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HomeMy WebLinkAboutX2022-0211 - Permits,'o City of Newport Beach - Building Division II IIII I II I III I IIII II I II II III II COMB Permit: X2022-0211 100 Civic Center Drive, Newporteac2 2 0 2 1 1 Beach, CA 92660 X 2 0 Project No : 0193-2022 f~ s n Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Issued Date : 06f13/2022 `'�exrnra.> Combination Type - SFP ELEC MECH PLUM GRAD Inspection Area : 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 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: 430 EL MODENA AVE NB Description: NEW SFR 5125 SF Legal Desc.: FIRST ADD TO NEWPORT HEIGHTS LOT 9 BLK 27(AND ALL -EX SWLYI/2- LOTS �y Owner: TJC HOME BUILDER LLC Address: 26880 ALISO VIEJO PKWY STE 100 ALSO VIEJO CA 92656 Phone: Applicant: ROSENE MARK Address: 26940 ALSO VIEJO PKWY STE 100 ALSO VIEJO CA 92656 Phone: 949-897-8034 Code Edit: 2019 Type of Construction: V-B-SPR Occupancy Group: R31U Added /New sq.ft. Bldg: 5125 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Y Flood Zone: X Construction Valuation: $980,700.00 Building Permit Fee: $7,371.00 Plan Check Fee: $5,528.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $164.00 Energy Compliance: $303.00 CA Seismic Safety: $127.49 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $40.00 TOTAL FEE: $24,734.71 PROCESSED BY: ZONING APPROVAL: Contractor: T J C HOME BUILDERS LLC Address: 26880 ALSO VIEJO PKWY #100 ALSO VIEJO, CA 92656 Phone: (949) 481-7026 Con State Lic: 1025507 Lic Expire: 04/30/2023 Bus Lic: ST30069037 Lic Exp Date: 05/31/2023 Worker's Compensation Insurance Carrier: TECH INS CO Policy No: TWC4081048 Expire: 03/0812023 Building Setbacks Use Zone: Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: 5' Front: 20' Left: 4' Right: 4' Parkina Spaces $1,213.80 $291.00 $0.00 $0.00 $1,046.00 $910.02 $152.00 $515.97 $294.84 $663.39 Plan Check Fee 0 E � 04 gam, y,'. OR Architect: NIEMERSKI KENNETH 0,� Address: 2031 ORCHARD DR #100 NEWPORT BEACH CA 92660 ' Phone: 949-553-9100 State Lic:CO23971 , Engineer: NGUYEN HUAN Address: 15 STUDEBAKER ' IRVINE CA 92618 Phone: 949-752-1612 State Lic:C-064238 a „ ..... Designer: Address: „ Phone: Special Conditions: 5 TO 6 BDRMS Fire Hazard Zone : N Planning Department - Plan check Fee Fair Share SJH Trans In -lieu Housing Fee Public Works Department - Park Dedication : $0.00 PM/ Plan Check : $203.00 San Dist: $0.00 NMUSD Fee: $5,391.20 Fire Department $620.00 Fire Inspection: $0.00 $0.00 Fire Plan Rev $0.00 $0.00 Demolition Fee $0.00 Building Dept Adm $0.00 General Service $0.00 Refund Deposit $0.00 Grading Bond: $0.00 $0.00 $0.00 $6,642.00 Fee Due at Permit Issuance : $18,092.71 PUBLIC WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: 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 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 iot more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do `) all of or (_) 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 owne, 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 rroln licensure under the Contractors' State License Law for the following reason: Jy r,y signature b)Jiw 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 legalIN sell a structure'hat I -ave 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 Omresslons Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.govlcalaw.htmi. Signature of Property Owner or Authorized Agent Date L;CENSED CCN T RACTOR'S DECLARATION : her.:Ly affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0 f( n e Business and Pr essi s Ccd my f e is n f rPl'force -trc' ^.f`ect. Licence bless License No Datl ` Contractor Jr. 'A'ORKERS' COMPENSATION DECLARATION . J.'.LF. r.c. FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNORE THOUSAND DOLLARS ($100,0001, IN ADDITION TO THE . OST OF COMPENS, TION, JAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm um cer penalty of perjury one of the following declarations: I leave and will ma,ntain 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 performance of the WOIK for which this permit is issued. Policy No. tiF-Fiave 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' compensatiol sU ce carrier and policy number are: :arrier Policy Number Expiration Date lame of Agent Phone # I certify that, in the performan of the to hich this it is i e I shall not employ any person in any manner so as to become subject to the workers' compensation laws o California, and agre tat, if should became subject t he wor a pensatio o isio s o ection 3700 of the Labor Code, I shall forthwith comply with those provisions. ///�����9yyglll� ,�—^T signature of Applicant Dat f IECLARATION REGA DING N R ENDING AGENCY hereby affirm under penalty of perjury that there is a construction lendi ency for the performance of the work for which 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 or mancebsd ate lawG reltrefi to building construction.1 �, Yq{�j nI�/I authorize representatives of this city or county Y�nt r-i of p o rty f spection purposes. �y'\ 1'�YI Date ;ionature of Prooertv Owner or Authorized Agent !/\ Print Property Owner's or Authorized Agent's Namq �LVVV ///111 LLL ACTION DATE UY DECLARATION OF COMPLIANCE W H ODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OFTITLE 40ZDFD AQMD RULE 1403 PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED EPA PERMIT EXTENDED AQM D PERMITFINAL 9TION P O BESTOSN� CERTIFICATE OF OTIFIC PROPOSED 1 OCCUPANCYISSUED SIGNATURE