HomeMy WebLinkAboutX2021-0695 - Permitsf� City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - MFP ELEC MECH PLUM
COMB Permit: X2021-0695 (IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�II
Project No : 0638-2021
Issued Date : 09/14/2021
Inspection Area : 4
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0911412024 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: 2005 BAJA NB
Description: MFR REPLACE WINDOWS, NEW SLIDERS, REMOVE INTERIOR CLOSET, DEMOLISHING A PARTITION, STUCCO EXTERIOR
Legal Desc.: TR 6227 (L.L.84-214032) PAR 51
Owner:
STRACK RICHARD
Address:
2005 BAJA
NEWPORT BEACH, CA 92660
Phone:
Applicant:
COBOS FERNANDO
Address:
4571 DELANCY DR
YORBA LINDA CA 92886
Phone:
714-932-3397
Code Edit: 2019
Type of Construction: V-B
Occupancy Group: R2/U
Added INew sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 1
No of Units : 3
Bldg Height: 0
Bldg Sprinklers: N
Construction Valuation: $85,000.00
Building Permit Fee: $1,089.00
Plan Check Fee: $947.43
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$30.00
Energy Compliance:
$61.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$4.00
TOTAL FEE: $2,401.23
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Contractor:
MATT GILES CONSTRUCTION
Architect:
Address:
16741 DAISY AVE
Address:
FOUNTAIN VALLEY CA 92708
Phone:
714-315-5928
Phone:
State Lic:
Con State Lic:
942422
Engineer:
NIKJOO SHAHRAM
Lic Expire:
01/31/2022
Address:
6011 E BRIGHTON LANE
Bus Lic:
BT30073989
ANAHEIM CA 92807
Lic Exp Date:
01/3112022
Phone:
714-777-7200 State Lic:C-036969
Worker's Compensation Insurance
Carrier:. EXEMPT
Policy No: NO EMPLOYEES
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: /
Front: /
Left: I
Right: I
'arking Spaces
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$76.23
$43.56
$98.01
Plan Check Fee
Designer:
Address:
Phone:
Special Conditions:
Planning Department -
Plan check Fee
Fair Share
SJH Trans
In -lieu Housing Fee
Public Works Department -
Park Dedication :
$0.00
P/W Plan Check :
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Fire Department
$52.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$1,054.68 Fee Due at Permit Issuance: $1,346.55
PUBLIC WORKS APPROVAL: N/(
PLAN CHECK BY: 1 Y 1p1�
APPROVAL T09SSUE: C"l�
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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)
action 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 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,
;loess 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 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 exempt from licensure under the Contractors' State License Law for the following reason:
my signature l pip"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
a structure that I 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
Jfessions Code; J's available upon request wherahis application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
Aal&j of Property OQrner or Authorized Agent Date
,ENSED COATRACTOR'S DECLARATI N
�RpY 9ifrm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) iv sjoP 3 o the Business and Profes ions e, a my li ense is in full force
I effect. License Class License No Date "1 Contractor Signature
)PFjERS' COMPENSATION DECLARATION
INING: FAILURE-M-SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($111,111), J DDITION TO THE
if QF?COMPENSATIgJ,pg MAGES AS PROVIDED FOR IN SECTION 37BG OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
fii MI affirm under penalty of perjury one of the following declarations:
hhave and wiN maietain 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
Drmance of Navo4for which this permit is issued. Policy No.
r�v&and wjjl.%eiWTin 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' compensa
rance carrier and policy number are:
r Agent
tify that, in the performa e o the
I should become subiec to th we
of
Policy Number
Date
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
atJrZ provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Date / � — I G/ _ g
IECLAR l ION REGARDING CONSTRUCTION LENDING AGENCY TT
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
ender's Name Lender's Address
ly my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owner'LbeNlfWSI have read this application and the information I hav vided i I agree to comply with all applicable city and county rdin nces anarelating to building construction.
I authorize representatives of this city orcounty ed property ' spection purposes. y e
ACTION
PERMIT EXPIRED
PERMIT CANCELLED
PERMIT EXTENDED
DATE BY DECLARATION OF COMPLIANCE WITH CODE OF
REGULATIONS PART 61 OF TITLE 40 AND AQMD
I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT FINAL 1W ASBESTOS IFICATION IS NOTAP CABLE TO
CERTIFICATE OF ( i f/ PROPOS E/W_�p�LITION
OCCUPANCY15SUED SIGNAT RE:2 \ /
FOR OFFICE USE ONLY
Civil Code).
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