HomeMy WebLinkAboutX2021-1453 - Permitsgw City of Newport Beach - Building Division
.�- 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
ia. Jq Inspection Requests Phone (949)644-3255
tam u = Combination Type - SFP PLUM
*X2021-1453*
[NE3P E_'0% d @ s
COMB Permit: X2021-1453
Project No: 1272-2021
Issued Date : 09117/2021
Inspection Area : 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 09/17/2024 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: 1726 CANDLESTICK LN NB
Description: SFR CHANGE OUT ALL WINDOWS, (4) PATIO DOORS, (7) SKYLIGHTS R REMODEL BATH 200 SF
Legal Desc.: N TR 3763 LOT 32
Owner:
SHALLA HILARY
Address:
1726 CANDLESTICK LN
NEWPORT BEACH CA 92660
Phone:
Applicant:
LUSHBAUGH WILLIAM
Address:
17191 CITRON
IRVINE CA 92612
Phone:
949-251-1710
Code Edit, 2019
Type of Construction: VB
Occupancy Group: R3/U
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 1
No of Units: 1
Bldg Height: 0
Bldg Sprinklers: N
Flood Zone: X
Building Permit Fee:. $1,009.00
Plan Check Fee: $877.83
Overtime Plan Ck:
40.00
Investigation Fee:
$0.00
Record Management:
$12.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$3.00
- Contractor: BRADCM IN
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� �jArchitect: LUSHBAU .��,L�IApA •••.
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Add s: 120 TUSTIN
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Address 17191 CITR •. •
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IRVINE CA 92612 01 mud
Cone 105
Lic E'3pire 031 '2023
Bus tic: BT3 55
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Lic Ez 06130 Phone: 714-883-0124 State Lic:C-083129
Workers Compensation Insurance
Carrier- . STA*.
Policya No. 9256 -
Expire. 06/2 022 l
'�t ,�-� P
Building Setliaear: /
Front: /
C 0 Left: /
Use Zone:
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultantl.
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
9
ens Ff
S az � E
1 14941 ` P
Special Conditions:
$0.4V" 'ork�`�PCa{nindDepartment -
$0.00 Plan check Fee
$0.00 Fair Share:
ans
$0.00 In -lieu Housing Fee:
PAN Plan Check
$0.00 San Dist:
$0.00 NMUSD Fee:
$90.81
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000�m•
his 1
em
K",a:
(no work starC G)
Fire Department
$52.00 Fire Inspection:
$0.00
*"W-—1�--Refund Deposit
$0.00
$0.00 Grading Bond:
$0.00
$0.00
$0.00
$0.00
$0.00
TOTAL FEE: $2,044.64 Plan Check Fee: $924.08 Fee Due at Permit Issuance : $1,120.56
PROCESSED BY: C_—� PUBLIC WORKS APPROVAL:
ZONING APPROVAL: PLAN CHECK BY: 7 t
GRADING APPROVAL: �'-" APPROVAL TO ISSUE: (�
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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)
(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
not 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 portior
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, thn
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of
improved for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section'
apply to an owner of property who builds or improves thereon, and who contracts for the projects with a "c
1 am exemptirppi licensure under the Contractors' State License L reason:17
By my signature below I acknowledge that, except for my pe tra residence in whic I u v sid fo at st
sell a Structure "at thave built as an owner -builder if it has not been constructed in its n;e IeIis
P"L-4ions CpEE,js $vailable upon request when this applicatipyl Js submitted or g eb site.http://www
Signature of Prep" Owner or Authorized Agentt"'
dCNSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed. 'ions r �x;� m tl-ection
dVct. LI�t3rise'Wass Licens o _may - D
WORKERS' COMP€NSATION DECLARATION '�
RArdlrgAQ: FAILUgnsTO SECURE WORKERS' COMPENSATION COVE _ _ _ UL, AND ALL SUWECT AN EMPLOYER TO CRIMINAL
006i OF COMPENSATION, DAMAGES As PROVIDED FOR IN SECTION 3' BOR CODE, INTEREST, AND ATTORNEY' E
I hereby affirm under�pp natty of perjury one of the following de arationnys,: -6
' I h;ve ancrwW maintain a certificate of consent.to s -in re t wor - mp do - d
pe-Kerntance of tDe wo&k for which this permit is issue. Po y
of the work, and the structure is not intended or offered for sale (Section 7044,
gh employees' or personal effort, builds or improves the property, provided that the
Imoletion, the Owner -Builder will have the burden of Provinq that it was not built or
ns ode: The Contractors' State
to the Contractors'
State License Law).
RS ninr�ISfe'i LPt�.•
to rr4�l@{ri of the improvements coved
that a cop of he a bi w�,`ggIW
Xi
/cal h 1.0I/0 � � t
Date
3 of{pq EJrgpVeM ons Co n
ontractor Sig nature
mayy`
L FINES UP TO ONE HUNDRED THOUSAND DOLLA
elations as provided for by Section 3700
' . ...
�s�lave and will .main.tain workers' compensation in uran _ ad b Ion 3700 of the Labor Code, for the performance of the work for which th' perm's iss
Rhsurance carrier and policy number are:
Carrier Wicy Number _ _ 8 E760arQjDat ll it x I
me of Agent
I certify that, in the performance of the work for whicil this
it, if I should become subject to the workers' mpe
(nature of Applicant
;reby affirm under penalty of perjury that there is a c
rder's Name
my signature below, I certify to each of the following
I am the property owner or authorized to act on the
I have read this application and the information I he
I agree to comply with all applicable city and count,
I authorize representatives of this city or count
mature of Pmoertv Owner or Authorized Agent
ACTION
di ellpl Ong I)F"Cn in any
'60 ofYth L b\or Code, I shall
Stai
AGENCY `
uction lending agency for the performance of
owner's behalf.
building construction.
inspection purposes.
DATE BY DECLARATION OF ZOMPLIANCE WITH CODE OF FEDERAL FOR OI
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERMITEXPIRED V. (SUBMITTED ASBESTOS NOTIFICATION TO
PER CANCELLED EPA
PERMIT EXTENDED N _ AQMD
CERTIFICATE OF ROSEDp'p'St�jry/"�'OOLITIO TIFICATION IS NOT APPLICABLE TO
OCCUPANCYISSUED SIGNATURE:/ �
so as to be e g§l}S�avto $I
i comply wi tihose provisions.
USE ONLY
is issued
Law does not
it, I cannot legallt
isiness and
Is In full force
r
IN'ADDITION TO THE
ibgr :Code, for th
:rs <compensatiol
i;.
€ :,,
pifoer aa, and agre