE Lic Expire: 06/3112021 Address: LONG BEACH, CA 90815 Bus Lic: BT30054663 Phone: 562-424-2286 Lic Exp Date: 0413012021 Phone: State Lic: Code Edit: 2019 Worker's Compensation Insurance Designer: Type of Construction: VB Carrier: STATE COMP. INS Address: Occupancy Group: R3/1.1 Policy No: 9111257 Added /New sq.ft. Bldg: 0 Expire: 0812912021 Phone: - Added /New sq. ft. Garage: 0 .. - No of Stories: 2 Building Setbacks - Rear: I Special Conditions: No of Units : 1 Front: / Bldg Height: 0 Left: I - - Bldg Sprinklers: Right: I Construction Building Permit Fee: $263.00 Excise Tax: $0.00 Plan Check Fee: $228.81 Additional Fee : $0.00 Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Investigation Fee: $0.00 Grading PC Consultant : $0.00 Record Management: $2.00 Grading Permit Fee: $0.00 Energy Compliance: $0.00 Grading PC Fee: $0.00 CA Seismic Safety : $0.00 WQ Insp. Fee: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Electrical %: Building Green Fee : $1.00 Mechanical %: X�--- \Plumbing %: TOTAL FEE : $541.06 �. rrt�a.�aa�� or. i ZONING APPROVAL: GRADING APPROVAL: I $0.00 $0.00 $0.00 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 $46.25 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: Plan Check Fee : $0.00 Fee Due at Permit Issuance ruouu vvunna nrrnuvn�: PLAN CHECK BY: APPROVALTOISSUE: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $541.06 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason (a) indicated below by the checkmark(s) I have placed next to the applicable item(s) 3ection 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 far is 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 'rofessions 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 of more than five hundred dollars ($500). 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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 nprovements 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 nproved 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' Stale License Law does not pply 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). 7 I am exempt from licensure under the Contractors' State License Law for the following reason: ly 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 legal) ell 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 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http:L/www.leginfo.ca.gov/calaw.html. signature of Property Owner or Authorized Agent Dale .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of p�erl'ury that I am licensed under provisions of Che ter 9 (commencing with SectrINAL ) o 'yv' 'oo2 of the Business and Proles ns o e,.a, �d my I}ffense is in full force nd effect. License Class . IS License No 1 CXJ33 ° ram D! Contractor Signature T'�` /!� I VORKERS' COMPENSATION DECLARATION DARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS I$100,0001, IN ADDITION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: ] I have and wil' 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 IN erfgrmHnoe of the work for which this permit is issued. Policy No. Nh ve and will ,ra;nialn 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' compensatior Isnr dc9 carrier a^d ,polity number are: n f t, / :arrier 99 TrA LLB �_ Policy Number '7.1 i/ �--��' Expiration Date �J L1 I Z Z- lane D` Agent Phone # c=rtify that, in tnn performance of the work for which this 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 if I should becoine subject to the work FS' are ensation rovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �� / ,j ,Ltas of ADDlican�0 �7RC Jute— I �i I�z / CLAt ATION REGARRt/ DING CONSTRUCTION LENDING AGENCY =rPby 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 ider's Name Lender's Address 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 ordinances and state laws relating to building construction. I authorize representatives of this city or county to enter the o tified r p y for inspection purposes. /"� r mature of Pronerty Owner or Authorized Anent '�G /</(AI Print Prooertv Owner's or Authorized ADent's Name c ACTION DATE BY J"CRATION OF COMPLIANCE WITH CODE OF FEDERAL [OROFFICEUSEONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED 11 Ll I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED UEPA PERMIT EXTENDED OAQIVID PERMIT FINAL /J� SBESTOS NOTIFICATION 15 NOT APPLICABLE TO CERTIFICATE OF -x. PROPOSED DEMI]fleyj?,,,,I/I OCCUPANCY155UED SIGNATURE: pyVV �KJJ((SSrr '' Civil Code). 0 r1 O CZ N W C O ohm muom m nm a cn =0 0 = n m C3 0 RIL 6