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HomeMy WebLinkAboutX2022-0089 - PermitsEwac'�a City of Newport Beach - Building Division `X2022--0089' COMB Permit: X1 v 100 Civic Center Drive., Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Project No : 0102-2022 >~ Inspection Requests Phone (949)644-3255 Issued Date : 0111312022 Combination Type -BLDG PLUM 9 t Inspection Area : 5 PERMIT EXPIRES 160 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0111312025 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: 272 EVENING CANYON RD NB Description: DEMO SFR (6 BEDROOMS) 2696 SF Legal Desc.: N TR 1116 LOT 61 Owner: BEDERMAN STACY Contractor: NICHOLSON CONSTRUCTION CO Architect: TEALE MARK Address: 272 EVENING CANYON RD Address: 1 CORPORATE PLZ #110 Address: 2900 BRISTOL ST BLDG A203 CORONA DEL MAR, CA 92625 NEWPORT BEACH CA 92660 COSTA MESA CA 92626 , Phone: Phone: 949-872.6637 Phone: 949-975-0123 State Lic:CO22162 Applicant: GLASS NANCI Address: 1 CORPORATE PLAZA DR STE 110 NEWPORT BEACH, CA 92660 Phone: 714-865-4465 Code Edit : 2019 Type of Construction: Occupancy Group: R3 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: Flood Zone: Construction Valuation: $12,000.00 Building Permit Fee: $122.00 Plan Check Fee: $223.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $4.00 Energy Compliance: $0.00 CA Seismic Safety : $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $2,652.98 PROCESSED BY: ZONING APPROVAL: Con State Lic: 660295 Engineer: Lic Expire: 12/31/2022 Address: Bus Lic: ST98032850 Lic Exp Date: 04/30/2022 Phone: Worker's Compensation Insurance Designer: Carrier: STATE FUND Address: Policy No: 9074255 Expire: 10101/2022 Phone: Building Setbacks Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical W Plumbing %: Rear: I Front: I Left: I Right: / 'Eking Spa $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $152.00 $0.00 $0.00 $10.98 0 State Lic: Special Conditions: CERT MAIL RECEIPTS ATTACHED Planning Department - Plan check Fee Fair Share SJH Trans In -lieu Housing Fee Public Works Department - Park Dedication : $0.00 PAN Plan Check : $0.00 San Dist: $0.00 NMUSD Fee: $0.00 Fire Department $156.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: $0.00 $0.00 $27.00 $265.00 $1,692.00 $0.00 $0.00 $0.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $2,652.98 PUBLIC WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjurythat I am exempt from the Contractors' State License Law for the reason(s) indicated below by the chec kmark(s) I have placed next to the applicable)tem(s) (Section 7031.5, Business and Professions Code: Any city or countythat requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant 1br 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 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 wfth 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 -Builder will have the burden of proving that it was not built or Im roved for the purpose of sale). LJ 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 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 Iegall sell a strucum thet 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 s"Ite:http://w .leginfo.ca.gov/celaw.htmi. Signature of Property Owner or Authorized Agent Date LICENSED TPI RACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 0) of D VI the Business and P Code, and y ricer is i I full force and affect. Licanse Class License No Date �" 3"LG Contractor Signature WORKERS' COMPENSATION DECLARATION NARIUNG: FAILURE TO 7ECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES UP TO ONE HUNDRED THOUSAND DOLLARS IS100,000), IN ADDITION TO THE CJ rr OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I :n:reby affirm ands: penalty of perjury one of the following declarations: ❑ 1 have andwill maintain a certificate of consent to self4nsure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for tt as rf.rMance of the work for which this permit is issued. Policy No. and vnil 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' carrier and policy number are: e of Agent :ertify that, in the performance if I should becom s ject atune of Applicant Policy Number Date the work forwhich this permit is issued, 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and workers' compensation rovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. A' 2 _ Date Y 1-13-22 CLARATION REGARDING CONSTRUCTION-EENDING AGENCY ®® Ireby 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). Iders 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 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 counVpzWnances and state laws relating to building construction. I authorize representatives of this city or couqjyrenler the above -identified plpparty for inspection purposes. nature of Property Owner or Authorized Agent c� Q ��Print Prooerty Owner's or Authorized ADent's Name Nand Glass DATE I BY PERM17CANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFIC4TEOF OCCUPANCY/SSUED PART 61 OF TITLE 40 AND AOMD RULE TO IS NOTAPPLICABLE TO Ist�.�t+;xarxvR��