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Home My WebLink AboutX2021-0444 - Permits��wno4,T City of Newport Beach - Building Division o� 'r 100 Civic Center Drive, Newport Beach, CA 92660 [.. Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - SFP ELEC MECH PLUM GRAD COMB Permit: X2021-0444 Project No : 0422-2021 Issued Date : 08131/2021 Inspection Area : 5 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 08/31/2024 OR 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 S Job Address: 24 SANDY COVE NB Description: SFR ADD 726 SF, MASTER BEDROOM/BATH, ENTRY, KITCHEN, GAME ROOM REMODEL 512 SF. Legal Desc.: N TR 15445 LOT 12 Owner: MAD NEVADA TR Contractor: MIKE HOLLAND CONSTRUCTION INCArchitect: Address: 24 SANDY COVE Address: 28081 MORRO COURT Address: NEWPORT COAST, CA 92657 LAGUNA NIGUEL CA 92677 Phone: Phone: 949-235-9477 Phone: Applicant: RICHART JASON Con State Lic: 898714 Engineer: Address: 1041 W 18TH ST Al 06 Lic Expire: 06/30/2023 Address: COSTA MESA CA 92627 Bus Lic: BT30058852 Phone: 949-422-9191 Lic Exp Date: 04/30/2022 Phone: Code Edit : 2019 Type of Construction: V-B Occupancy Group: R3/U Added /New sq.ft. Bldg: 726 Added /New sq. ft. Garage: 0 No of Stories: 1 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Construction Building Permit Fee: $2,958.00 Plan Check Fee: $2,291.31 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $42.00 Energy Compliance: $153.41 CA Seismic Safety: $28.49 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $9.00 TOTAL FEE: $9,138.06 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Worker's Compensation Insurance Designer: Carrier: STATE COMP INS Address: Policy No: 9140185 Expire: 07/29/2022 Phone: Building Setbacks Use Zone: Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: 10 Front: 10 Left: 0 Right: 0 Parking Speca $0.00 $0.00 $0.00 $1,239.84 $237.00 $272.16 $152.00 $207.06 $118.32 $266.22 WILL BE INVALID or Holidays ILI State Lic: �j 7 GHAZLANIANDY 4202 ATLANTIC AVE #204 LONG BEACH CA 90807 562-253-2385 State Lic:C-060867 RICHART JASON 1041 W 18TH ST All 06 COSTA MESA CA 92627 949-422-9191 Special Conditions: NO FEES REQ FOR IRSD EXEMPT FROM SCHOOL DIST VHFHSZILANDSLIDE Planning Department - Plan check Fee Fair Share: SJH Trans : In -lieu Housing Fee: Public Works Department - Park Dedication : $0.00 PNV Plan Check: $50.75 San Dist: $0.00 NMUSD Fee: $0.00 Plan Check Fee : $9,138.06 NI Fire Department $208.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: $0.00 $ ;8.50 $?7AO $265.00 $564.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $0.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: ' 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 Businss and Professions 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 not more than five hundred dollars ($500). ❑ 1, as owner of the property, or my employees with wages as their sale compensation, will do L) 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 improved for the purpose of sale). ❑ 1, 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 Iicensure 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 that I have 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://w .leginfo.ca.gov/calaw.htm 1. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjur0hat I am licensed under provision �gf pte[,91rrro}�imending with Section 7 i�isis'n 3 of the Business and Pr ss �n lic I; in full force and effect. License Class License No 7} _ r (/, r Cat L / Contractor Signet a �i WORKERS' COMPENSATION CLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SURJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS I$100,Oa0), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: I have and mill 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 pgff*;aRge of the work for which this permit is issued. Policy No. end wlI maimain 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 carrier and policy number are: is cf Agent cerilfy that, in the performance of the i, 1 should becurne subjjee�t't�gl�hh ,WJ9- lature of ADolicant / / ✓ K 1 . Policy Number Date 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 egret comp nsatJl'b/1� provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /M1 I"rP�l. Date/Cf' ��2� nereby affirm unr'er penalty of perjury that there is a construction lending agency far the performance of the work for which this permit is issued (Section 3097, Civil Code). _m,uer's ,Jame Lender's Address 3y 7.y aignature-beloea, f 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 ordmancps and state lanws relating to building construction. I authorize representatives of this city or county th Ide ifie mperty for inspection purposes. j ,/E P signature of PropertyOwner or Authorized Agent + Print Property Owner's or Authorized Agent's Nam K ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE PERMIT EXPIRED PERMIT CANCELLED PERMIT EXTENDED PERMITFINAL RL CERTIFICATE OF OCCUPANCYISSUED I SUBMITTED ASBESTOS NOTIFICATION TO EPA OMD SBE5705 NOTIFICATION IS NOT APPLICABLE TO 'WPOSk csMiir1'��•//611FIO SIGNATUR t—Z