HomeMy WebLinkAboutX2022-0270 - Permits�H'rO,V,
City of Newport Beach - Building Division
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100 Civic Center Drive, Newport Beach, CA 92660
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Permit Counter Phone (949)644-3288
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Inspection Requests Phone (949)644-3255
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Combination Type - SFP ELEC MECH PLUM
F 11fl � Il� 111111p1111111111111p111 COMB Permit: X2022-0270
x Rob 7 e AA ee AA rr Project No : 0239-2022
�� ° V®/SF Inspection Area : 5 o2z
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PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS 1
Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from I
Job Address: 2900 OCEAN BLVD NB
Description: SFR INTERIOR REMODEL 2252 SF & ADD 52 SF TO GROUND FLOOR
Legal Desc.: RESUB OF CORONA DEL MAR BLK 35 LOT 7 AND BLK 35 LOT 8
Owner: NIEDRINGHAUS DANIEL Contractor: CUSTOM BUILDERS & DESIGN
Address: 2900 OCEAN BLVD Address: 22605 LA PALMA AVENUE #512
CORONA DEL MAR, CA 92625 YORBA LINDA CA
Phone: Phone: 7141692-8598
Applicant:
THORNTON ROBERT A
Address:
P.O. BOX 1512
NEWPORT BEACH CA 92559
Phone:
949-650-9876
Code Edit : 2019
Type of Construction:
Occupancy Group: R3/1.1
Added /New sq.ft. Bldg: 52
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units : 1
Bldg Height: 0
Bldg Sprinklers:
Construction
Building Permit Fee: $4,353.00
Plan Check Fee: $3,701.79
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management :
$52.00
Energy Compliance:
$303.00
CA Seismic Safety :
$65.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$20.00
TOTAL FEE: $10,429.39
PROCESSED BY:
ZONING APPROVAL:
M
Con State Lic:
409392
Lic Expire:
07/31/2023
Bus Lic:
ST30078781
Lic Exp Date:
05/31/2023
Worker's Compensation Insurance
Carrier: STATE COMP FUND
Policy No: 9023594
Expire: 10/01/2022
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: / d
Front: IUI
Left: / rl
Right: /
'arking Space
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$304.71
$174.12
$391.77
0
3Y OR PERMIT WILL BE INVALID
No work on Sundays or Holidays
Architect: THORNTON ROBERT A
Address: P.O. BOX 1512
NEWPORT BEACH CA 92659
Phone:
949-650-9876 State Uc:CO24186
Engineer:
BLACK IAN
Address:
19401 OLANA LANE
HUNTINGTON BEACH CA 92646
Phone:
714-593-4125 State Lic:S-005505
Designer:
Address:
Phone
Special Conditions: KEVIN RAY TO
HAUL DEBRIS
Fire Hazard Zone : N INSPECT "t"
Planning Department -
Plan check Fee
Fair Share :
SJH Trans :
In -lieu Housing Fee:
Public Works Department -
Park Dedication :
$0.00
P/W Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Fire Department
$208.00
Fire Inspection:
$0.00
$0.00
Fire Plan Rev
$0.00
$0.00
Demolition Fee
$0.00
Building Dept Adm
$27.00
General Service
$265.00
Refund Deposit
$564.00
Grading Bond:
$0.00
$0.00
$0.00
Plan Check Fee : $4,212.79 Fee Due at Permit Issuance : $6,216.60
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 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 tolls 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 L) all of or L) 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).
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).
❑ I am exempt from licensure 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://www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 091 ofp (vision 3 of the Business and Professjon de n y license is in full force
and effect. License Class License No Date try 2x Contractor Signature +�/
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE 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
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
Ill and will 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 thl
rmance of the work for which this permit is issued. Policy No.
� I ave 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' compensatior
I
carrier and policy number are:
;arrierx4a+'AA,- Coo_,P Policy Number �l D t3 . °� III"( Expiration Date
Jame of Agent Phone #
:1I certify that, in the performance of the work forwhich 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 agree
hat, if I should become subject to e (w�ork.P(,s/G compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
3ignatureof Applicant & �tyl ^'�` Dat�,
)ECLARATION 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
3y 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 county ordinances a state laws relating to building construction.
I authorize representatives of this city or county to en th abo - entified property for inspection purposes.
Signature of Property Owner or Authorized Agen Print Property Owner's or Authorized A ent's Nam �� Date S- i'1'2'Z
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERMIT EXPIRED
PERMIT CANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCYISSUED
I SUBMITTED ASBESTOS NOT]FICATIOIJ TO
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:3_1 -Z3 P4 AQASBESTOS NOTIFICATION
� PROPOSED DEIVICILLITN�/1
SIGNATURE: 6 /✓L
APPLICABLE TO
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