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HomeMy WebLinkAboutX2022-1308 - Permitsrxlvp•r,� City of Newport Beach - Building Division *X2022-1308* COMB Permit: X2022-1308 0� g 10c Civic Center Drive, Ney/port Beach, CA 92660 Project No : 1208-2022 w m. Permit Counter'Plione (949)644-3288 2 Inspection Requests Phone (949)644-3255 Issued Date : 0510612022 Combination Type - BLDG PLUM 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 Holidays "� Job Address: 1227 MARIAN LN NB �" 6 �� Description: DEMO SFR W/ATT GAR 2860 & 486 SF 3 BEDROOMS W/SEWER CAP Legal Desc.: N TR 1973 LOT 41 Owner: KLIEWER JASON & WEND] Contractor: OWNER/BLDR Architect: �-✓ Address: 316 ALSO AVE Address: KLIEWER JASON Address: C-IF', � NEWPORT BEACH, CA 92660 O/B AUTH ATT Phone: 925/998-8246 Phone: Phone: State Lic: Applicant: KLIEWER JASON & WENDI Address: 316 ALSO AVE NEWPORT BEACH, CA 92660 Phone: 925/998-8246 Code Edit : 2019 Type of Construction: Occupancy Group: R3/U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 0 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Construction Valuation: Building Permit Fee: $122.00 Plan Check Fee: $223.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management : $0.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $2,444.98 PROCESSED BY: ZONING APPROVAL: Con State Lic: 0/8 Lic Expire: Bus Lic: Lic Exp Date: Worker's Compensation Insurance Carrier: Policy No: Expire: 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: / Engineer: ORELLANA FREDY Address: 51 DEVONSHIRE IRVINE CA 92620 Phone: 949-754-2826 State Lic:C-068955 Designer: Address: - Phone: Special Conditions: - - - Fire Hazard Zone : N . $0.00 Planning Department- Fire Department $0.00 Plan check Fee : $104.00 Fire Inspection: $0.00 $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 $0.00 SJH Trans : $0.00 Demolition Fee $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $27.00 $0.00 Public Works Department- General Service $265.00 $0.00 Park Dedication : $0.00 Refund Deposit $1,692.00 PAN Plan Check : $0.00 Grading Bond: $0.00 $0.00 San Dist: $0.00 $0.00 NMUSD Fee: $0.00 $0.00 $10.98 $0.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $2,444.98 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 hlave7placed ;:=xt 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 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 im ovements 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 ed 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 lCensure under the Contractors' State License Law for the following reason: By my signature below I acknowledge that, except for my personal resident 'n which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall) sell a structure that I have built as an owner -builder if it has not been c str ted in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7�f the Business and Professions Code, is available upon request when this ap Ication is s mi d or at the following Web site:http://www.leginfo.ca.gov/calaw.htm]. Signature of Property Owner or Authorized Agent Dat LICENSED CONTRACTOR'S DECLARATIO I hereby affirm under penalty of perjury that I am licensed under provisi s of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. Licer.Ea Class License No Date Contractor Signature COMPENSATION DECLARATION 'ARNING' FAILUR. V SLCURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$100,0001, IN ADDITION TO THE DST OF COMPENSAI ION. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hcreby affirm under penalty of perjury one of the following declarations: I I have and wi;1 rnaintain 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( e, formance of t' i work for which this permit is issued. Policy No. ! hive 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' ounce carnar ace policy number are: r-irr Policy Number Date ame of Agent _ Phone # 31 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 agref ;a,, If I shouln oernn,e subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignature of Applicant Date_ iECLARATION REGARDING CONSTRUCTION LENDING AGENCY hereby 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). Ender's Name Lender's Address y my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owners behalf. I have read this application and the information I have provided is cect. I agree to comply with all applicable city and county ordinances arfdor ate laws relating to building construction. I authorize representatives of this city or county to enter the ab,1�(id-i ntified property for inspection purposes. -ttL ignature of Prooertv Owner or Authorized Agent Print ProoerN ce� Owner's or Authorized Afit5 's Name , 1SOv�l K(„(0 ACTION DATE BY/ I DECLARATION REGULATIONS PARTOM UANF TITLE 4 CE WITH CODE OF FEDERD AQMD RULE AL I FOR OFFICE USE ONLY PERMIT EXPIRED LJ I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED EPA PERMIT EXTENDED OM D PERMIT FINAL CERTIFIC47E OF OCCUPANCY ISSUED /l V BEST NOTIFICATI NOT APPLICABLE TO P POSED EM LiTION SIGNATURE: YL Date S G--1