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Home My WebLink AboutX2022-0627 - Permits� ,t;� , City of Newport Beacha7 Building Division *X2022-0627* COMB Permit: X2022-0627 `. d.. 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 0569-2022 r. % Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 ''tvc3ra�u-v`� Combination Type - SFP MECH ELEC PLUM Issued Date Inspection Area : 2 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 5:00 p.m. No work on Sundays or Holidays. Job Address: 105 VIA YELLA NB • • ° °.a-9a •� Description: DELTA 1 REVISION ADD'L SCOPE: FIREPLACE REFURBISH & FIXTURE RELOCATION ON MASTERBATH (X2022-0437/REV22.0389) ° Legal Desc.: N TR 907 LOT 389 • •° ° Owner: ERICSEN TIMOTHY Contractor: OWNER/BLDR Architect: Address: 105 VIA YELLA Address: ERICSEN TIMOTHY Address:„ ° NEWPORT BEACH, CA 92663 •aa Phone: 714-231-7601 Phone: 714-231-7601 Phone:. State Lic: ••°i °•;.,• �a®•.� Applicant: ERICSEN TIMOTHY Address: 105 VIA YELLA Con State Lic: O/B Engineer. ° o •�.�n� t•:E ° '� • Lic Expire: Address: • NEWPORT BEACH, CA 92663 Phone: 714-231-7601 Bus Lic Lic Exp Date: Phone: State Lic: �•° ° oa; Code Edit: 2019 Worker's Compensation Insurance Designer: ERICSEN DESIGN M ype of Construction: V-B Carrier: Address: 105 VIA YELLA Y.f Occupancy Group: R3/U Policy No: NEWPORT BEACH, CA 92663 {� Added /New sq.ft. Bldg: 0 Expire: Phone: 714-231-7601 Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear: / Special Conditions: HIGH DENSITY ZONE No of Units : 1 Front: / LIQUEFACTION ZONE CIO Bldg Height: 0 Left: / Bldg Sprinklers: Right: I Flood Lone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation. $3,000.00 Building Permit Fee: $127.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $110.49 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: $2.00 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 %: $8.89 San Dist : $0.00 Building Green Fee : $1.00 Mechanical %: $5.08 NMUSD Fee: $0.00 $0.00 Plumbing %: $11.43 $0.00 TOTAL FEE : $317.89 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $317.89 PROCESSED BY: W ZONING APPROVAL: GRADING APPROVAL: PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: 17)�� 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 CWtf o'r'tbat 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 fivTItMldred dollars ($500). 'I; A$ owner;pf 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, Mess and PrefeSslons 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 arenot 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 itwas not built or uCOed for the pyrpose of sale). ,I, asowner oi".q roperty, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not II?tU an ownpj ptproperty who builds or improves thereon, and who contracts far the projects with a licensed Contractor pursuant to the Contractors' State License Law). '1%%exempt froLicensu re under the Contractors' State License Law for the following reason: ",signature I:R low 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 legall) i. ahiucture 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 i}ess'Ons Code, is.aveilable upon request when this appthe following Web site:http://www.leginfo.ca.gov/calaw.html. Data_X 3 /l�/L,L Q 2tUT of Propt?ty Owner or Authorized Agent / Y ENSED CQNTJ?,JCTOR'S DECLARATION areby affirm under 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 t effect. License Class License No Date Contractor Signature COMPENSATION DECLARATION rARNING: 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 1$100,000), IN ADDITION TO THE 'AST 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: 1 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 thr erformance of the work forwhich 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' rance carrier and policy number are: is of Agent certify that, in the performance of if I should become subject to the of Policy Number Date forwhich 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 agree ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. q ' / /1 Date!'}� K 31q ZL CLARATION REGARDING CON&ItRUCTIPN LENDING AGENCY :reby 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: 1 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 ordina n e laws relating to building construction. I authorize representatives of this city or county to enter t M dentified pro for inspection purposes. ��11 [,�/ 1 3 nn+,, ,.a ornn, .. n,.,nor nr Aurhnrivorl Arrant `,_ Print Prooertv Owners or Authorized Aqent's Name. (`rV'G`N ` ✓ Date DATE BY DECLXRATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED L_I I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED EPA PERMIT EXTENDED QMD PERMITFINAL CERTIFICATEOF OCCUPANCY)SSUED Iy� q� ?�L / ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO PROPOSED DEMOLITIGfM11,7� SIGNATURE: X i�i/�'Y"�`. zL