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HomeMy WebLinkAboutX2021-1701 - Permitsy Prtweiu� City of Newport Beach - Building 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - BLDG PLUM Division II�IX0II�II0�I�I� II XZO2_� -101 �_O 2 TgSWI j tyle AVC COMB Permit: X2021-1701 Project No : 1486-2021 Issued Date: 0710112021 Inspection Area : 6 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0710112024 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: 502 JASMINE AVE NB Description: MFR (3) INTERIOR FIRE PLACES Legal Desc.: PM 282-18 PAR. 1 OF PROJECT 938-01 LOCATED ON AP 459-193-25 TOGETHER Owner: CHURCH OF SOUTH LAS VEGAS Address: 3051 W. HORIZON RIDGE PKWY Record Management: HENDERSON, NV 89052 Phone: 702-361-1579 Applicant: PEREZ WENDY Address: 502 JASMINE AVE Lic Exp Date: NEWPORT BEACH, CA 92625 Phone: 702-374-5454 Code Edit: 2019 Type of Construction: V -B Occupancy Group: R31U Added /New sq.ft. Bldg: Added /New sq. ft. Garage: No of Stories: 0 No of Units : 2 Bldg Height: 0 Bldg Sprinklers: Construction Valuation: $14.000.00 Building Permit Fee: $314.00 Plan Check Fee: $273.18 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: $1,052.44 PROCESSED BY: ZONING APPROVAL: Contractor: O W NER/BLDR Address: PEREZ WENDY FOR OWNER Phone: 702-374-5454 Con State Lic: O/B Lic Expire: $0.00 Bus Lic: Park Dedication : Lic Exp Date: P/W Plan Check: Worker's Compensation Insurance Carrier: Policy No: Expire: Building Setbacks Use Zone: 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: / Left: / Right: I Parkina Soaces $0.00 $0.00 $0.00 $0.00 $237.00 $199.00 $0.00 $0.00 $0.00 $28.26 Plan Check Fee Architect: Address: Phone: Engineer: Address: State Lic: Phone: State Lic: ®� Designer: BADIYI BAHRAM` Address: 2785 E FOOTHILL BLVD STE 120A ��`°" PASADENA CA 91107 Phone: O\'e a Special Conditions: high density form on plans u, M 7- - W1 Planning Department - Fire Department Plan check Fee: $0.00 Fair Share: 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 $468.18 Fee Due at Permit Issuance : $564.26 cm ® o o a o " PUBLI(- WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: n c�a_o c.. _ r u , <' APPT2[)WLOTO ISSUE: 0 o c o goo occ. c oo� �° oar Fire Department LIDA $0.00 Fire Inspection: $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 $468.18 Fee Due at Permit Issuance : $564.26 cm ® o o a o " PUBLI(- WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: n c�a_o c.. _ r u , <' APPT2[)WLOTO ISSUE: 0 o c o goo occ. c oo� �° oar 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 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 applicant 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 U 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). Ibyltoructure 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 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). exempt from licensure under the Contractors' State License Law for the following reason: gnature 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 legal], that I have built as an owner -builder if it ha 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 t is ication is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.htmi. ;ignature of Property Owner or Authorized Agent Datliy%/-�'� .ICENSED CONTRACTOR'S DEC LARATIO ��� hereby affirm under penalty of perjury that I am lice ed unr provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force nd effect. License Class icense No Date Contractor Signature VORKERS' COMPENSATION DECLARATION IARNING: 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 ($100,000(, IN ADDITION TO THE OST 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: 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 erformance 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' compensatioi Isurance carrier and policy number are: Policy Number of Agent Date Ify that, in the perform ce 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 )ire should become sub' the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ' �� of Applicant Da CLARATION REGA G CONSTRUCTION LENDING AGENCY areby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Ider's Name Lender's Address 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 o Inances and state laws relating to building construction. I authorize representatives of this city or county toJd' epl t�e ab -Identified property for inspection purposes. �� nature of Prooertv Owner or Authorized Aaent 1a/ / X _._ Print Property Owner's or Authorized Agent's Name _ ACTION DATE BY I DECMATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION •I0.' � PERMITCANCELLED UEPA PERMITEXTENDED CMD PERMITFINAL * p ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF 7x4-24 .L�Q..Lj PROPOSED DEMOLITION �� • • • • • • • e OCCUPANCYISSUED SIGNATURE: Date !•1 '(V rn E- m z 00 u� o rn C: U o N M W m V Az 0m FD nv rAz o Q m � woo F >-c U o '> U U 0 0 ' -2.9 L d d C N O) d T a {°0 .s..L... 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