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Home My WebLink AboutX2019-2377 - Permitst City of Newport Beach - Building Division IIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIII IICOMB Permit: X2019-2377 t� 100 Civic Center Drive; Newport Beach, CA 92660 X 2 0 1 9 2 3 7 7 Project No: 1710-2019 Permit Counter Phone (949)644-3288 Inspection Requests Phone(949)644-3255 Combination Type - MFP ELEC PLUM MECH Issued Date : 0913012019 Inspection Area : 1 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: 611LIDOPARK DR NB St: 1 Ft: 3 Unit: 3-C - Description: MFR INTERIOR REMODEL 1045 SF Legal Desc.: TR 815 LOT 2 AND POR LOT 3 AN UND 1/42 INT TOGETHER WITH UNIT 6F AND Owner: BRICK LISE Contractor: RANCHO LAGUNA BUILDERS - Architect:. SMITH BRADFORD 'Address: 611 LIDO PARK DR #6F Address: 1433 CORAL DR Address: 425 30TH ST #22 (Ga NEWPORT BEACH, CA 92663 LAGUNA BEACH CA 92651 NEWPORT BEACH CA 92663 Phone: Phone: 949.422.0982 Phone:. 949.631.3682 State Lie:C014146 Applicant: SMITH BRADFORD Con State Lie: 687520 Engineer: Address: 425 30TH ST #22 Lie Expire:. 04/30/2020Address: NEWPORT BEACH CA 92663 Bus Lie: BT30056781 � f VR Phone 949-631-3682 Lie Exp Date: 03/31/2020 /t°°yy State Lic Code Edit : 2016 Worker's Compensation Insurance Design _rR11 'r Type of Construction I -A -SPR Carrier: W/C EXEMPT Address: .%�/ p� Occupancy. Group: R21IJ Policy No: (NO EMPLOYEES) ,®- � ry®Ip� Added /New sq.ft Bldg:. 0 Expire: hone: l7 Added /New sq. ft. Garage: 0 1t�y'' /q/:J No of Stories: - 0 Building Setbacks Rear: I SpeciiafASn �yl-QUEFACTION AREA No of Units . 41 Front: I (;rfll�p+® Bldg Height: 0 Left: I �N Bldg Sprinklers: Y - Right: / Finod 7nne: X Hee 7nne: Parkina Snaces0 Fire Hazard 7nne : N Building Permit Fee: $1,001.00 TOTAL FEE $2,130.07 PROCESSED BY: - ZONING APPROVAL: `GRADING APPROVAL: Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: $0.00 Plan Check Fee: $870.87 Overtime Plan Ck: $0.00 $0.00 Investigation Fee: $0.00 $0.00 Record Management: $14.00 .Energy Compliance:. $0.00 $0.00 CA Seismic Safety:. $0.00 $0.00 Disabled Access `. $0.00 - Hazardous Mat $0.00 $70.07 Building Green Fee : $4.00 TOTAL FEE $2,130.07 PROCESSED BY: - ZONING APPROVAL: `GRADING APPROVAL: Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: $0.00 Planning Department- $0.00 Plan check Fee: $0.00 $0.00 Fair Share $0.00 $0.00 SJH Trans $0.00 In -lieu Housing Fee: $0.00 $0.00 Public Works Department - $0.00 Park Dedication : -$0.00 - PAN Plan Check: $0.00 $70.07 San Dist: $0.00 $40.04 NMUSD Fee: $0.00 $90.09 Plan Check Fee $0.00 II $0.00 $2,130.07 Fee Due at Permit Issuance: $0.00 B9 • ®4 f LIALIC`WIOhK% APPPOVAL� PLAN CHECK BY: / y E' �ARPROVXL TO IGSW G 4 4 �• i Y G aoo 4G ac e W coo® oo� 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 II $0.00 $2,130.07 Fee Due at Permit Issuance: $0.00 B9 • ®4 f LIALIC`WIOhK% APPPOVAL� PLAN CHECK BY: / y E' �ARPROVXL TO IGSW G 4 4 �• i Y G aoo 4G ac e W coo® oo� 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) >..4.. (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). - ❑ 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 legall 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/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby.affirm under penalty of perjury that am licensed under provisions of Chapter 9 (commencing with Section 0 f�y Ision 3 of the Business and Pr e s Co nd c nse is in full force and effect. License Class License No Date r'2C Contractor Signatu WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 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. I hereby affirm under penalty of perjury one of the following declarations: 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 performance of the work for which this permit is issued. Policy No. I have 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' compensatio insurance carrier and policy number are: Carrier - Policy Number Expiration Date Name of Agent Phone # I certify that, in the perfor nce of Ip fm i h this ermit is Issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre tha , if I should become subi t to the works o a 6provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 9 9 Signature of Applicant DECLARATION REGA DI G STRUCT ON LENDING AGENCY I hereby affirm under penalty of perjury that there is 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 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 countyto enter the above -identified property for inspection purposes. ntt/ i� / Signature of Pro erty Owner or Authorized A ent Print Property Owners or Authorized Agent's Na Lj ��--U-CA 0- AWX! r�— C ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE - 1403 •• . • . •• + PERMIT EXPIRED I SUBMITTED At BESTO1 N TI 1CATIONfg .• PERMITCANCELLED EPA• + •- + PERMITEXTENDED OAQM6 PERMITFINALA38ESTOS OTIFIC �j OTA CABLE TO CERTIFICATEOF —7-22</l Q/:..�. PR POSE DE 1 TI N••�: r ••• OCCUPANCYISSUED SIGNA7UR . pp-�S c> C Ute`-' = Cn Sammic-ca oa Z c U c 4 CU mai c,. u, to o C) oQ �C•V 0 LL 0LI a u 'c nca c a) (D C 0. 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