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Home My WebLink AboutX2021-2013 - Permitsti NNt•o4� City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2021-2013- - �, 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 1 2 0 1 3 Project No : 1760-2021 F.. i Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - SFP ELEC MECH PLUM Issued Date : 1211412021 Inspection Area : 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 1211412024 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: 423 SAN BERNARDINO AVE NS Description: SFR ADD 2296 SF (483 sf 1st FL, 1813 sf 2nd FL), REMODEL 1385 SF. Legal Desc.: FIRST ADD TO NEWPORT HEIGHTS BLK 13 LOT 18 Owner: WERNER NICK] & PAT Contractor: CP MC CLARY CONSTRUCTION INC Architect: Address: 423 SAN BERNARDINO AV Address: 1013 LINDEN PLACE Address: NEWPORT BEACH, CA 92663 COSTA MESA CA 92627 Phone: Phone: 714-271-1055 Phone: State Lic: Applicant: BUSHMAN WALT Con State Lic: 513053 Engineer: BERHE MAICHEL Address: 2480 SANTA ANA AV Lic Expire: 1013112023 Address: 1700 E GARRY AVE STE 104 COSTA MESA CA 92627 Bus Lic: BT00004228 SANTA ANA CA 92705 Phone: 949-642-3468 Lic Exp Date: 08/31/2022 Phone: 949-335-9698 State Lic:C-076445 Code Edit : 2019 Type of Construction: V-B-SPR Occupancy Group: R3 Added /New sq.ft. Bldg: 1244 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Y Flood Zone: X Construction Building Permit Fee: $5,498.00 Plan Check Fee: $4,356.07 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $100.00 Energy Compliance: $303.00 CA Seismic Safety : $80.21 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $25.00 Worker's Compensation Insurance Carrier: STATE COMP INS FUND Policy No: 1300846 Expire: 06/01/2022 Building Setbacks Excise Tax: Additional Fee: Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical W Plumbing %: TOTAL FEE: $18,464.52 PROCESSED BY: ZONING APPROVAL: V K44 K- Rear: 5' Front: 20' Left: 4' Right: 4' Parking Spaces $0.00 $291.00 $0.00 $0.00 $0.00 $0.00 $152.00 $384.86 $219.92 $494.82 Plan Check Fee Designer: Address: Phone: Special Conditions: GREENLEAF TO HAUL DEBRIS eq, 9 ; �V`c:� Planning Department - Plan check Fee Fair Share SJH Trans In -lieu Housing Fee Public Works Department - Park Dedication : $0.00 PNV Plan Check, $203.00 San Dist: $1,068.00 NMUSD Fee: $4,224.64 Fire Department $208.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: $4,719.59 Fee Due at Permit Issuance PUBLIC. WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAI. TO ISSUE: ' $0.00 $0.00 $27.00 $265.00 $564.00 $0.00 $0.00 $0.00 $13,744.93 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 the permit to file a signed statement that he Dr 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 Iicensure 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 sale compensation, will do (_) all of or U portions of the 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, through 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 Iicensure under the Contractors' State License Law for the following reason: By 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 legall) sell 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 Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Date Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of per�usy that I am licensed under provisions�pf )rFj�pt�r rlmencing with Section 7000) of Ivl ion 3 of the Business and urof jeyrs'�od ^rpy license is in full force and effect. License Class t License No �J 1S l!� S Dat 'Z Z Contractor Signature( L lA WORKERS' COMPENSATION DECLARATION WARNING: 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 I$100,000I, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the fallowing declarations: ❑ I 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 rformance of the work for which this permit is issued. Policy No. 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' compensatio I rance carrier and policy number are: Carrier Policy Number Expiration Date ne of Agent certify that, in the 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 agre t, if I should becom4RNG c the compensation provisions of Section 3700 of the Labor Cade, I shall forthwith comply with those provisions. nature of ApplicantDat l 7 (�CLARATION REGACONSTRUCTION LENDING AGENCY )reby 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, 'vil Code). Ider's Name Lender's Address my signature below, I certify to each of the fallowing: 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 titled property for inspection purposes. y q (� 1 (nature of Procerty Owner or Authorized Agent Print Property Owners or Authorized Agent's Name IXOC 't-��Z`II Date lZ\l`� ?l1 ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED I SUBMITTE'1 ASBESTOS NOTIFICATIOP' TO PERMIT CANCELLED OrpA _ PERMIT FINAL ❑ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO CERTIFICATE OF PROPOSED C EN70LITiON _ OCCUPANCY ISSUED SIGNATURE: