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Home My WebLink Aboutx2022-0784 - Permitsrp City of Newport Beach - Building Division *X2022-0784* COMB Permit: X2022-0784 i u z 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 0428-2022 ,r Permit Counter Phone (949)644-3288 sa Inspection Requests Phone (949)644-3255 4 Combination Type -SFP ��`�" iR Issued Date 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: 436 VISTA PARADA NB . Description: MFR REPLACE (3) DOORS AT (E) OPENINGS, NO SIZE CHANGES. -STOP WORK 122-0024• Legal Desc.: N TR 7166 LOT 25 Owner: SMITH PETER IN Contractor: OWNERIBLDR Architect: UUG Address: 436 VISTA PARADA Address: SMITH PETER Address: NEWPORT BEACH, CA 92660 O/B FORM ATTACHED °°•'.� n'° Phone: 949-375-4157 Phone: 949-375-4157 Phone: State Lic: Applicant: SMITH PETER W Con State Lic: O/B Engineer: Address: 436 VISTA PARADA Lic Expire: Address: NEWPORT BEACH, CA 92660 Bus Lic Phone: 949-3754157 Lic Exp Date: Phone: State Lic: ° Code Edit : 2019 Worker's Compensation Insurance Designer: Type of Construction: V-B Carrier Address: ,', °„ • ° Occupancy Group: R3/U Policy No: - a Added /New sq.ft. Bldg: 0 Expire: Phone: OP •°d°,' Added/New sq. ft. Garage: 0 m '°p" No of Stories: 2 Building Setbacks Rear: I Special Conditions: No of Units : 3 Front: I Bldg Height: 0 Left: / Bldg Sprinklers: Right: I Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $15,833.00 Building Permit Fee: $348.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $302.76 Additional Fee : $0.00 Plan check Fee: $0.00 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: $348.00 Grading PC Consultant: $0.00 SJH Trans : $0.00 Demolition Fee Record Management: $0.00 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 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 : $999.76 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $999.76 2 PROCESSED BY: 3:5 PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: OWNER -BUILDER 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) action 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, priorto 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 Tess' ns 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 ore 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 L) portions of the work, and the structure is not intended or offered for sale (Section 7044, ainess 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 Irov ents 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 Jr ed 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 )ly 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). ..•. I am exe apt froTn licensure under the Contractors' State License Law for the following reason: rqy 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 legally Fa struct4Qe 11ha4 (have built as an owner -builder if it has not n constructed i "ts'En 'rety by licens od contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Ifeseio Pravailable upon request when thi ap is R 4R3 d-Or a he frill W site:http://www.leginfo.ca.gov/calaw.htmi. ligture o of Property Owner or Authorized Agent o I A Date TENSED GONTRACTOR'S DECLARATI 11 afepy of nVurter penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force deffect. I,icengerlass License No Date Contractor Signature )RJlERS;GOMPENSATION DECLARATION 4N1NG: 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 ($10D,000), IN ADDITION TO THE iTX COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. arelZ( affirmunder Qenalty of perjury one of the following declarations: fleve and gvill laintain 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 the f9eance of thg'wdjk 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' compensatiol Trance carrier and policy number are: ;arrier Policy Number Expiration Date dam Agent Phone # certify that, in the performance a work forwhich ermit 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 become subjectt w ers' compe olio rovlslon of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Jam' %� do2.- signature of Applicant X Date '? Y )ECLARATION REGAIRDINGICONSTRUCTION ttWDING AGENCY 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 Cod -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 or ' antes and s laws relating to building construction. I authorize representatives of this city or county to t abo a -id ntifi d grope for inspection purposes. .p _ —IA- Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name SAA r 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 LJEPA PERMIT EXTENDED MD PERMIT FINAL �F "{�/n • % % ASBESTOS NOTIFICATION IS NOT (ABLEETTOO CERTIFICATE OF l (�r� PROPOSED DEMOLITI` OCCUPANCY ISSUED SIGNATURE: }� `�'�✓�/—