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HomeMy WebLinkAboutX2021-1998 - Permits���r•r,� City of Newport Beach - Building Division *X2021-1998* COMB Permit: X2021-1998 100 Civic Center Drive, Newport Beach, CA 92660 Project No: 1745-2021 Permit Counter Phone (949)644-3288 • Inspection Requests Phone (949)644-3255 /'� /�,, I r� I S � C: - § r Issued Date : Area : 2021 Combination Type - MFP ELEC MECH PLUM 1 V `�./ V i� F 1 Inspection Area : 2 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST SE COMPLETED B.Y 09/02/2024 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 pA. No work on Sundays or Holidays Job Address: 280 CAGNEY LN NB St: 1 FI: 2 Unit: 205 Description: MFR BATHROOM REMODEL 90 SF Legal Desc.: TR 8336 LOT 5 UNIT 116 OF PROJECT LOCATED ON AP 423-011-22 TOGETHER Owner: SHARE SHAREY Contractor: OWNER/BLDR Architect: Address: 27982 RURAL LANE Address: SEE X2021-1930 Address: LAGUNA NIGUEL, CA 92677 Phone: 626-384-0263 Phone: Phone: State Lic: Applicant: SHARE SHAREY Con State Lic: OIB Engineer: RADVAR SHAHROKH " Address: 27982 RURAL LANE Lic Expire: Address: 6412 TULAGI ST LAGUNA NIGUEL, CA 92677 Bus Lic: IRVINE CA 90630 • • • • • - Phone: 626-384-0263 Lic Exp Date: Phone: 714-270.6780 State Lic:C-066139 Code Edit : 2019 Worker's Compensation Insurance Designer: • - Type of Construction: V-B-SPR Carrier: Address: ' Occupancy Group: R2 Policy No: Added /New sq.ft. Bldg: 0 Expire: Phone: Added /New sq. ft. Garage: 0 , No of Stories: 2 Building Setbacks Rear: / Special Conditions: , No of Units : 1 Front: / .. Bldg Height: 0 Left: / " Bldg Sprinklers: Right: / Flnnd 7nne: Use Zone: Parkino Soaces: 0 Fire Hazard Zone : N Construction Valuation: $8,000.00 Building Permit Fee: $212.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $184.44 Additional Fee : $0.00 Plan check Fee : $52.00 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: $0.00 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 Disabla Access : $0.00 P/W Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $14.84 San Dist: $0.00 Building Green Fee : $1.00 Mechanical %: $8.48 NMUSD Fee: $0.00 $0.00 Plumbing %: $19.08 $0.00 TOTAL FEE : $491.84 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $491.84 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: `v ` 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 items) (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 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 not more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do U 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 im oved 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 a p o 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). I am exempt from licensure underthe 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 legallt sell a structure that I have built as an owner -builder if has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Sectio 7 44 of the Business and Professions Code, is available upon request whe thi applicatiion is submitted or a e following Web site:http:/Iwww.leginfo.ca.gov/calaw.html. of Property Owner or Authorized Agent Date 2 41 L-4 LICENSED CO.MT?ACTOR'S DECLARATIONQ\ I hereby affirm urd=, penalty of perjury that I am lilersk under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force cnd eftt. License Class License No Date Contractor Signature WORKERS' COMPENSATION DECLARATION YIAPNINGFAILURE 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 COST O' COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. I hareby affirm under penalty of perjury one of the following declarations: I nave 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, forth perisrr,lance of the wort: 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 performance of the work for which this permit is issued. My workers' i�rmle_e carrier and,oelicy number are: Policy Number me b, Agent :_ Phone # Date I certify that, in the parformance 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 It, if I should becomq�sl(/blect to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Inature of Applicanf / \ C OR ICLARATION REG�"t7��DING STRUCTION LENDING AGENCY ereby 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, Civ 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 q inter tl}aabove-identified p pert for inspection purposes. 1 / �+, ,f Inature of ProOertv Owner or Authorized Agent % Print Property Owner's or Authorized Agent's Name X r�r ACTION DATE BY VI REOI�TIONS POF COMPLIANCE WITH CODE ART61O OF 40 AND AQMF FEDERULERAL I FOR OFFICE USE ONLY PERMITEXPIRED 1 SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED EPA PERMIT EXTENDED AQM D PERMIT FINAL CERTIFICATE OF OCCUPANCYISSUED 1� �r v f/�1/ v'U ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO 05ED$EgflOLlT 1f IGNA uRE: XX(