HomeMy WebLinkAboutX2021-2277 - PermitsCity of Newport Beach - Building Division *X2021-2277* COMB Permit: X2021-2277
100 Civic Centel Drive, Newport Beach, CA 92660 Project No: 1969-2021
Permit Counter Phone (949)6443288*
c: Inspection Requests Phone (949)644-3255
* Combination Type - SFP ELEC PLUM MECH Issued Date : 02117/2022
Inspection Area : 2
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0211712025 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 O 9 ° 9 °
Job Address: 2641 VISTA DR NB
999°
Description: SFR -CIO WINDOWS &DOORS, REPLACE STONE VENEER W/NEW STUCCO, REMODEL CLOSET, MSTR BATH, NEW BALCONY WINEW DOORS 330 SF
Legal Desc.: TR 1014 LOT 44 WLY 40 FT
Owner:
LEVY JEAN-CLAUDE & MADONNA
Contractor:
BACKBREAKER INC
Architect:
Address:
2641 VISTA DR
Address:
29236 SAN FRANCISQUITO CANYON Address:
NEWPORT BEACH, CA 92663
SANTACLARITA, CA 91390
Phone:
949/239-9158
Phone:
818-209-5863
Phone:
Applicant:
CHILDS CYNTHIA
Con State Lie:
877306
Engineer:
Address:
2732 E COAST HWY #B
Lie Expire:
12/3112022
Address:
CORONA DEL MAR CA 92625
Bus Lie:
BT30077926
Phone:
949-718-3528
Lie Exp Date:
02/28/2023
Phone:
Code Edit :
2019
Worker's Compensation Insurance
Designer:
Type of Construction: VB
Carrier:
ACE AMERICAN INSURANCE COMPANY
Occupancy Group: R3IU
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 2
No of Units: 1
Bldg Height: 0
Bldg Sprinklers: N
Flood Zone: X
Construction
Building Permit Fee: $799.00
Plan Check Fee: $695.13
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$32.00
Energy Compliance:
$61.00
CA Seismic Safety:
$0.00
Disabled Access:
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$2.00
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 %:
0910112022
Rear: /
Front: /
Left: I
Right: I
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$55.93
$31.96
$71.91
11
TOTAL FEE: $1,800.93 Plan Check Fee
PROCESSED BY: -7
3
ZONING APPROVAL: A
Phone:
0 09
CHILDS CYNTHIA
2732 E COAST HWY#B
CORONA DEL MAR CA 92625
""•
949-718-3528 State Lic:CO22985 "'�'•°
SHEPPARD STEVEN THOMAS
99
28782 EL MID LANE
MISSION VIEJO CA 92692
949-481-9669 State Lic:S-0054
•��°
Address:
°
M
0
Special Conditions:
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
Z
0
W
M
Fire Department
$62.00
Fire Inspection:
$0.00
$0.00
Fire Plan Rev
$0.00
$0.00
Demolition Fee
$0.00
Building Dept Adm
$0.00
General Service
$0.00
Refund Deposit
$0.00
Grading Bond:
$0.00
$0.00
$0.00
$808.13 Fee Due at Permit Issuance : $992.80
PUBLIC WORKS APPROVAL:
PLAN CHECK BY: 6 `
GRADING APPROVAL: _ _ APPROVAL TO ISSUE:
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 checkgfark(s)_Lhave placed next to t+be 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
'he 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
Drofessions 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
iot more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) 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 TI8ti0tended 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
mproved for the porpese of sale).
i!a;owner pPthg ptbperty, 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 ownerof property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
Q 1 ae"exempt from licensure under the Contractors' State License Law for the following reason: I
ly my signature below lacknowledge 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
V a atrycture thVIVaLe 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
Professions Code, is.%vailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Sigr"we of ProqpJeKy Owner or Authorized Agent Date
LICERIED CONTRACTOR'S DECLARATION
I rerW4ry affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) Divi ion 3 of the Business and Professi ns m icense is in full force
apdtffeT. LicerpSe FT*s License No Date ^ao'a7Contractor Signature
WORKERS' CC?MPENSATION DECLARATION
FAJVFll(jTAILUREJb UCLfRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEN
:DST 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:
I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director
performance of the work for which this permit is issued. Policy No.
If, have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the
isurance carder and policy number are:
:arrier Policy Number
tame of Agent t-ri
certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any ma
t, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall foi
nature of Applicant
CLARATION REGARDING CONSTRUCTION LENDING AGENCY
:reby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for
Ider's Name Lender's Address
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 corr
I agree to comply with all applicable city and county ordi to nd laws relating to building construction.
I authorize representatives of this city or county to en/ter n I le roperty or Inspection purposes.
nahve of Pmnerty Owner or Authorized Agent /l !, Print Property Owner's
ACTION
PERMIT EXPIRED
PERMIT CANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCYISSUED
DATE BY DEC RATION gTEO 1PLIANCE WITH CODE OF FEDEI
REG LATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
I SUBMITTED ASBESTOS NOTIFICATION TO
TO
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND D LARS L$'100,000), IN ADDITION TO THE
Industrial Relations as provided for by Section 3700 of the Labor Code, for
of the work for which this permit is issued. My workers'
Date
so as to become subject to the workers' compensation laws of California, and
i comply with those provisions.
Date
this permit is issued (Section 3097, Civil Code).
FOR OFFICE USE ONLY