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Home My WebLink AboutX2019-4013 - PermitsLr, City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit. X2019-4013 100 Civicis Center Drive, Newport Beach, CA 92660 . Permit Counter Phone (949)644-3288 Project No: 2759-2019 5r Inspection Requests Phone (949)644-3255 Combination Type - MFP MECH ELEC PLUM Issued Date : 01/02/2020 Inspection Area : 6 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Construction Hours: Monday - Friday 7:00 a. In. 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: 17 AUVERGNE NB Description: MFR MASTER BATH REMODEL 63 SF Legal Desc.: Owner: Address: CONN SONJA 17 AUVERGNE Contractor: REBORN CABINETS Architect: $0.00 NEWPORT BEACH, CA 92657 Address: 5515 E LA PALMA AVE Address: Phone: 949-933-0911 CA Seismic Safety: ANAHEIM CA 92806 Disabled Access : $0.00 Hazardous Mat Phone: 714-507-1694 Phone: Applicant: Address: BATIOFF LUBA 5515 E LA PALMA AVE Con State Lie: 443682 Engineer: ANAHEIM, CA 92806 Lie Expire: Bus Lie: 08/31/2021 BT30066303 Address: Phone: 714.507-1694 Lie Exp Date: 03/31/2020 Phone: Code Edit: 2016 Type of Construction: V -B Occupancy Group: R2IU Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 6 Bldg Height: 0 Bldg Sprinklers: N Building Permit Fee: $232.00 Plan Check Fee: $201.84 $40.00 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: $521.24 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Worker's Compensation Insurance Carrier: BERKSHIRE HATHAWAY Policy No: REWCO20156 Expire: 11/30/2020 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: / Front: I Left: / Right: I $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $16.24 $9.28 $20.88 Designer: Address: Phone: State Lie TAWADROUS SARAH 1074 VIA ROMALES SAN DIMAS CA 91773 State Lic:C-085212 Special Conditions: 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 PAN Plan Check : $0.00 San Dist: $0.00 NMUSD Fee: $0.00 $0.00 $0.00 Plan Check Fee : $241.84 Fee Due at Permit Issuance : $279.40 e-• D DY• YDP O ° v m • =�, m PLIkil2 WORKS APPROVAL: o « o m m m PLAN CHECK BY: •AVROVAL TO ISSUE: E O i• ® f ,.4G Fli OC m • 0196 V^ua 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 Plan Check Fee : $241.84 Fee Due at Permit Issuance : $279.40 e-• D DY• YDP O ° v m • =�, m PLIkil2 WORKS APPROVAL: o « o m m m PLAN CHECK BY: •AVROVAL TO ISSUE: E O i• ® f ,.4G Fli OC m • 0196 V^ua 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 items) (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 (_) 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). ❑ 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: e year prior to completion of the improvements covered by this permit, —1cannot legally By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least on 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/caiaw.htmi. Date Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0 of Division 3 of the Business and Prof ssio s CodC, and icen : is II I orce License No Date l a.— Contractor Signature and effect. License Class / 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 ($700,0001, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: El I 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 th pert rmance of the work for which this permit is issued. Policy No. have and will plain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work far which this permit is issued. My workers' compensatioi surance carrier a p Icy number ain.% re f Expiration Date ame of Agent �I certify that, in the performance of the work for 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 ogre Tal, if I should-bec e s ject to the workers' compensati n pro 's' ns of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ^� Dat _ DL d� ignature Of Applicant DECLARATION RE RD NG CONSTRUCTION LENDING AGENC _ hereby affirm under penalty of perjury that there is a construction lending agency fo Lendeer's Address of the work for which this permit is issued (Section 3097, Civil Code). ender's Name y 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 coup t nter a ab ve-'den 'tied r perty for inspection purposes. ignature of Property Owner or Authorized A ant Print PropertyOwner's or Authorized Agent's Nam 4CTION DATE BY DECLARATION OF COMPLIANC H CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 • ••• ••• PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICWIGIN TQ •• s • • • • • • • • •e PERMIT CANCELLED EPA • s PERMIT EXTENDED QMD PERMITFINAL ESTOS NOTIFICATION 15 NOT APPLICABLE TO CERTIFICATE OF POS D OUTI N • `• • ' ° ° OCCUPANCY ISSUED SIGNAT A