HomeMy WebLinkAboutX2020-2800 - Permitsw City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
'`U.. Inspection Requests Phone (949)644-3255
Combination Type - SFP MECH ELEC PLUM
IIII0II�IIII�I�I�IIIIII�III0III1 II
COMB Permit: X2020-2800
Project No : 2212-2020
Issued Date: 12101/2020
Inspection Area : 4
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INS C M &OWP T B 2023 OR PERMIT WILL BE INV/
Construction Hours: Monday -Friday 7:00 a.m. to 6:30 p. I . , rk on Sundays or Holidays
Job Adress: 440
SUERTE NEI
Description: SFR AILT(KITCHEN, (2) BATHROOMS) 265 SF *STOP WORK* 120-3487 MECHANICAL COMPONENTS
Legal Desc.: N TR 7148 LOT 33
Owner: STEFFENS HEATHER 8: NATE Contractor: OWNERIBLDR Architect: BAILEY DAVID
Address: 440 VISTA SUERTE Address: HEATHER STEFFENS - Address: 23183_ LA CADENADR#101
NEWPORT BEACH, CA 92660 LAGUNA HILLS CA 92653
Phone: 949-751-8176 Phone: 949-751-8176 Phone: 949-573.1050 State Lic:CO27404
Applicant:. BAILEY DAVID
Address: 23183 LA CADENA OR #101
LAGUNA HILLS CA 92653
Phone: 949.573-1050
Code Edit : 2019
Type of Construction: V -B
Occupancy Group: R31U
Added /New sq.ft. Bldg: 0
A(Tded /New sq. ft. Garage: 0
No of Stories: 1
No of Units.: 1
Bldg Height: 0
Bldg Sprinklers:
Flood Zone: X
Building Permit Fee: $484.00
Plan Check Fee: $421.08
Overtime Plan Ck:
$0.00
Investigation Fee:
$484.00
Record Management:
$12.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Ma)
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $1,545.13
PROCESSED BY:
ZONING APPROVAL:
Con State Lie: OIB
Lie Expire:
Bus Lie:
Lie Exp Date:
Worker's Compensation Insurance
Carrier:
Policy No:
Expire:
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: I
Right: I
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$33.88
$19.36
$43.56
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
Special Conditions:
Planning Department -
Fire Department
Plan check Fee:
$46.25
Fair Share
$0.00
SJH Trans
Fire Plan Rev
In -lieu Housing Fee
$0.00
Public Works Department -
Park Dedication :
$0.00
P/W Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
State Lie:
Plan Check Fee: $408.17 Fee Due at Permit Issuance : $1,136.96
PUGUC WORKS APPROVAL:
u c
PLAN CHECK BY:
GRADING APPROVAL: - _ APPtROVAL TO ISSUE:
a c
I
Fire Department
$46.25
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: $408.17 Fee Due at Permit Issuance : $1,136.96
PUGUC WORKS APPROVAL:
u c
PLAN CHECK BY:
GRADING APPROVAL: - _ APPtROVAL TO ISSUE:
a c
I
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 Divisiov 311f 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 L) 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
vements 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
im roiled for the purpose of sale). -
B owner of the property, am exclusively contracting with licensed Contractors toconstructthe project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
y 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).
U I am exempt from licensure under the Contractors' State License Law for the following reason:
By my signature below I acknowledge that, except for my person rest nce in which I must have resided for at least one year prior to completion of the improvements covered by thjs p� mit, I cannot legall)
sell a structure that I have built as an owner -builder if 't has n t an co structed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 o usiness and
Professions Code, is available upon request wh t appl' aE is sub ed or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Da
LICENSED CONTRACTOR'S DECLARATi
I hereby affirm under penalty of perjury that I am I ansa r isio f Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, a m Ice a in full force
and effect. License Class License No Date Contractor Signature
WORKERS' COMPENSATION DECLARATION
NANNING: 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 (5100,000), 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:
ZI 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
3erformance of the work for which this permit is issued. Policy No.
:3I 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' compensatiol
nsurance carrier and policy number are:
barrier Policy Number Expiration Dale
�Btciei
of Agent Phone #
ntity that, in the performance t work f r whi his 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 agre
I should become sub' ct to e o ars' ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. O 1
>ignature of Applicant DgT Zl
DECLARATION REGA O TRUCT BLENDING AGENCY
hereby affirm under p natty o p II t h re 's a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
-ender's Name Lender's Address
3y my signature below, I certify to each of thefollo ing:
I am the property owner or authorized to lc n the property owners behalf.
I have read this application and the information I have provi d is orrect.
1 agree to comply with all applicable city and count ordi s and state ws relating to building construction.
I authorize representatives of this city or cou t ante th ab a -i a Ified property for inspection purposes.
signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Nam a. vt D Iz
ACTION DATE BY D C I CO PLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
TIONS P T6 OF TITLE 40 AND ACMD RULE
PERMIT EXTENDED I I LJAq p -
PERMITFINALJ�-L� TOS NOTIFIC 10 1rT16CABLE TO
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