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Home My WebLink AboutX2022-1634 - Permits (2),, City of Newport Beach - Building Division `X2022-1634` COMB Permit: X2022-1634 ' 7, 100 Civic Center Drive, Newport Beach, CA 92660 PfOJ2Ct No : 1491-2022 r» �, Permit Counter Phone (949)644-3288 4 ar Inspection Requests Phone (949)644-3255 r:a�rx��y �tx Combination Type - BLDG GRAD Issued Date: 06/22/2022 Inspection Area : 4 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 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: 303 ESPERANZA NB . .... ° Description: MFR DRAINAGE & BLOCK WALLS TX 15' (INSIDE P/L)44, Legal Desc.: TR 5878 (L.L.84-214031) PAR 43 +y "„• 8y Owner: THE BLUFFS HOA Contractor: SIKORSKI CONSTRUCTION LLC Architect:<`»� . •°•� o Address: 303 ESPERANZA Address: 124 MELODY LN Address:=�i�'`•� NEWPORT BEACH, CA 92660 COSTA MESA, CA 92627 �ree�� Phone: Phone: 773-578-7963 Phone: State Lie: •° �„;,,.....• .. . Applicant: SIKORSKI DAVID Con State Lie: 1058853 Engineer: Address: 124 MELODY LN Lie Expire: 1013112023 Address: .• ...... COSTA MESA CA 92627 Bus Lie: BT30061790 Phone: 773-578-7963 Lie Ezp Date: 01/31/2023 Phone: State Lie: s. • • • • • Code Edit: 2019 Worker's Compensation Insurance Designer: • ••° oa®. Type of Construction: Carrier: EXEMPT - NO EMPLOYEES Address: Occupancy Group: U Policy No: Added /New sq.ft. Bldg: 0 Expire: Phone: Added /New sq. ft. Garage: 0 No of Stories: 0 Building Setbacks Rear: / Special Conditions: HOA APPROVAL ATT No of Units, 0 Front: / TO PLANS Bldg Height: 0 Left: / Bldg Sprinklers: Right: / Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $8,500.00 Building Permit Fee: $229.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $199.23 Additional Fee : $0.00 Plan check Fee : $52.00 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: $6.00 Grading Permit Fee: $237.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 Energy Compliance: $0.00 Grading PC Fee: $199.00 Public Works Department - General Service $0.00 CA Seismic Safety : $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access : $0.00 PAN Plan Check : $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical °/: $0.00 San Dist: $0.00 Building Green Fee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $923.23 Plan Check Fee : $450.23 Fee Due at Permit Issuance : $473.00 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: 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) ction 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 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 fessions 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 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, ,iness 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 rovements 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 roved for toe tJdr%se of sale). I, V owner orthe 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 owp5:Cf'pjoperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I am exem*pt frort licensors under the Contractors' State License Law for the following reason: r Ywignature 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, a structure Mat I.heve 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 fe%ions C8" is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. r"ure of Property Owner or Authorized Agent Date )C-NISED QONIVACTOR'S DECLARATION - �aeby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70�00 �of /Di ;s3io� 7of the Business and Professio7�5 e d lic ern full [ce I.WVct. License Class License No Date Contractor Signature „ - �� )R4ERS' EOPA4NSATION DECLARATION tylyG: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE Is UNLAWFUL, ANO SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE ;T OPCOMPE NSATIOR,bAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. reby 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 formance of the work for which this permit is issued. Policy No. 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 trance carrier and policy number are: Policy Number a,of Agent ertify that, in the performance of the work for which this permit is issued, I shall not if I should become subject to the wD1kers' compensgtion prrpAionspf Section 3700 re of Applicant RATION REGI Date person in any manner so as to become subject to the workers' compensation laws of California, and agree r Code, I shall forthwith comply with those provisions. 7 Date � � G 2- Z hereby 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) .ender's Name Lender's Address 3y 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 county to enter above-identifie roperty for inspection purposes. y >ignature of Property Owner or Authorized Agent -^ - Print Property Owner's or Authorized Agent's Name 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 ASBESTOS NOTIFICATION TO PERMIT CANCELLED LIEPA PERMIT EXTENDED r QM D PERMITFINAL /1j 1 ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OCCUPANCY ISF PROPOSED DEMO�+Tt6fQ7 OCCUPANCY ISSUED SIGNATURE: '2