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HomeMy WebLinkAboutX2019-2931 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit: X2019-2931 a' 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 2 9 3 1 h s� Permit Counter Phone (949)644-3288 Project NO :2062-2019 Inspection Requests Phone (949)644-3255 Combination Type - SFP. ELEC MECH PLUM Issued Date : 09/16/2019. Inspection Area : 6 PERMITS EXP/RE 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: 21 HARCOURT NB - - Description: SFR CONVERT FAMILY ROOM TO 5TH BEDROOM & BATHROOM (216 SF) Legal Desc.d Owner: SUCHARD. TALMOR & ANNA Contractor: [RAJ PARSA Architect: INSPECTOR Address: 21 HARCOURT Address:24602 SELVA ROAD A Address: - NEWPORT COAST CA 92657 DANA POINT, CA 92629 Phone: Applicant: HORZAD KATRIN Address: .24602 SELVA ROAD A DANA POINT, CA 92629 Phone: 949.202-8223 Code Edit : 2016 Type of Construction: VB Occupancy Group:. R3IU 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: Construction Valuation: $17 Building Permit Feer $360.00 Plan Check Fee: $313.20 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $8.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $794.20 PROCESSED BY:. ZONING APPROVAL: V GRADING APPROVAL: Phone: 949-202-8223 Con State Lie: 1018274 Lic Expire: 09130/2020 Bus Lic: BT30067783 Lic Exp Date: 06/3012020 Worker's Compensation Insurance Carrier: EXEMPT Policy No: o©o°° Expire: Phone: Building Setbacks Rear: / Refund Deposit Front: I Left: I 000c,` Right: Use Zone: Parkina Soaces: 0 Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant: Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $25.20 $14.40 $32.40 Plan Check Fee Phone: State Lic: . Plan check Fee:. $40.00 Engineer: $0.00 - Fire Plan Rev Address: $0.00 0 om°® Park Dedication : $0.00 PiW Plan Check : o©o°° San Dist: Phone: State Lic: $0.00 Refund Deposit $0.00 o °p o m 000c,` Designer: HORZAD KATRIN o °p.O. ° Address: 24602 SELVA ROAD A m DANA POINT, CA 92629 Phone: oo©°o ° Special Conditions: IRSD- 4-5 BEDROOMS LATERALNOtT� CHANGING °° n �Oi�riA�iir L(.t'Ix�7wV ooc,�o, ccco°o u , Fire Hazard Zone : N o o ° Planning Department- Fire Department . Plan check Fee:. $40.00 Fair Share: $0.00 SJH Trans : Fire Plan Rev In -lieu Housing Fee: $0.00 Public Works Department - Park Dedication : $0.00 PiW Plan Check : $0.00 San Dist: $0.00 NMUSD Fee: $0.00 $0.00 Fee Due at PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: Issuance: $794.20 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 $0.00 Fee Due at PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: Issuance: $794.20 i• OWNER -BUILDER DECLARATION. I hereby affirm under penalty of perjury that I am exempt from the Contractors' Stale License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) lection 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 is 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 'rofessions 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 applcant to a civil penalty of of more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or nproved for the purpose of sale). 1 I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not pply to an owner of property who. builds, or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). 7 I am exempt from licensure under the Contractors' State License Law for the following reason: ly my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall, ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. signature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION. j hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and rofes$i5 s o , an lice a is in full force nd effect,'License Class License No Q/sYe` Contractor Si ure ' VQRKERAI' OPPENSATION DECLARATION ARNING: FAILURE Te SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS 100, 00 N 0 (TION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION OTOS OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 1%4eby affirm -under penalty of perjury one of the following declarations: 21 have a ir16wAI*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 th eFformance of the work for which this permit is issued. Policy No. q• .••• JI have arid Nilj pfaintain 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' compensatio Isurence carrier and policy number are: :arrier • Policy Number Expiration Date '�a„rAnn.b.••• _ Phone# the work f which is 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 'min rk rornsQf Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /4 I l i �re l l ('� hereby affirm under penalty of perjury that there is a constructionianding agency for the performance of the work for which this permit is issued (Sectior(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 th property o sea behalf. I have read this application and the information v provid is corre t. I agree to comply with all applicable city and u roan nd-st awe -w ' to building construction. I authorize representatives of this city or cou ty 'n - o arty f inspection purposes. 's �� �✓ 3i nature of Property 0 nerorAuthori7Wgen Print Property Owner's or Authorized A e Name e ACTION DATE Y DECLAR TI OF COMPLIANCE TH CODE OF FEDERAL FOR OFFICE USE ONLY RE ULANS PART 610E TITLE 40 AND ACIMD RULE 1403 PERMITEXPIRED L1 I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED OEPA PERMIT EXTENDED MD PERMITFINAL' A ES 9; TI IC ION NOT PLICABLE TO CERTIFICATE OF /!�jpnc OSEDD OCCUPANCYISSUED URE: A