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Home My WebLink AboutX2021-1767 - PermitsCitylofMwport 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 - BLDG PLUM IIIIIIIIIIIIII�IIIIIIII01111111111111111111111111111�IIII COMB Permit: X2021-1767 Project No: 0278-2021 Issued Date : 07/07/2021 Inspection Area : 2 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0710712024 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: 80 LINDA ISLE NB Description: DEMO SFR (4,000 SF) 5 BEDROOMS W/SEWER CAP 0015 Legal Desc.: N TR 4003 LOT 80 Owner: FANTICOLA CHRISTIAN Address: 1422 EDINGER AVE TUSTIN CA 92780 Phone: 9491400-8777 Applicant: CERNICH PAUL Address: 101 SHIPYARD WAY #A NEWPORT BEACH, CA 92663 Phone: 949-723.0147 Code Edit, Type of Construction: Occupancy Group: Added /New sq.ft. Bldg: Added /New sq. ft. Garage: No of Stories: 0 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Flood Zone: Contractor: PENINSULA HOME BLDRS INC Address: 101 SHIPYARD WAY #A NEWPORT BEACH CA 92663 Phone: 949-723-0147 Con State Lic: 842666 Lic Expire: 07131/2022 Bus Lic: BT30008665 Lic Exp Date: 01/3112022 2019 Worker's Compensation Insurance VB Carrier: WC EXEMPT R3/U Policy No: (NO EMPLOYEES) 0 Expire: 0 Building Setbacks Rear: / Front: / Left: / Right: / Use Zone: Parkino Snares n Building Permit Fee: $122.00 Plan Check Fee: $223.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $0.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $2.00 TOTAL FEE: $2,445.98 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $10.98 Plan Check Fee Architect: Address: Phone: Engineer: Address: Phone: Designer: Address: WALZ JOHN ROBERT 23 CORPORATE PLAZA 9150 NEWPORT BEACH CA 92660 949-836-8977 State Lic:C031388 GABRIEL MICHAEL R 483 E 20TH STREET ° COSTA MESA CA 92627 • • a• 949-646-6596 State Lic:S-002939 .... r' s s t •�Pa Phone: Special Conditions: TIGHT QUARTERS TO HAUL' a a a DEBRIS/HAULER SLIPS a ATT TO PERMIT Fire Hazard Zone : N Planning Department - Fire Department Plan check Fee : $104.00 Fire Inspection: $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 SJH Trans : $0.00 Demolition Fee In -lieu Housing Fee: $0.00 Building Dept Adm $27.00 Public Works Department - General Service $266.00 Park Dedication : $0.00 Refund Deposit $1,692.00 PAN Plan Check : $0.00 Grading Bond: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $2,445.98 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: t a • • a oa a a®Fa-• 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). LJ I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, throu( improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of cc improved for the purpose of sale). 111, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 70, apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contra( ❑ I am exempt from licensure under the Contractors' State License Law for the following reason: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least or sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I Professions Code`, is available upon request when this application is submitted or at the following Web site: http:/1www.IS 1,gnaturiif of Prop6itl*Owner or Authorized Agent QCENgED CCINTM31CTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700C andeffect. License Class _ __. License No DateL - COMPENSATION DECLARATION RE FO+aESURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL Naj(TIOtI,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. filsl'bb7giffirm *0& penalty of perjury one of the following declarations: the work, and the structure is not intended or offered for sale (Section 7044, employees' or personal effort, builds or improves the property, provided that the pletion, the Owner -Builder will have the burden of proving that it was not built or Business and Professions Code: The Contractors' State License Law does not pursuant to the Contractors' State License Law). year hand that a copy of the applicable law, Section 7044 of the Business and z.gov/calaw.html. Date jsi�f the Business and Professi s d nd y I' a se is in full force Contractor Signature AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DO Rs (r 000 N ADDITION TO THE 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 :e of the wails for which this permit is issued. Policy No. Ppyg and of inta /i I -Main 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 it end policy number are: ....., Policy Number Expiration Date Phone # in the fftx f r wh h thi rmit 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 becommp nsat' n rovisions of Section 7 f t e Labor Code, I shall forth ith comply with those provisions. /f / 9 plicant 7 Date �I % Z / I oar_ i ounlNlr_ _oury I TTTTT �� hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for _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 w e s b(te (awjslatin I have read this application and the information I have pro ad s corr agree to comply with all applicable city and county ordi nce d st to ilding construction. I authorize representatives of this city or county t me a ab a-ide f spection purposes. Signature of Property Owner or Authorized Agen Pd roperty Owner's ACTION DATE BY DECLARATIO OF C ITH CO E OF FEDERAL FOR C REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMIT EXPIRED L#1 SUBMITTED ASBESTOS NOTIFICATION TO PERMITQINCELLED EPA PERMIT EXTENDED QMD PERMIT FINAL ESCS NOTIFICA 0 IS NO P LICA LE TO CERTIFICATE OF .r PROPOSED E�/gOLITI F/^, OCCUPANCYISSUED 1 L� SIGNATURE/ '11 this permit is issued (Section 3097, Civil Code). USE ONLY