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Home My WebLink AboutX2021-0022 - PermitsU*'."� City of Newport Beach - Building Division IIIIIIIIII�IIIIIII��IIIIIIIIII COMB Permit: X2021-0022 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 1 0 0 2 2 Project No: 0024-2021 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255Issued Date : rea : 2021 Combination Type - SFP MECH ELEC PLUM Inspection Area : 5 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 01/12/2024 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 p.m. No work on Sundays or Holidays Job Address: 428 MORNING CANYON RD NB Description: SFR REMODEL (2) BATHROOMS & KITCHEN 227 SF Legal Desc.: N TR 1237 LOT 26 Owner: GOSSEN BRADIANGELA Contractor: RICKER CONSTRUCTION Architect: BAILEY DAVID . Address: 428 MORNING CANYON RD Address: 25672 SPINNAKER DRIVE Address: 23183 LA CADENA DR #101 CORONA DEL MAR, CA 92625 SAN JUAN CAP CA 92675 LAGUNA HILLS CA 92653 s Phone: Phone: 949-310-3491 Phone: 949-573-1050 State Lic:CO27404 Applicant: BAILEY DAVID Con State Lic: 928609 Engineer: ° a a • �; Address: 23183 LA CADENA DR #101 Lie Expire: 0212812023 Address: LAGUNA HILLS CA 92653 Bus Lie: BT300 Phone: 949-573-1050 Lie Exp Date: 01/30/2021 Phone: State Lie: +++a "a ' aaaa Code Edit: 2019 Worker's Compensation Insurance Designer: Type of Construction: VB Carrier: STATE COMP Address: Occupancy Group: R3/U Policy No: 9264587 Added /New sq.ft. Bldg: 0 Expire: 1112012021 Phone: Added /New sq. ft. Garage: 0 No of Stories: 1 Building Setbacks Rear I Special Conditions: -� �s Iy+=:� =aa No of Units : 1 Front: / � �; Bldg Height: 0 Left: / Bldg Sprinklers: N Right: I Flood Zone: Z Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $55,000.00 Building Permit Fee: $849.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $738.63 Additional Fee : $0.00 Plan check Fee : $46.25 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: Won Grading PC Consultant: $0.00 SJH Trans : $0.00 Demolition Fee Record Management: $8.00 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: Won 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 W $59.43 San Dist: $0.00 Building Green Fee : $3.00 Mechanical %: $33.96 NMUSD Fee: $0.00 $0.00 Plumbing %: $76.41 $0.00 TOTAL FEE : $1,814.68 Plan Check Fee : $784.88 Fee Due at Permit Issuance : $1,029.80 PROCESSED BY: _ PUBLIC WORKS APPROVAL: Cr ZONING 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 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 is 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 'rofessions 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 of 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 (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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 nprovements 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 nproved for the purpose of sale). 7 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 pply 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). 7 1 am exempt from licensure under the Contractors' State License Law for the following reason: ly 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 legall) ell a-tructure 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 'I.r."essions C6 is, is available upon request when this application is submitted or at the following Web site:http:llwww.leginfo.ca.gov/calaw.html. signature of Property Owner or Authorized Agent Date .ECERSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0 (�)Pf�DIy�/on.3 f the Business and Pr sions�Cgd and II force nd effect License (-lass License No Date /.K Contractor Signaturkr7� VORKERS' COMPENSATION DECLARATION IJ 'ARNINr;: FAILURE TO SEIURE 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 23-0P COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. `n7str; affirm under penalty of perjury one of the following declarations: "ave and =rll mrintain 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 th `�O.ance of the work for which this permit is issued. Policy No. ,is 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' compensatiol yr ce carrier and policy number are: ner Policy Number Expiration Date ne of Agent Phone # certify that, in the performance ofWrsen It is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation la s of California, and agre I, if I should becom s ject t eprovisions of SP,Stinn a7nn ntltaa-ai,,,rrnt9Tfiall forthwith comply with those provisions. nature of Applicant Dat CLARATION REGARDING ONS RU TION ENDING AGENCY )reby 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, LA ode). 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 owners behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and counly ordinances and state laws relating to building construction. I authorize representatives of this city or count enter the v ti d rty for inspection purposes. 6,1 (/ nature of Property Owner or Authorized Agent 4nt Property Owners or Authorized Agent's Name D t TION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED OEPA PERMITEXTENDED 4W D PERMITFINAL ASBEST N IFICATION N TAPP BLE TO CERTIFICATE OF • / OPOSED D OLITION i// lOCCUPANCY ISSUED SIGNATURE: