HomeMy WebLinkAboutX2021-3147 - PermitsFwe�
City of Newport Beach - Building Division
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100 Civic Center Drive, Newport Beach, CA 92660
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Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
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Combination Type - MFP ELEC MECH PLUM
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2021-3147
x 2 0 2 1 3 1 4 7 Project No : 2722-2021
Issued Date : 11/22/2021
Inspection Area : 4
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 1112212024 OR PERMIT WILL BE INV,
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: 2 CANYON ISLAND DR NB
Description: MFR BATHROOM REMODEL & DEMO NON -LOAD BEARING WALL @ MASTER BATH, NEW BARN DOOR @ MASTER BATHROOM 100 SF
Legal Desc.: TR 8445 LOT 1 UNIT 2 B G1 2 OF PROJECT LOCATED ON AP 442.241.01
Owner: FARDE SIMA C tractor: RONALD JC ANDERSEN Architect: BDAIWI MUSTAFA
Address: 2 CANYON ISLAN I DR 12 g, / d� ress� 29 RESERVE r (reyg hg 001 PARKCENTER DR #204
NEWPORT BEAC , CA late: 3 ( `� L IRVINE CC 9960.1 If a ltlftlegANTA ANA CA 92705
Phone: 7141883-9700 Phone: 714-471-9034 Phone: r�1714-6733-6611 State Lic: C033953
Applicant: FARDE SIMA Co ate
❑ 804ew tJ 100% r I,•!.r..
Address: 2 CANYON ISLAN DR Li re 1� Address:
NEWPORT BEAC , CA 2 3 1/'
k f�fPhone: 7141883-9700 Exo /= t0 f��ofiE�• State Lin
Code Edit: 2019 Worker's Compensation Insurance Designer:
Type of Construction: V-B- PR XP
-Address:
Occupancy Group: R2,Ue' -Added /New sq.ft. Bldg: Phone:
Added /New sq. ft. Garage:E
No of Stories: 2 Building Setbacks Rear / Special Conditions: j
No of Units : 7 Front: /
Bldg Height: 0 Left: /
Bldg Sprinklers: Y �` @ Ric,Lht: / e I a%ncT)tr' g
Flood Zone: X 1 4� e o e: Y'Q A rMn Soaces: 0 �° fr l d nn ,,.r
Building Permit Fee: $3310 (grj�,started} $0.o0
Plan Check Fee: $287.97
1
Additional Fee :
$0.00
Overtime Plan Ck:
$0 0I 6
Grading Bonds Fee:
$0.00
Investigation Fee:
$Oi ON(Ae.
rading PC Consultant -
$p nn
Record Management :
$010
Grading Permit Fee:
$0.00
Energy Compliance:
$0 0
Grading PC Fee:
$0.00
CA Seismic Safety:
$0 , 0
_
_TCS insp. Fee:
0.00
Disabled Access :
$0. D-
Hazardous Mat
$0.00
Electrical %:
$23.17
Building Green Fee :
$1.00
Mechanical %:
$13.24
1
Plumbing %:
$29.79
TOTAL FEE: $738.17
PROCESSED BY:
ZONING APPROVAL:
Planning �3itrt12Mr`( started)
Plan check Fee : $52.00
Fair Share : $0.00
In -lieu Housing Fee : $9 00
Public Works DepartmiSDI . initials:
San Dist: $0.00
NMUSD Fee: $0.00
N
Fire Departmint
Fire Inspecti: n: $0.00
Fire Plan Rev l- $0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check
k ®e ® Fee : $339.97 moo Fee Due at Permit Issuance : $398.20
co 0 0` o 0 o RUBLICiWORK6 APPROVAL:
c o 0 o u u
PLAN CHECK BY:
GRADING APPROVAL: GC000 0 .o.APPROVAL TO ISSUE:
C C C G ® O
Q C C, C G 40 B O
00 000 O O 00 00 000
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 U 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
improved for the purpose of sale).
I, as owner of the props to construct the project (Sedti ess and"P'roiContractors' State License Law does not
apply to an owner of property ho 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 licensui i and I retractors' State License Law for the following reason: ^
By my signature below I ackn Iedgb'(30mreept-fer-R3"efsarra, r� idence�ir NcM-mnst have resided for at leas and y ar prior to completion of the improvements covered by this permit, I cannot Iegall
sell a structure that I have bui as an owner -build if it has not been constructed in its entiretyb licensed contractgrs, 1 r tend tt na,p9�y, he a licable law, Section 7044 of the Business and
Vyebsit ttp://wvJfpt.le�.�35/dal�w.fiW41J�/o f'�°
Professions Code, is availabl upo €n this )' lion i ubmi a or t thgg wind .
�' Date
Signature of Property Owner Aut riz t (,F`'
LICENSED CONTRALTO 'S D C ON
I hereby affirm under penalty perj at I Iicen , r_ C -1 er0Vn�r.1ffit n't3dW^ CU'�'i ii '+ f ot Fs .+ P ofessions Code, and my license is in full force
Signature
and effect. License Class icense No DaContractor
WORKERS' COMPENSAII ON DECLARATION
WARNING: FAILURE TO SECURE WO KERS' NCOEs A S NgpJ�� I9MR; }0"6 INAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGE AS PR VIDED FO SECTOF AB CO I R 7 A'fY'S ES. '
I hereby affirm under penalty o perju one of folioc1 s: (k�i,
r
Section 3700 Labor Code, for th
❑ I have and will maintain a certi sent re rkers' nsa 0, Iss-ued y e Director of Industrial Relations as provided for bX.. of the
performance of the work for w ch this permit is issued. Policy No.
❑1 have and will maintain wo- ers' 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 nu ibef ° I
'' Q
Darner o fur be xpi ti r 3Y
Na of Agent R II,, yy,,.��P,,h,��o` #'
I ce 'fy that, in the perforate ce of the work for�tl itp pftirt *d, I shall not employ any person ir1�;5i1�i?IT1�NW1k W.@9WAd subject to the workers' Pompensation laws of California, and agre
Labor Code, I forthwith those
that, if I should become subjec o t orkers' corflpensation provisions of Section 3700 of the shall comply with provisions.
l 12 2 / Zd 2 i
' re of Applicant Date l
DECLARATION REGARD N -TION I 06DIN6-AGE4"-V,.
hereby affirm under penalty oi perjury that there is a construction lending agency for the performance of the work for whic�I this ermitd dssu , (Section 3097. Civil. Code).
iii16"19.
Lender's Name Lender's Address B�
By my signature below, I certify o eac o e o owIng: .g ::.,•••
I am the proy owner or u I e y owner�s'�e a
pert
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 county to a abov -identified property for inspection purposes.
Signature of Property Owner or Authorized AgentPrint Property Owner's or Authorized Agent's Name !, ""'"" Date
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
U I SUBMITTED ASBESTOS JOTIFICATINTO
• • ••
• �
PERMIT CANCELLED
•• •• • • • •
EJEPA • °
PERMIT EXTENDED
L1AQMD
PERMIT FINAL
ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO
CERTIFICATE OF
PROPOSED DEMOLITION •
OCCUPANCY ISSUED
SIGNATURE:,)'
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