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HomeMy WebLinkAboutX2022-0312 - PermitsCity of Newport Beach - Building Division `X2022-0312* COMB Permit: X2022-0312 $whry .` 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 0286-2022 H v Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 • i ; . d ri E-_ i 9 Issued Date : 02/03/2022 Combination Type - SFP ELEC MECH PLUM Inspection Area : 2 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0210312025 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: 1607 BAYADERE TER NB Description: SFR BATHROOM REMODEL 320 SF Leqal Desc.: TR 2813 LOT 157 AND POR OF LOT 158 > > Owner: BAYADERE LLC Contractor: MENDIA PABLO Architect: Address: PO BOX 7067 Address: 5416 EVERETT AVENUE Address: NEWPORT BEACH, CA 92658 MAYWOOD, CA 90270 Phone: Phone: 213-453-2354 Phone: State Lic: Applicant: MENDIA PABLO Con State Lic: 836845 Engineer: Address: 5416E VERETT AVE Lic Expire: 0413012022 Address: MAYWOOD, CA 90270 Bus Lic: BT30077240 , Phone: 213-453-2354 Lic Exp Date: 11/30/2022 Phone: State Lic: Code Edit : 2019 Worker's Compensation Insurance Designer: MENDIA PABLO Type of Construction: V-S Carrier: EXEMPT Address: 5416 EVERETT AVENUE Occupancy Group: R3/U Policy No: MAYWOOD, CA 90270 Added INew sq.ft. Bldg: 0 Expire: Phone: Added INew sq. ft. Garage: 0 No of Stories: 1 Building Setbacks Rear: / Special Conditions: No of Units : 1 Front: I Bldg Height: 0 Left: / Bldg Sprinklers: Right: I Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $25,600.00 Building Permit Fee: $511.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $444.57 Additional Fee : $0.00 Plan check Fee : $62.00 Fire Inspection: $0.00 Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 Investigation Fee: $0.00 Grading PC Consultant : $0.00 SJH Trans : $0.00 Demolition Fee Record Management : $4.00 Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department - General Service $0.00 CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access : $0.00 PAN Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $35.77 San Dist: $0.00 $0.00 Building Green Fee : $2.00 Mechanical %: $20.44 NMUSD Fee: $0.00 Plumbing %: $45.99 $0.00 TOTAL FEE : $1,115.77 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $1,115.77 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: J� GRADING APPROVAL: APPROVAL TO ISSUE: S p� 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) ction 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 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 fessions 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 more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U portions of lusiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of cam nproved for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044 pply to an owner o, property who builds or improves thereon, and who contracts for the projects with a licensed Contractc I am exempt from Iicensure under the Contractors' State License Law for the following reason: ly my signature oelow I acknowledge that, except for my personal residence in which I must have resided for at least one ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I u 'roiessions Corte, it available upon request when this application is submitted or at the following Web site:http://www.legii lign..ture of Fmpertv Owner or Authorized Agent .ICENSED CONTRACTOR'S DECLARATION hereby affirm ur.der penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70poill rd effect. License Class License No Date \\ i COMPENSATION DECLARATION 'ARNING: FAILUnE TC SE-URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEN DST OF COMPENSATION; DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY's FEES. hereby affirm. wider penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director erformance of the work for which this permit is issued. Policy No. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the Isurance carrier and policy number are: Policy Number of Agent that, in the performance of the work for which this permit is issued, I shall not employ any person in any lould become sub to the 1 Tk com ensation provisions of Section 3700 of the Labor Code, I shall of Applicant _ Ireby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for Ider's Name Lender's Address work, and the structure is not intended or offered for sale (Section 7044, ployees' or personal effort, builds or improves the property, provided that the on, the Owner -Builder will have the burden of proving that it was not built or Business and Professions Code: The Contractors' State License Law does not pursuant to the Contractors' State License Law). that a copy of the applicable law, Section 7044 of the Business and Date 13 of the Business and Profeygion. , and my It se is in full force Z?, Contractor Signatur CIVIL FINES UP TO ONE HUNDRE THOUSAND DOLLARS ($100,000), IN ADDITION TO THE Industrial Relations as provided for by Section 3700 of the Labor Code, for of the work for which this permit is issued. My workers' Date o as to become subject to the workers' compensation laws of California, and comply with those provisions. �1 / -7 DateX L- — -3 — --' Z— this permit is issued (Section 3097, Civil Code) By 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 clu7ty ordinance and state laws relating to building construction. I authorize representatives of this city or coun en v ide Ill Ie property for inspection purposes. Signature of PropertyOwner or Authorized A ent z - _... Print Property Owner's or A horized Agent's Name /'(J j Da. ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOROFFICI USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE �1 1403 PERMIT EXPIRED I SUBMITTED ASBESTOS NOTI FICATI0N TO PERMIT CANCELLED EPA PERMIT EXTENDED AQM D PERMIT FINAL I BESTO OTIIFFiCIT I-K4+1 APPLICABLE TO CERTIFICATE OF POP D LITIO OCCUPANCY ISSUED �' , SIGNATURE:-