HomeMy WebLinkAboutX2022-0540 - Permits4 tiy:w9Yi4,�.. City of Newport Beach - Building Division *X2022-0540* COMB Permit: X2022-0540
b 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 0492-2022
Permit Counter Phone (949)644-3288 r'�
p Inspection Requests Phone (949)644-3255 k Issued Date : 03/02/2022
r zra1� Combination Type - SFP MECH ELEC PLUM �
Inspection Area : 6
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 03/02/2025 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: 11 RIEZ NB
Description: SFR REMODEL 800 SF
Legal Desc.:
Owner:
GLASSER DARIN
Address:
11 REIZ
NEWPORT COAST CA 92657
Phone:
Applicant:
NORBERG MICHAEL
Address:
619 S FREMONT AVE #C
ALHAMBRA CA 91803
Phone:
661-803-5797
Code Edit: 2019
Type of Construction: VB
Occupancy Group:
R3/U
Added /New sq.ft. Bldg:
0
Added /New sq. ft. Garage:
0
No of Stories:
2
No of Units:
1
Bldg Height:
0
Bldg Sprinklers:
N
Flood Zone:
X
Construction Valuation: $64
Building Permit Fee:
$921.00
Plan Check Fee: $801.27
Overtime Plan Ck:
$0.00
Investigation Fee:
_ $0.00
Record Management :.
$32.00
Energy Compliance:
$61.00
CA Seismic Safety:
- $0.00
Disabled Access:
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$3.00
TOTAL FEE: $2,155.97
PROCESSED BY:
ZONING APPROVAL:
Contractor:
HARTMAN BALDWIN INC
Architect:
BUCKLEY BRYCE
Address:
100 W FOOTHILL BLVD
Address:
100 W FOOTHILL BLVD • ,
CLAREMONT CA 91711
CLAREMONT CA 91711
Phone:
909-621-6296
Phone:
909-721-0374 State Lic:C037052
Con State Lic:
653340
Engineer:
MUTKA JASON RICHARD _ _ • .
Lic Expire:
09/30/2022
Address:
PO BOX 77144 .,
Bus Lic:
ST30078034
CORONA CA 92877
Lic Exp Date:
02/28/2023
Phone:
951-235-0276 State LicC-072255 ,
Worker's Compensation
Insurance
Designer:
,
Carrier:
INSURANCE COMPANY OF THE WEST
Address: • -•
Policy No: WVE505736801
Expire: 10/01/2022
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: /
Front: /
Left: /
Right: /
larking Spaces
$0.00
$0.00
$0.0a
$0.00
$0.00
$0.00
$0.00
$64.47
$36.84
$82.89
Plan Check Fee
Phone:
Special Conditions:
0
Planning Department -
Plan check Fee
Fair Share
SJH Trans
In -lieu Housing Fee:
Public Works Department -
Park Dedication : $0.00
P/W Plan Check : $101.50
San Dist : $0.00
NMUSD Fee: $0.00
Fire Department
$52.00
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
$965.02 Fee Due at Permit Issuance : $1,190.95
PUBLIC WORKS APPROVAL: AC
CN G PLAN CHECK BY: SFc
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
the 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 lcensure 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 sole compensation, will do (_) all of or L) 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
im 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
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 licensure 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 legally
sell a structure th3` I lave 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.html.
SignabDe of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I i,ereLy 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 Codee, and my li nse is In full force
and ^f"ect. License Class License No Date �C ' .� P1Z Z Contractor Signature )!C
VVORS(ERS' COMPENSATION DECLARATION
,JARK.I.G: 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 ($100,000), IN ADDITION TO THE
nr1ST OF COMPENSATIOK, JAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
herehy affirm uocer pJnalty of perjury one of the following declarations:
❑ I I.a✓e 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 the
3erfoymance of the IN01K for which this permit is issued. Policy No.
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'
cantor and policy nun*er are:
Policy Number
of Agent
Date
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
if I should become subjP� tgRhe workers _compensation provi�s of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
of
>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, Civil Code).
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 ,ejabgve-iden-tif�d�propeerty for inspection purposes. 1�
nature of Prooertv Owner or Authorized Aoent gym-` ---� rint Prooertv Owner's or Authorized Aaent's Name 7K � I t vff LrDE
0
ACTION
DATE
BY
DECLARATION OF COMPLYANCE WITFTCODE OF FEDERAL
FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED
I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED
LJEPA
PERMIT EXTENDED
QMD
PERMIT FINAL
ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF
OCCUPANCYISSUED
PROPOSED DEM_OLLTJOiJ�i`
SIGNATURE: SC iG�I