HomeMy WebLinkAboutX2022-0125 - Permits�wrrr : City of Newport Beach - Building Division *X2022-0125*
H �*, 100 Civic Center Drive, Newport Beach, CA 92666
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COMB Permit: X2022-0125
F"+ Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Project NO : 2536-2021
Combination Type - SFP
G r�h'l°, 9®rl
Issued Date : 04114/2022
Inspection Area : 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST
VALID INSPECTION. PROJECTS
Construction Hours: Monday -Friday 7:00 a.m,
Job Address:
MUST BE COMPLETED BY 04/14/2025 OR PERMIT WILL BE INVALID
to 6:30 Saturday
1951 GO DR NB
p.m. and from 8:00
a.m. to 6:00
p.m. No work on Sundays or Holidays
Description: DELTA 2 AD
A 2 ADDL SCOPE ADD 24 SF ROOF TO 2ND FLR ROOF
DECK
Legal Desc.: N TR 4710 LOT 6
Owner: CNQ1951 S NTI Contractor:
Address:
BRYAN PACIFIC BUILDERS
Architect:
NE ORTIBEA H, Address:
NEWPORT BEACH, CA 92660
413 CALLE DELICADA
Address:
Phone:
SAN CLEMENTE CA 92672
Phone:
714-360-4488
Phone:
Applicant: KENT ART
State Lie:
Address: 61416TH ST Con State Lie:
Lie Expire:
585047
02129/2024
Engineer:
....
WU FRANK H '+°+•+
HUNTINGTON BEACH, CA 92648
Phone: 714-272A624 Bus Lie:
BT30066161
Address:
68 BLUECOAT
°
Lie Exp Date:
ode Edit:
11/30/2022
Phone:
IRVINE CA 92620 + • e •
949-832-0250 State Lic:S-002025
•°�
2019 Worker's Compensation
Typeof Construction: V-B
Insurance
Designe•+
+
•`
Carrier:
Occupancy Group: R3/U
PREFERRED PROFESSIONAL INS
Address
"•"+`+
.° +Ji
Added /New sq.ft. Bldg: 0 Policy No:
ON1212001
,
J
Added /New sq. ft. Garage: 0 Expire:
12I1612022
Phone:
No of Stories: 2 Building Setbacks
No of Units
Rear: 6
-
`• ° J...
: 1
Bldg Height:
Front: 20
Special Conditions:
. ° •
; • < ° J o
• -
p
Bldg Sprinklers: N
Left: 6
i
Flood Zone: X
Right: 6
Use Zone: Parkin Spaces: 0
Construction Valuation: _ $4,320 00
Fire Hazard Zone : N °
Building Permit Fee: $161.00 Excise Tax:
Plan Check Fee: $140.07
$0.00 Planning Department
-
Overtime Plan Ck: Additional Fee :
$0.00 Grading Bonds Fee:
$0.00 Plan check Fee
Fire Department
$0.00 Fire Inspection:
Investigation Fee: $0.00 Grading PC Consultant:
Record Management:
$0.00 Fair Share :
$0.00 SJH Trans
$0.00
$0.00 Fire Plan Rev $0.00
$16.00
Energy Compliance: 16.00 Grading Permit Fee:
:
$0.00 In -lieu Housing Fee :
$0.00 Demolition Fee
$0.00
CA Seismic Safety: $0.00 Grading PC Fee:
$0.00 Public Works Department -
Building Dept Adm $0.00
WQ Insp. Fee:
Disabled Access : $0.00
$0.00 Park Dedication :
$0.00
General Service $0.00
Hazardous Mat $0.00 Electrical %:
PNV Plan Check :
$0.00
Refund Deposit $0.00
Grading Bond: $0.00
Building Green Fee : $1.00 Mechanical %:
$0.00 San Dist:
$0.00
Plumbing %:
$0.00
$0.00 NMUSD Fee:
$0.00
$0.00
TOTAL FEE : $318.63
$0.00
Plan Check Fee : $0.00
-
Fee Due at Permit Issuance : $318.63
Pr
4L: CNC
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
OWNER -BUILDER DECLARATION
I hereby affrtm under penalty of perjury that I am exempt from the Contrators' State License Law for the reason(s) indicated below by the che(s) I have placed next to the applicable items)
;Setion 7031.5, Businessstatement that he orsheA'Is reused pursuant to the �prov s ons oftthe Contracto lrs' StaterLice se Lalish, or repir any w (Chapterstructure
9 (commencing withrto its issuance, also Se Section 7000) of requires the
of the Business end
:he permit to file a signed
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).
ill do (_) all of or (, portions oft a work, and the structure is not intended or offered for sal (Sec It v tl d that the
❑ I, as owner of the property, or my employees with wages as their sole compensation, w
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of cum
improved for the purpose of sale).
❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044
apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractc
❑ 1 am exempt from licensure under the Contractors' StatLicense
residence in r the following reason:
hich I must have resided for at least one
By my signature below I acknowledge that, except for my personal
sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I u
Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.legi
Signature of f tdpeRty Owner or Authorized Agent
LICENSED CONTRACTOR'S DECLARATION
T 16r�by affm yAder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with SecDate7000
and effet. L, . ZP. Class License No
AAjd e' eC S-WMPENSATION DECLARATION EMPLOYER TO
. wOS'j OF CO it RSATRON, DAMAGES AS PRONDEO FOS UNLAWFUL AND SHALL SUBJECT AN
R INS COTION 3706GE 1OF THE LABOR CODE, NT REST, AND ATTORNEY'S F ESRIMINAL PEN/
I Siereby aff�; 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
perfo ce of the work for which this permit is issued. Policy No.
'have apt wiR maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the
�. �np.urance carrier apd policy number are:
�nfTier Policy Number
�• .�.
Name of Agent
I certify that, in the performance o work for which this permit is issued, I shall not employ any person in any mann
that, if I should become subject to �o>r compensation provisions of Section 3700 of the Labor Code, I shall forthv
nature of Applicant \ "
CLARATION REGARD CONSTRUCTION LENDING AGENCY
weby affirm under penalty of perjury that there is a construction lending agency forthe per Address
of the work for wt
Lenider's Name
my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owne behalf.
I have read this application and the information I have provided ' corre laws relating to building construction.
I agree to comply with all applicable city and county ordinan d 9
Ified property for inspection purposes.
I authorize representatives of this city or county to entn�f%t / print Prooertv Owners or
Signature of Property
owner
or FAwinorizcu r,y=
ACTION
DATE BY
PERMIT EXPIRED
PERMITCANCELLED
PERMIT EXTENDED
PERMITFINAL
f� 1�
CERTIFICATE OF
Y�
I V
OCCUPANCYISSUED
CLARATION F COMPLIANCE WITH CODE OF FEDERAL FOR
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
TO
TO
mployees' or personal effort, builds or improves the prope y, pro
etion. 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).
ear prior to completion of the improvements covered by this permit, I cannot legally
derstand that a copy of the applicable law, Section 7044 of the Business and
f �vi Business and Professi license is in full force
ontrator Signature
TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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 ogre
1 comply with those provisions. e�
Dat
this permit is issued (Section 3097, Civil Code).
USE ONLY
D t �/