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HomeMy WebLinkAboutX2019-0013 - Permits�w,.,w City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 F,+ +Permit Counter Phone (949)644-3288 v Inspection Requests Phone (949)644-3255 x;. Combination Type - MFP ELEC MECH PLUM PERMITS EXPIRE 180 DAYS AFTEF Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Job Address: 5 SOUTHAMPTON CT NB Description: MFR REMODEL KITCHEN 300 SF Legal Desc.: TR 10987 LOT 2 UNIT 148 OF PROJECT LOCATED ON AP 442-351-08 HE Owner: JAGTINDER SINGH DANG Contrac Address: 17150 EUCLID ST #101 s: FOUTAIN VALLEY CA 92708 Phone: Phone: Applicant MARTNEZ JOEY r60 State L d" Lic Expu Address: 18627 BROOKHURST ST #205 FOUNTAIN VALLEY CA 92708 s Lic �., Phone: 714-580-7189 xp Code Edit. 2016 Worker' rnpen Type of Construction. V-B R2IU o]icy No Occupancy Group: Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 Ex - No of Stories. 2 Bw S tb��s No of Units: 4 Bldg Height: 0 Bldg Sprinklers: Flood Zone: a Zone: Ills iiiiii iiiii iiiii iiiii iiii iiiii iiiii hill 3i4111 COMB Permit: X2019-0013 Project.No : 0011-2019 Issued Date: 0111712019 Inspection Are: St C&&EOR ALI. D\t�IiNSP y 8:.m. No VVrtra un\d"ays or Holi00a.m 0$)631"o D rchitect: Q 26 LARRY ddress: t0 432 EL MAR DR r MISSION VIEJO CA 92691 •, _�,� one: 949-582.5960 State Lic:C008526 8 ^.: E Rp p 0x�,d ss: ri°0 112019 ho State 690 anon Insuran , - �'L7esigne: �qlj` K,4, Address:) P®S�aup? Sp onditic 0�D�K Front: I 9, Left: I� Right: I SQ' Construction Valuation: $75 000.00 Building Permit Fee: $938.00 Excise Ta\Fee: $OrORiO'(K Planning Depa t- ire Department Plan Check Fee: $816.06 Additiona$0. Plan c as: $40,00- Fire Inspection: $0.'1n Overtime Plan Ck: $0.00 Grading B$0.00 are : - °'$0.00 Fire Plan Rev $'r00 Investigation Fee: $0.00 Grading Pnt : $0.00 SJH Trans - $0.00 Demolition Fee Record Management: $4.00 Grading P$0.0 In -I' 0 is e : $0.0o Building Dept Adm $0.00 Energy Compliance: $0.00 Grading P�O,e • .00 lic s Department - General Service $0.00 CA Seismic Safety: $0.00 WO Insp.r $0.00 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 $6 San Dist: $0.00 Building Green Fee : $3.00 Mechanical W 7.52 NMUSD Fee: $0.00 $0.00 Plumbing %: $84.42 $O.00 TOTAL FEE : $1,988.66 Plan Check Fee: $856.06 Fee Due at Permit Issuance : $1,132.60 PROCESSED BY: ZONING APPROVAL: 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 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 (_) 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-Builderwill hav the burden of proving that it was not built or ffim roved for the purpose of sale). - I, as owner'of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Bus' 8' note ssions Code: The Co . actors' 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 Co rsuant to the Contractors' State Licens Law), ❑ 1 am exempt from Rcensure 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 e resided for at least OMW ompletion of I a 11I �gy nt overed by this permit, I cannot legal) sell a structure that I have built as an owner -builder if it has not been cons s entirety by licensed contractors. 1I4�r r land that "�-Pooq �/ abl law, ction 7044 of the Business and Professions Code, is available upon request when this applic mitt or at the following Web sit ://www.leginfo.cbggv/coa fvtbtml. Signature of Property Owner or Authorized Agent /0 to LICENSED CONTRACTOR'S QS.9.6 11710N ' ' I hereby affirm under penalty of perury that am licensed LIDs of hapter 9 (commencing with 1 ectl'pn 7000j g/f [yv th ess fession e, an my license is in full force and effect. License Class o,e}� ; Icense No _ Halo---�'siici�l'c�'c„nr.=ter ­f­ WORKERS' COMPENSATIONVECLARATION B [,-I (/ WARNING: FAILURE TO SECURE WORKER COMPENSATION COVERAGE t5 UNLAVJFUL`;rAND SHALL SUBJECT AN EMPLDYER`T RIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THO SAND D LLAR5(f100,000), IN ADDITION TO THE COST OF COMHeNSATION, DAMAGES ASP VIDE5fOF IN SECTION 3706 OF THE LABOR -CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perju k one of the following declarations:. L❑ 1 k:ave and fahlmaintain a certif to of consent to self Insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 700 of the Labor Code, for th, oerfgrmance of the work for which this' ermit is issued. Policy No. 01 Eve and will maintain workers' co pensatlon insurance as required by Section 3700 of the Labor Code, for the performance of the work or whit t d is Iss d M� workers' compensatior Insun3nce carr;tr and policy number are. Car fur_ ' fI Policy Number _�,tIL of Agerf• err certify that, in'the performance of the ork foi`jh this t" Is d, I shall n em IgQyy��ny person in Her so asIoEMZIE" o the workers' compensa on v,1 'f California, and agrer { F tit Lficnt' subject to the wor rs co nsaiion io o echo �L�bor Cade, I s forthwitH "Oose provisions. 3ignatu o \ - at 7ECLA. ON E 1 G ,,yy�� hereby affirm ultder j3enalty of perjury that t re i truc n Iendi�ng, WW performance of the work for which It is issued S n C e _ender's Name YY�� Lender's Address 3y my signature below, I certify to each of the ollowing: I am the property owner or authorized to a on the property ow i' behalf. ..w I have read this application and the inform on I he a ,rovide Is I agree to comply with all applicable city an c a d state laws relati ing c En3cfFd'n" � I authorize representatives of this city or co t o ant a r�opGe Ion purposes. 3i nature of Pro erty Mine onze. Agen Print Property Owner's or Authorize 's Name ACTION DATE BY D OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE U ONLY r / REG UTA NS PART 61 OF TITLE 40 ANDACII RULE PERMIT EXPIRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED LJEPA PERMIT EXTENDED OM PERMITFINAL ASB OS NOTIF I NOTAPPLICABLE TO CERTIFICATE OF PROPO OL OCCUPANCYISSUED srt9RAr F-