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Home My WebLink AboutX2022-0609 - Permitsw r City of Newport Beach - Building. Division- *X2022-0609* COMB Permit: X2022-0609 q 100 Civic Center Drive, Newport Beach, CA 92660 _ s 6 Project No: 1350-2021 �,. y Permit Counter Phone (949)644-3288 !'� � � ) v Inspection Requests Phone (949)644-3255 8 d i L �"ryrra�u'F's '' Combination Type - MFP Issued Date : 03102/2022 Inspection Area: 4 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 03/0212025 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: 23 CHATHAM CT NB Description: DELTA 2 REVISION & CHANGE OF ARCHITECT, ADDED SCOPE CONC FILL IN (E) SUNKEN FLOOR & REPLACE (E) FIREPLACE IN FAMILY ROOM (X2021-1332/REV22-0272) Legal Desc.: TR 11451 LOT 1 UNIT 51 OF PROJECT LOCATED ON AP 442-371-05 TOGETHER Owner: HASMAN ROBERT Contractor: OWNER/BLDR Architect: RANIER]RANDY .ovv °.G,G• Address: 23 CHATHAM CT Address: HASMAN ROBERT Address: 5868 MESQUITE SPRINGS RD ° NEWPORT BEACH CA 92660 TWENTY-NINE PALMS CA 92277 Phone, Phone: 702-769-2725 Phone: 714-296-5502 State Lic:CO24225 Go Go s Applicant: HASMAN ROBERT Con State Lic: O/B Engineer: SHERAFATI ARDALAN • • •. Address: 23 CHATHAM CT Lic Expire: Address: 17901 VON KARMAN AVE #600 °G <««• NEWPORT BEACH CA 92660 Bus Lic: IRVINE, CA 92614 v Phone: 702-769-2725 Lic Exp Date: Phone: 949-522-5001 State Lic:C-085331 G 0 • «• ° Code Edit : 2019 Type of Construction: V-B Occupancy Group: R2IU Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: - 2 No of Units: 4 Bldg Height: 0 Bldg Sprinklers: N Valuation: $3,700.00 Building Permit Fee: $144.00 Plan Check Fee: $125.28 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $10.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE : $332.28 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Worker's Compensation Insurance Carrier: Policy No: Expire: Building Setbacks Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: /V15W Rear: I Front: / Left: I Right: / larking Spaces $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Plan Check Fee Designer: Address: Phone: Special Conditions: Fire Hazard Zone Planning Department - Plan check Fee Fair Share SJH Trans In -lieu Housing Fee: Public Works Department - Park Dedication : $0.00 PAN 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 $0.00 Fee Due at Permit Issuance : $332.28 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: o « - aGos •G s G i e o s s o G o G 0o s G®««G GFOoi oc«oo 9 G O G oeeceo J O44p« 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 nnr�o�rrt more than five hundred dollars ($500). 0 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, 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 property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply 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 frOR1-1Censure under the Contractors' State License Law for the following reason: By my gignature'b'eiow lacknowledge that, except for my pers idence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legalh seN s'sstructure; hjt I'hyve built as an owner -builder if if not been nst ted ' f ntirety by licensed contractors. ICI understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, k-available upon request when t plica i n' b to a foil Ing eb site:http://www.leginfo.ca.gov/calaw.html. _ p1gnatlye of Property Owner or Authorized Agent r Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm 4lyrjereenalty 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 on; effect. License Class License No Date Contractor Signature W@Kr%ERS' CQpdPENSATION DECLARATION WARMNG: FAILURE TQ SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000(, IN ADDITION TO THE �QSTJf COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. Ph&eby affirm yride$ penalty of perjury one of the following declarations: ®4-lave and wj11 mpiptain 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 p wuvance of 4hework for which this permit is issued. Policy No. ❑I 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 insurance carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # ®1 certify that, in the performance a wo for which 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 agre that, if I should become subject the or s' ensa visions of Section 3700 of the Labor Code, shall forthwith comply with those provisions. �/' Signature of Applicant Date/ DECLARATION REGARDING CONSf RUCT N G AGENCY I 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). Lender's Name Lender's Address By 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 ordinanc and state laws rela in, to building construction. I authorize representatives of this city or Count o enter the a-ident1 1 rty for inspection purposes. Z 2 2 Signature of Property Owner or Authorized Agent iM�erty Owners or Authorized Agent's Name Dates 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 NOTIFICATION TO PERMIT CANCELLED UEPA PERMIT EXTENDED QMD PERMIT FINAL i a 4 S�LUASBESTOS NOTIFICATION IS NOTAPPLICABLE TO CERTIFICATE OF .J PROPOSED DEMOLITION OCCUPANCYISSUED SIGNATURE: lF _