HomeMy WebLinkAboutX2022-0223 - Permitsry �, City of Newport Beach - Building Division
d 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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v Inspection Requests Phone (949)644-3255
r"irrwu`"�r Combination Type- SFP ELEC PLUM MECH
*X2022-0223*
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COMB Permit: X2022-0223
Project No : 0200-2022
Issued Date : 01/2512022
Inspection Area : 1
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0112512025 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: 217 E EDGEWATER AVE NB
Description: SFR BATHROOM REMODEL 40 SF - -
Legal Desc.: NEWPORT BAY TR SUB OF BLK C LOT 8 -
Owner:
KILPATRICK CHRIS
Address:
9 WICKLAND
IRIVINE, CA 92620
Phone:
949-616-6456
Applicant:
KILPATRICK CHRIS
Address:
9 WICKLAND
IRIVINE, CA 92620
Phone:
949-616-6456
Code Edit : 2019
Type of Construction: V-B
Occupancy Group: R3/U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units : 1
Bldg Height: 0
Bldg Sprinklers:
Construction Valuation:
Building Permit Fee: $161.00
Plan Check Fee: $140.07
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$6.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $392.27
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Contractor: OWNER/BLDR
Architect:
Address:
Address:
Phone:
Phone:
Con State Lic: O/B
Engineer:
Lic Expire:
Address:
Bus Lic:
Lic Exp Date:
Phone:
Worker's Compensation Insurance
Designer:
Carrier:
Address:
Policy No:
Expire:
Phone:
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee :
Electrical %:
Mechanical %:
Plumbing %:
Rear: /
Front: /
Left: I
Right: I
°arkino Spaces
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$11.27
$6.44
$14.49
Plan Check Fee
0
MIGLIOZZI JORGELINA ELIANA
22195 EL PASEO STE 250
RANCHO SANTA MARGARITA, CA 92688 ....
949-697-7749 State Lic:C035585 •.... •
• • ••.•.o
Special Conditions:
Planning Department -
Plan check Fee:
Fair Share
SJH Trans
In -lieu Housing Fee
Public Works Department -
Park Dedication :
$0.00
P/W Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
•
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State Lic: ••
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0
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Fire Department
$52.00
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
$0.00 Fee Due at Permit Issuance : $392.27
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE: 1/
a r
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 (_) 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 an 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 comple ion, the Owner -Builder will have the burden of proving that it was not built or
improved for the purpose of sale).
owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, B isiness and Professions Code: The Contractors' State License Law does not
ppI, as an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor prsuant 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 per residence in which I must have resided for at least one 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 has o b constructe s entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
Professions Coge, is available upon request when ap ica ml ed or at the following Web site:http://www.leginfolca.gov/calaw.html'
� ignatute of Pro[ A'Owner or Authorized Agent Dat
t"EN;ED CQMUCTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
vride act. License Class License No Date Contractor Signature
WORKERS' COMMSATION DECLARATION
WARNING• FAILURE TOSECTIRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (E100,000), IN ADDITION TO THE
COSTUF COMPEN§A•TJ0N•DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
lt"6 .affirm L)jtd2gq(!nalty of perjury one of the following declarations:
••Tteve and wilF 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 th
(jp%rrA rice of the work for which this permit is issued. Policy No.
have and wilhmaintain 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'
vsurance carrier and p3licy number are:
farrier •••• • Policy Number Expiration Date
of Agent
I certify that, in the performance he yaofk for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree
let, if I should become subject t h 6rker ompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
ignature of Applicant Inf/� D ! ZS (Z Z
IECLARATION REGARDING C STRUCTION LENDING AGENCY
hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 309 , Civil Code).
.enders 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 o ner's behalf.
I have read this application and the information I have prov' ed' correct.
I agree to comply with all applicable city and cou ty i n and state laws relating to building construction.
I authorize representatives of this city or coun n r ve-identified property for inspection purposes. n /
od.a o...,.on„ n-noPe nr A„eHnn—H An—Va Mao a 1 V ` /' LIIL/S {e lL nil%pit Cla l r/1 �tiZ
ACTION DATE BY Y I RDECLARATION OF I EGULATIONS PA COMPLIANT E CE ITH AND DE OF RULE
I FOR OFFICE USE ONLY
PERMIT EXPIRED
I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED
EPA
PERMIT EXTENDED
MN
CERMI T FI NAL
PERMFICATEL
OCCUPANCY ISSUED
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SBESTD M CAT IS �PPLICA'
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SIGNATURE: i1