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Home My WebLink AboutX2019-3213 - PermitsCity of Newport Beach - Building Division �11111111111p1111111111�11111p111111111111p1111Jill t. 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 3 2 1 3 Permit Counter Phone (949)644-3288 u Inspection Requests Phone (949)644-3255 Combination Type - SFP ELEC MECH PLUM COMB Permit: X2019-3213 Project No : 2220-2019 Issued Date : 1012212019 Inspection Area : 4 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. 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: 26 HERMITAGE LN INS Description: SFR -REMODEL BEDROOMS 779 SF, WINDOW DOOR ALT Legal Desc.: N TR 7223 LOT 109 Owner: YI CHIN Contractor: Address: 26 HERMITAGE LN Address: NEWPORT BEACH CA 92660 Phone: 949-858-7540 Phone: Applicant: SKENDERIAN TODD Con State Lic: Address: 1100 S COAST HWY, #316 Lic Expire: LAGUNA BEACH CA 92677 Bus Lic: Phone: 949-715-5461 Lic Exp Date: Code Edit : 2016 Type of Construction: VB Occupancy Group: R3/U Added /New sq.ft. Bldg: Added /New sq. ft. Garage: No of Stories: 1 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: N Flood Zone: X Construction Building Permit Fee: $1,078.00 Plan Check Fee: $937.86 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management : $50.00 Energy Compliance: $66.50 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat, $0.00 Building Green Fee : $4.00 TOTAL FEE: $2,391.96 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: MICHAEL ROBERTS HOME BUILDER Architect: SKENDERIAN TODD 6 CALLE ALIMAR Address: 1100 S COAST HWY, #316 RANCHO SANTA MARG CA 92688 LAGUNA BEACH CA 92677 949-858-7540 Phone: 949-715.5461 State Lic:C030518 681116 Engineer: KHOURY NADER 09/3012021 Address: 1278 GLENNEYERE ST#201 BT30060668 LAGUNA BEACH CA 92651 09130/2020 Phone: 949-637-8367 State Lic:C-061402 Workers Compensation Insurance Carrier: BENCHMARK INS CO Policy No: CST5015128 Expire: 01/24/2020 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: I Front: I Left: / Right: I 'arkino Soaces $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $75.46 $43.12 $97.02 Plan Check Fee Designer: Address: Phone: Special Conditions: 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 $40.00 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 $977.86 Fee Due at Permit Issuance : $1,414.10 PUALIC;'VGRK£ AP?ROVAL: PLAN CHECK BY: - APPRQ,VA.L ))0 .SSIJE: 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 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 (_) 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-Builderwill have the burden of proving that it was not built or i5im 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). ❑ 1 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://w .leginfo.ca.gov/calaw.htmi. 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 70 0) o Division 3 of the Business and Pr es ' c ns Code, an y 'ce is in full force and effect. License Class License No Dat Contractor Signatur - WORKERS' COMPENSATION DECLARATION ✓DARNING: 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 1$100,0001, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: 111 have 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 the pe/ormance of the work for which this permit is issued. Policy No. have and wil Intain 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' rance carrier d olicv numbw'are: 1) — In of Agent iv certify that, in the performance of the work for which , if I should become subject to the wor.Kefs' cpmpen: of Number Date 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 I provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ILO��i 4 CLARATION REGFrYRDHVG CONSTRUCTION LENDING AGENCY Dreby 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 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 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 and state laws relating to building construction. I authorize representatives of this city or county Jo iynter a Ebo tiff property for inspection purposes. ` , nature of Prooertv Owner or Authorized ADent Print Prooertv Owner's or Authorized Aoent's NamAY wi G ACTION DATE BY RDECLARATION I EGULATIONS OF COM O TNTCE E WITH CODE OF EDLERAL I FOR OFFICE USE ONLY PERMIT EXPIRED II I SUBMITTED i,SBESTGS NOTIFICd NON TO PERMITCANCELLED LJEPA i PERMIT EXTENDED L3AQMD PERMITFINAL b4ASBEST4 NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF 'q� ` PR O)D EMOLV.GC OCCUPANCY ISSUED I� -I / SIGNAT 1 Civil Code).