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Home My WebLink AboutX2020-1726 - Permit Applicationr�,1'wrry_ City of Newport Beach -Building Division � I�Illlillllllllllillllllllllllll �WIIIIIII jj 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 210 1 7 2 6 91 Permit Counter Phone (949)644-3268 �' te�� +k Inspection Requests Phone (949)644-3255 Qo�o Combination Type - SFP ELEC MECH PLUM PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSP TIO Construction Hours: Monday - Friday 7:00 a.m. to 6:30 Job Address: 28 POINT LOMA DR NB Description: SFR REMODEL KITCHEN 285 SF &ADD 76 SF -- Legal Desc.: N TR 7432 LOT 43 Owner: BROEDLOW T A & E K Address: 28 POINT LOMA DR CORONA DEL MAR, CA 92625 Phone: Applicant: ANGELL BILL Address: 27171 SOLEDAD MISSION VIEJO CA 92691 Phone: 949-584-5919 Code Edit : 2019 Type of Construction: V Occupancy Group: R Added /New sq.ft. Bldg: Added /New sq. ft. Garage: No of Stories: 2 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Flood Zone: X Building Permit Fee: $1,635.00 Plan Check Fee: $1,342.13 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $20.00 Energy Compliance: $61.00 CA Seismic Safety: $10.40 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $4.00 PROCESSED BY: 11 TOTAL FEE: $3,556.34 ZONING APPROVAL: WQ Electrical Mechanical °o Plumbing %: �syaeoa i V ear: 85-85 A./1 ont: fi `y V _eft: 5110 Right: 511in al Fee. qC Co: �rmit $0.00 $0.00 $011Q 14.45 �trrz:uu a.m. r� `O. Architect: Address: I ieu using Fee till orks Department - rk Dedication : $0.00 PAN Plan Check : $43.00 San Dist: $0.00 NMUSD Fee: $0.00 Phone: Engineer: Address: Phone: Special I Permit: X2020-1726 No:1371-2020 09/15/2020 :D BY 0911612023 OR P MfP:.WXL BE INVALID p.m. No work on Sun s^o3e,Holidays n. State Lie: ACh A / a + Y ]AD HAN ' LN ' KE� ST, CA 92 3$� -§698 tafell ;0 r 9 „ GELL BIL rr,\a`y• " +' 27171 SO DAD'\�\ ' MISSI VI CA9 1 94 84-59.9 , itions:/ Fire Department $185.00 Fire Inspection: $0.00 $0.00 Fire Plan Rev $0.00 $0.00 Demolition Fee $0.00 Building Dept Adm $0.00 General Service $0.00 Refund Deposit $0.00 Grading Bond: $0.00 $0.00 $0.00 Check Fee : $1,455.94 Fee Due at Permit Issuance : $2,100.40 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 re (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, ' the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contract..., ontractors' t� Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. A ioll not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) of or L) Business and Professions Code: The Contractors' State License Law does not apply to an owner property w improvements are not intended or offered for sale. If, however, the building or improvement is d within one, n(s) I icate ow by the checkmark(s) I have placed next to the applicable items) ove, de lish, pair any structure, prior to its issuance, also requires the applicant for License La Chap' (commencing with Section 7000) of Division 3 of the Business and n of Sectioq .5 by, applicant for a permit subjects the applicant to a civil penalty of improved for the purpose of sale). : Qp- I�Qv ❑ I, as owner of the property, am exclusively contracting with licensed Contractors to c truct th��CPtroje a do apply to an owner of property who builds or improves thereon, and who contracts for th roject�v�ith a lied Co ❑ 1 am exempt from licensure under the Contractors' State License Law for the fol ing re C) By my signature beir,v, I acknowledge that, except for my personal residence in w h I mi�gqstal ve d for at 1911 sell a structure thit I have built as an owner -builder if it has not been construct in its enMty by sed cgr([ractl F rofe3sions Code, 's available upon request when this application is submitt or at the follow' eb site //wv Signature of Property Gwner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under prov' ons of Ch ¢ter 9 (commencin with Section and effect. LIC3iEe Cfass Licen o Date ✓VORKERS' COMPENSATION DECLARATION I NARNIAg: FAILUR': TU SECURE WORKERS' COMPENSATION COVERAG UNLAWFU AND SHALL SUW ECT AN EMPLOYER TO CRIMINA ,OrT CF COMPENSATION, DAMAGES As PROVIDED FOR IN SECTION 3 OF THE L R CODE, INTEREST, AND ATTORNEY'S FEES. hPr3hy affirm unoer penalty of perjury one of the follow' declarati s: or the 3usiness and P pursuant to the is not intended or offered for sale (Section 7044, rt, builds or improves the property, provided that the Lave the burden of proving that it was not built or Law). State License Law does not one year prior to completion of the impr enI vered by this permit, I cannot legall7 I. I understand that a copy of the applicable 7044 of the Business and .leginfo.ca.gov/calaw.html. -', te'., 7.. 0 of Division 3 of t a and Pro o d my lic a is i f II roe - ff Cactor Signature pp J 'ENALTIEs ANg�afaL HE O ONE HU y1 SAyp DOLLARS (5100,000), IN AO ION TO THE ❑ 1 have and will, mcintain a certificate of conse o set-in re for workers' compensation, issued by the Director.:of 3,3, funnance of the work for which this permit is is ad. 70lic o. ❑I nave and 'will mat,ltain workers' compen Ion IU it ce, as required by Section 3700 of the _Labor Code for the_ pe nsurance carrier and policy number are: �\ S 3arrier Vry Policv Number 14ame of Agent Ir- certify that, in the a rmanc f the wort or whio� If I should becom t th a s' comper Ignature of Applicant DECLARATION REGA DI O RUCT ENt hereby affirm under p "tX erjury th ere is a c _ender's Name 'r . 3y my signature below a �{;.tQ h of the following I am the property owner dr' n to acPron the I have read this application an to anon I I agree to comply with all applica�i�(y u authorize representatives of this cito Signature of Property Owner or Authorized A' ACTION DATE BY `(� PERMIT EXPIRED PERMITCANCELLED PERMITEXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCYISSUED SIGNATURE: I shall not employ any person in any manner so ction 3700 of the Labor Code, I shall forthwith c mding agency for the perMKWce of the Len �d, s ress (� Ier's behalf. �Q,,1 rC� correct. and ate Is r ing Ailding to ve-i e I rk*r inspectio purp Print rope 4CPLI ITH CODE F FEDE L OF TITLE 40 AND MDRLO :1" ASBESTOS IS NOXAP➢LICABLE TO ; or Authorized Ao OFFICE USE ONLY Section 3700 of the Labor Code, for of the Work jqF who this permit is issued. My workers' orris 7ect to the workers' compensation laws of California, and agre h provisions. Da e_j is issued (Section 309 , Ci it Code). ;LLI ^ U, ., 72 N OLp�) a z A4 W N C F-� 0 O c�