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Home My WebLink AboutX2021-0193 - PermitsCity of Newpr .tch - Building Division IIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIII II COMB Permit: X2021-0193 ' 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 1 0 1 9 3 F Project No: 0205-2021 Permit Counter Phone (949)644-3288 U - Inspection Requests Phone (949)644-3255 c'osrsav-'s`+ Combination Type - MFP ELEC MECH PLUM Issued Date : 2021 Inspection Arearea : 2 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 02/23/2024 OR PERMIT WILL BE INVALID 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: 14 STARBURST CT NB Description: MFR MASTER BATHROOM REMODEL 35 SF Legal Desc.: TR 8835 LOT 3 UNIT 23 P-23 G-23 CP -23 OF PROJECTLOCATED ON AP Owner: BRANTLEY DAVID L & OLIVIA Contractor: INVISION DESIGN & CONSTRUCTION Architect: WOLL EDWIN Address: 14 STARDUST CT Address: 7 SERENA COURT Address: 8325 VENICE BLVD .... NEWPORT BEACH, CA 92663 NEWPORT BEACH, CA 92663 LOS ANGELES, CA 90034 + Phone: Phone: 949466-0141 Phone: State Lic:C012598 .... ° oeoeoo 0o a Applicant: GOERTZEN JARED Con State Lie: 1063606 Engineer: Address: 7 SERENA CT Lie Expire: 0212812022 Address: NEWPORT BEACH, CA 92663 Bus Lie: BT30073052 mo m •° ° Phone: 949-466-0141 Lie Exp Date: 09130/2021 Phone: State Lie: ° • • o mm + m o Code Edit: 2019 Worker's Compensation Insurance Designer: ma o Type of Construction: V -B Carrier: ATEGRITY SPECIALTY Address: • • o Occupancy Group: R2 Policy No: 01 CPKP200127160 Added /New sq.ft. Bldg: 0 Expire: 12104/2021 Phone: Added /New sq. ft. Garage: 0No of Building Setbacks Rear: I Special Conditions:No of Units Front: �a�9 Q° ...... o ... Bldg Heights U Left: I i�•�." C�o 13 Bldg Sprinklers: Right: I Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $2.800.00 -- Building Permit Fee: $127.00 Excise Tax: $0.00 Planning Department- Fire Department Plan Check Fee: $110.49 Additional Fee : $0.00 Plan check Fee : $46.25 Fire Inspection: $0.00 Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share: $0.00 Fire Plan Rev $0.00 Investigation Fee: $0.00 Grading PC Consultant: $0.00 SJH Trans : $0.00 Demolition Fee Record Management: $8.00 Grading Permit Fee: $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $0.00 Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department - General Service $0.00 CA Seismic Safety: $0.00 WO.Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access : $0.00 P/W Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $8.89 San Dist: $0.00 Building Green Fee : $1.00 Mechanical %: $5.08 NMUSD Fee: $0.00 $0.00 Plumbing %: $11.43 $0.00 TOTAL FEE : $318.14 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $316.14 PROCESSED BY: c C7� PUBLIC WORKS APPROVAL: _ ZONING APPROVAL: 'v �,� PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: 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 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 U 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 im roved 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). LJ 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 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,tfl2Cl 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! ig-available upon request when this application is submitted or at the following Web site:hltp://www. leginfo.ca.gov/calaw.html. $IW&Lae of Property.9wner or Authorized Agent Date LICENSED CUNTRACTOR'S DECLARATION I Tlgreb% affirm unger penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section; 0 f Division 3 of the Business and Pro ions de d my cense is in full force and effect. License lass License No Date L Contractor Signature r f1QR}(ERS' 6QDRP4NSATION DECLARATION NARISIdG: FAILURE JO S;WRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDR TH USAND DOLLARS ($100,00D), IN ADDITION TO THE ;9F,T.W COMPENBATION, BAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. .4Evol; 'affirm under penalty of perjury one of the following declarations: tD1-ftle and v�ll rWtain 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 oelliorminnce oft h ework for which this permit is issued. Policy No. L0 and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Cade, for the performance of the work for which this permit is issued. My workers' compensatiol ce carriEraf d policy number are: )arrier Policy Number Expiration Dale flame of Agent Phone # :11 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 agre hat, if I should beco 'act to t works ' c mpens ion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. t` f Signature of Applicant (, Date ZT�/ Z )ECLARATION REG I C UCTION LEND GENCY hereby affirm under p nalty f perjury that there is a co ction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil ode). _ender's Name Lender's Address 3y my signature below, I certify to each of the following: 1 am the property owner or authorized to act on the property owner's behalf. 1 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 cou ty nter t a-identi 'ed property fo inspection purposes. 3i nature of Pro artOwner or Authorized A ent Print Property Owner's or Authorized Agent's Name(dl't iill`U' Date ZZ Z ACTION DATE BY DE LARA ION OF COM NCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY R ULATIONS PART 61 OF TITLE 40 AND AOMD RULE 3 PERMIT EXPIRED W I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED EPA PERMIT EXTENDED 0AQMD - PERMITFINAL ASBESTOSNOTIFICATIO ISNOTAP LICABLE O CERTIFICATE OF L 9,(7 R POSED'dy`'(��`'I�ITION �'N1I fI OCCUPANCY ISSUED D "` slr.N TIIRF- V \ V . .