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Home My WebLink AboutX2017-2093 - Permitsq§iti1'p City of Newport Beach - Building Division €r' 'x 100 Civic Center Drive, Newport Beach, CA 92660 Address: Permit Counter Phone (949)644-3288 Address: Inspection Requests Phone (949)644-3255 e dasnxM}e `' Combination Type - SFP MECH ELEC PLUM Illltlll�ltlll lll�II�IIIC!III�IIIII e ® e Xa2 011 7 7 0 2a0°9°' v c c o � e e e9a eoo eeo oeo ceo 00 0 o A o00 o eoe 0 o�c c PERMITS EXPIRE 180 DAYS AFTER IS§UAI Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Salied Job Address: 66 SIDNEY BAY DR NB Description: SFR REMODEL 1,176 SF Legal Desc.: Owner: AMIRPOURVAHDATYAR Address: 6121 DE LA GUERRA TER BAKERSFIELD CA 93306 Phone: Applicant: JEANETTEITEALE MARK Address: 2900 BRISTOL ST BLDG A203 COSTA MESA CA 92626 Phone: 949.975-0123 Code Edit: 2016 Type of Construction: VB Occupancy Group: R31U Added/New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: N. COMB Permit: X2017-2093 Project No : 1465-2017 Issued Date: 1210712017 Inspection Area : 6 a.m. to V110 p.m. Ho work on Sundays or Holidays i Contractor: BOARDWALK CONSTRUCTION INC Architect: TEALE M �, �'' u Address: 1199 ARDEN DR Address: 2900 BRISTOL ST BLDG A203 $0.00 ENCINITAS CA 92024 Demolition Fee COSTA MESA CA 92626 Phone: 805-901-9848 Phone: 949-975-0123 State Lic:CO22162 Con State Lic 804291 Engineer: BURKE THOMAS Lic Expire: 04/3012018 Address: 312 OCEAN AVE Bus Lic BT30052303 Fair Share LAGUNA BEACH CA 92651 Lic Exp Date: 08/31/2018 Phone: 949-494-0776 State Lic:S-005088 Worker's Compensation Insurance Designer: Record Management: Carrier: STATE COMP INS FUND Address: In -lieu Housing Fee Policy No: 1730258 - $0.00 Grading PC Fee: Expire: 03/19/2018 Phone: '$0.00 Building Setbacks Rear: / Special Conditions: $0.00 Front: / $0.00 Left: $0.00 Hazardous Mat $0.00 Right: I $72.17 San Dist: 'lood Zone: X Use Zone: Parking Spaces: 0 Fire H Construction Valuation: $94.080.00 Fire Plan Rev $0.00 $0.00 Demolition Fee Building Permit Fee:. $1,031.00 Excise Tax: $0.00 Planning Department - General Service Plan Check Fee: $896.97 Additional Fee : $0.00 Plan check Fee: Overtime Plan Ck: $0.00. Grading Bonds Fee: $0.00 Fair Share Investigation Fee: $0.00 Grading PC Consultant: $0.00 SJH Trans Record Management: $38.00 Grading Permit Fee: $0.00 In -lieu Housing Fee Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department - CA Seismic Safety: '$0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Disabled Access : $0.00 PAN Plan Check : $0.00 Hazardous Mat $0.00 Electrical %: $72.17 San Dist: $0.00 Building Green Fee: $4.00 Mechanical %: $41.24 NMUSD Fee: $0.00 Plumbing %: $92.79 TOTAL FEE: $2,213.67 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: �C^ Plan Check Fee: $896.97 $0.00 $0.00 Fee Due at Permit Issuance : $1,316.70 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: Fire Department $37.50 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 Fee Due at Permit Issuance : $1,316.70 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION o e •� i •' I hereby affirm under penalty of perjury that I am exempt from the 6,,ontr4tofs'0tjte License LaIN 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`tRaNrequiree a permit 1Q,&ri.%%ct, 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). V ❑ I, as owner of the property, or my employees with wages as thea solg cofipeltVtiQn, wil►do(I all ofor 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 L* dAl not appy to an owne (af 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 SdiQ 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). 1, 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:hftp://www.leginfo.ca.gov/calaw.htmi. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penaltyoff"dury that I am licensed under provisions g�ff Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profession po a d nYlicense is in full force and effect. License Class J'S _ License No vo•1 IcL 1 Dale Z- ContractorSignatur INORKERS' COMPENSATION DECLARATION NARNING: 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 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: PI 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 IN Lairmance of the work for which this permit is issued. Policy No. - Is 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 urance carrier andpolicy number are: Carrier S�./t1 £ � J Policy Number Expiration Date 3.110 Name of Agent Phone # ❑I certify that, in the performance ofwork r which 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 that, if I should become subject the rk compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant Dat L _ II— DECLARATION RE R INGC N T I N LENDING AGENCY I hereby affirm under penalty of perjury =Vie is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Name Lender's Address By my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owns behalf. I have read this application and the information I have prov' d i correct. I agree to comply with all applicable city and cou ordin n es d state laws relating to building construction. I authorize representatives of this city or co ty a ter t ab -identified property for inspection purposes. Sionature of Pronertv Owner or Authorized Anent Print Property Owner's or Authorized Agent's Name DATE BY N RAL N'OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY }ttGULATIONS PART 61 OF TITLE 40 AND AQM D RULE NOTIFICATION TO PEHMITFINAL J/7gr I T/{SOBUROOStTIFICOAI NI Np'I'APPLICABLE TO CERTIFICATE OF _1I ( V �r'wCyV\r OCCUPANCY ISSUED