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Home My WebLink AboutX2021-2441 - Permitsl" tag City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - SFPELECMECHPLUM ��traix 111111111111111111111111111111111 111111111 COMB Permit: X2021-2441 X 2 0 2 1 2 4 4 1 Project No : Issued Date: 09/13/2021 Inspection Area : 5 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUS-T-BE COMPL�ED BY 0911312024 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 6:0 p.m. No work on Sundays or Holidays Job Address: 220 NARCISSUS AVE NS Description: SFR INTERIOR ALTERATION OF BASEMENT BATHROOM (CITY STANDARD) AND LAUNDRY ROOM 100 SF ; - Legal Desc.: Owner: DAHLIA DEL MAR LLC Contractor: SIEMONSMA CONST Architect: _-.....� Address: 220 NARCISSUS AV - Address: 1048 IRVINE AVE #430 CDM CA 92625 Phone: " -done 949 722-0628 Phone: i State Lie: If r'l pjICap02: Applicant: Address: SIEMONSMA DAVID 1048 IRVINE AV STE 430 ._. - - e ------ 07/31/2022 Enginedr.. Ar}d Sto o/f Or ❑ 100% rr(el�funle�cNEWPORT Phone: 9 9-4222 06 BEACH CA 92660 Lie LieSEzp Date' �' 03Y3112022 6 `,n""t.- ,�`: � , Phone: TI�t9teli ... r.nn�STR11C Code Edit . 2019 Type of Construction: V-B Occupancy Group: R3/U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 3 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: N Flood Zone: X $12 000.00 Building Permit Fee: $280.00 Plan Check Fee: $243.60 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management : $0.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access: $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $632.60 PROCESSED BY: ZONING APPROVAL: iii�uien�e. "�''tiT� ]a., QRj{)'tJ'SEldff]NSAAPrHA'VItT - Carrier w, V EXEMPT ddress: 1048 IRVINE AV STE 430 * Policy No NO EMPLOYEES NEWPORT BEACH CA9: { Expire Phone: p p � ' S d 91 ME Zone: A -,y 1 it f '� ' In I Right: I r �ng Bonds Fe : i�_0/�9qqQ Grading PCI KnEitartS0:0® Grading Permit Fee: $0.00 PC Fee: $0.00 �G�r�qading N dt,0:l nsp. Fee C�1y� Electrical %: Plan Check Fee : 0 Fire Hazard Zone : N .......... m� arr ,er0'kni� $ �-- g3 ° �'�,'FF! oapartment ]an cheee Fair Share: s 10 Wolin �Ot`t��" r'on: ire Plan Rev SJH Trans : \ $0.00 Demolition Fee In -lieu Housing Fee : $0.00 Building Dept Public Works Department. mw� PNV Plan Check: $0.00_I?;^P. init-WJiAwn $0.00 Fee Due at Permit Issuance PJBLC'.VCRKS .APPROVAL: PLAN CHECK BY: GRADING APPROVAL: , AFPROVA-L TO ISSUE: M.i S I $0.00 $0.00 $0.00 $0.00 $o.00 $0.00 $0.00 $0.00 $632.60 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 g (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 ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale). J I, as owner of the property, am exclusively contracting with licensed Cootractw�construcF•iMe=prej�"EfSti'70�4, Business and Professions Code: The I pply to an owner of property v#,kQ baAlds ocimproves thereorr," aridwFid contracts for the projects with a licensed Contractor pursuant tq the Contractors' State Lic( 1 am exempt from licensur under the Contracts�'^'^"^^ —' =' "-'le following reason: ,f RppllCabie: ly my signature below I ackno ledge, that, except fr _ .., „a,,.:,co., or at least one year prior to completion of the provggr ell a structure that I have built s an lowner-bull ' ' s no een constructed in its entirety by licensed contractors.-� ¢tar�yhrlr!$iifal 'rofessions Code, is available on request when this application is submitted or a,),�he fo!<,by{ng Weirs_ire;Etjtp://wwvid� f�.d�?gBLlc .h'tmml. r� lignature of Property Owner or utho,rized Agent °'� ` .ICENSED CONTRACTOR DECLARATION y, hereby affirm under penalty of erlurthat am Ora^�=^' y,.,,,PHier a (commencing with Sectig0) DI1 a usiness and P,rP�f�e� nd effect. License Class License No ' - Dat��Kt\ Contractor Signatu�"S 1/ORKERS' IC ENSATI N D -CARATfON IARNING: FAILURE TO SECURE WOR FIT COMPENSATION COVERAGE tS UNLAWF4 ,, AND SHALL SUBJECT AN EWPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED T OST OF COMPENSATION, DAMAGES PRO�dDED'ra:,°rIW�$ECTIOVi706UF THE LABOR CODF WTFPCCT PFFs hereby affirm under penalty of rjuryytJn1q o?r I have and will maintain a rlific4te nt to elf Boa. for,_Woakers' compensation- Issued by the Director of Industrial Relations as provided for by erformance of the work for whit this ad. F o icy No It have and will maintain work s' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of t e work r whit this pe Isurance carrier and policy P Y num r are: e of Agent .� m N. 2 b+ti n 8 -••vj �"/' r' pyhr}g I ify that, in the pertormanc of the or fo hi hXthis per jrl shall not employ any person in arryhmlrtl 'abecome bject to the workers' I sat, if should become / t to he ers' mpk r motion 3700 of the Labor Code, I shall forthwith comply with those provisions. li ure of Applican )ECLARATION REGA*51NG CLorein ON LENDING AGENCY hereby affirm under penalty ofer c Ion an ing agency for the performance of the work for which th-pArpit .ender's Name Lender's Address 3y my signature below, I certify following I am the property owner or auct on t R,vepD€ vided iI have read this application ation I have provided is correct. I agree to comply with all applicable city and Co ordinances and Ste laws relating to building construction. I authorize representatives of this city or co to r the ova-ide I "ed property for inspection purposes. signature of Property Owner or Authorized Ag t Print Property Owner's or Authorized Agl ACTION DATE BY LARATION OF COMPLIANCE WI CODE OF FEDERAL FOR OFFICE USE ONLY GULATIONS PART 61 OF TITLE 40 AND AQMD RULE I SUBMITTED ASBES", OS NOTIF-CATIONITO PERMIT EXTENDED PERMITFINAL n/J CERTIFICATE OF je OCCUPANCYISSUED TO .c l Date State License Law does not !d by this permit, I cannot 7044 of the Business and ($100,000), IN ADDITION TO THE 3700 of the Labor Code, for is issued. My workers' laws of California, and