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Home My WebLink AboutX2021-0990 - Permitswv City of Newport Beach - Building Division i 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 'rrvasv.'fi-' Combination Type - SFP ELEC MECH PLUM COMB Permit: X2021-0990 III'�X 2 0 2 1 0 9 90�� II Project No: 0907-2021 Issued Date: 05/10/2021 Inspection Area : 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0511012024 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: 2424 HOLLY LN NB Description: SFR -ADD MASTER BDRM 324 SF & REMODEL 156 SF Legal Desc.: N TR 1702 LOT 25 Owner: GOHL TRACY Contractor: NEWPORT CONSTRUCTION SVCS Architect: Address: 21862 SEASIDE LN Address: PO BOX 10611 Address: HUNTINGTON BEACH, CA.92646 NEWPORT BEACH CA 92658 Phone: 949-500-3920 Phone: 714-915-9622 Phone: State Lic: Applicant: MONTOYA JERRY Con State Lic: 1065935 Engineer: RAHMAN MOKSUDUR Address: 3517 DEERFORD ST Lic Expire: 05/31/2022 Address: 14616 MCKENDREE AVE LAKEWOOD CA 90712 Bus Lic: BT30072178 CHINO CA 91708 Phone: 562-331-4673 Lic Exp Date: 0613012021 Phone: 213-400-8078 State Lic:C-069263 Code Edit: Type of Construction: Occupancy Group: Added /New sq.ft. Bldg: Added /New sq. ft. Garage: No of Stories: 1 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Construction 2019 Worker's Compensation Insurance Designer: MONTOYA JERRY V-B Carrier: EXEMPT Address: 3517 DEERFORD ST R31U Policy No: no employees LAKEWOOD CA 90712 324 Expire: Phone: 0 Building Permit Fee: $1,744.00 Plan Check Fee: $1,339.92 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $28.00 Energy Compliance: $61.00 CA Seismic Safety: $11.05 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee: $4.00 TOTALFEE:' as PROCESSED BY: Building Setbacks Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: 77 3 4�a e .. ZONING APPROVAL: •' Y \ lfi/� 9 ^ e - - GRADING APPROVAL: �� ""• o ° "` ® a e Be y e, s�,� 3 o Ear nm eae Rear: 10 Front: 20 Left: 4 Right: 4 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $122.08 $69.76 $156.96 Plan Check Fee Special Conditions: a/%_ pr3 INSPEIOR Planning Department - Plan check Fee Fair Share SJH Trans In -lieu Housing Fee Public Works Department - Park Dedication : $0.00 P/W Plan Check : $86.00 San Dist: $0.00 NMUSD Fee: $0.00 Fire Department $185.00 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 $1,628.92 Fee Due at Permit Issuance : $2,178.85 PUBLIC WORKS APPROVAL: PLAN CHECK BY: 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 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). 111, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U 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 70��44 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 Contra or pursuant to the Contractors' State License Law). ❑ 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 on' year prior to completion of the improvements covered by this permit, I cannot legal) sell a structure 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 Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 000) of. Svisi a usiness and Profession; Cody, and my license is in full force and effect. License Class License No Da Contractor Signatur // WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE LTIES ANO CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: 111 have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Directo� of Industrial Relations as provided for by Section 3700 of the Labor Code, for th performance of the work 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' compensatio insurance,awler and policy number are: Policy Number e of Agent zrtify that, in the performance of the work for which this permit is issued, I shall not employ any person in any if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall signature of Applicant IECLARATION REGAANG CONSTRUCTION LENDING AGENCY hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work f ender's Name Lender's Address ly 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 correc I agree to comply with all applicable city and county ordinaa G® state laws relating to building construction. I authorize representatives of this city or county teffhe above -identified property for inspection purposes. ;kmature of Property Owner or Authorized AgenW Print Property Owner ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR REGULATIONS PART 61 OF TITLE 40 AND AQM D RULE 1403 PERMITEXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED UEPA PERMIT EXTENDED QMD PERMIT FINAL SBESTOS NOTIF ION IS NO LICABLE TO CERTIFICATE OF '�'•�j%f PROPOSE O N OCCUPANCYISSUED SIGNATUREZ Date so as to become subject to the workers' compensation laws of California, and i comply with those provisions. Dat 1 this permit is issued (Section 3097, 'vi1 Code). USE ONLY e � e e e• n J'JO OJ �'� O O JVO tee•