HomeMy WebLinkAboutX2022-1709 - Permits,wtY, City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
rw. Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
r"rvna° Combination Type -MFP
`X2022-1709' COMB Permit: X2022-1709
Project No : 1562-2022
Issued Date : 06/1712022
Inspection Area : 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 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: 2115 SHERINGTON PL NB
Description: MFR WATER DAMAGE TO UNITS D-101, A-206, N-206, 0-109, US-208, DS-107, DS-207, XS-108, WS-211, XS-106 & YS-209��
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Legal Desc.: P BK 15 PG 36 PAR 1 6 ye..
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Owner: UDR NEWPORT BEACH NORTH L Contractor: SIGNAL RESTORATION SERVICES Architect:
Address: 1745 SHEA CENTER DR, STE 200 Address: 7221 ORANGEWOOD AVE Address:
HIGHLANDS RANCH CO 80129 GARDEN GROVE, CA 92841
Phone: Phone: 714-763-4153 Phone: State Lic:
Applicant: SIGNAL RESTORATION SERVICES
Con State Lic:
986693
Address: 7221 ORANGEWOOD AVE
Lic Expire:
09/30/2023
GARDEN GROVE, CA 92841
Bus Lic:
BT30071857
Phone: 714-763-4153
Lic Exp Date:
05/31/2023
Code Edit: 2019
Worker's Compensation
Insurance
Type of Construction: V-B
Carrier:
STARR INDEMNITY & LIABILITY
Occupancy Group: R2/U
Policy No:
1000002994
Added /New sq.ft. Bldg: 0
Expire:
10/16/2022
Added /New sq. ft. Garage: 0
No of Stories: 3
Building Setbacks
Rear: /
No of Units : 1
Front: /
Bldg Height: 0
Left: I
Bldg Sprinklers:
Right: I
Flood Zone: X
Use Zone:.. Parking Spaces: 0
Construction Valuation:__. $15,000.00
Building Permit Fee: $331.00
Plan Check Fee: $287.97
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$16.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $687.97
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Engineer: LOVELACE MILES
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Address: 10609 VISTA SORRENTO PKWY, #102
SAN DIEGO CA 92121
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Phone: 858-535-9111 State LicC-039734
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Designer:
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Address:
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Phone:
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Special Conditions:
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Fire Hazard Zone: N
9 09
Excise Tax:
$0.00
Planning Department -
Additional Fee,
$0.00
Plan check Fee :
Grading Bonds Fee:
$0.00
Fair Share :
Grading PC Consultant :
$0.00
SJH Trans :
Grading Permit Fee:
$0.00
In -lieu Housing Fee
Grading PC Fee:
$0.00
Public Works Department -
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
P/W Plan Check :
$0.00
Electrical %:
$0.00
San Dist:
$0.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
Plumbing %:
$0.00
Fire Department
$52.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
Plan Check Fee : $0.00 Fee Due at Permit Issuance
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$687.97
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
iot 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 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
mprovements 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
'mproved for the purpose of sale).
❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7041, 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 Contractor pursuant to the Contractors' State License Law).
❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason: I
By my signature below I acknowledge 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 lega�
sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I II nderstand 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 ate
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm updgr'p`apalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 of Division 3 of the Business and Profess' is
apd effe4. License Efass License No Date Z Contractor Signatur
46WGRS' CD MPEI;ISATION DECLARATION
NAQNINQ: FAILUROTO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND D LARS ($100,000), IN ADDITION TO T
COSTOF OOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATfORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
••..••
" f bgVk and will maifltain 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
�rmance of the wo&for which this permit is issued. Policy No.
1*4 we" and Jrmaintain 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' compensa
i9 rqr" carrier altd policy number are:
darner_" Policy Number Expiration Date
a Bf.Agent
:ERify that, fi"the p;rforman � of th ork fo hich Is permit is issued, I shall not employ any person in any
if I should become subje o t1 orkers' omp ation provis�ns of Section 3700 of the Labor Code, I shall
signature of Applicant —t"w` --
IECLARATION REG ING CONSTRUCTION ENDING AGENCY
hereby affirm under penalty of perjury that theFS is a construction lending agency for the performance of the work for w;
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 prier's behalf.
I have read this application and the information I have pr, d is c0 act.
agree to comply with all applicable city and county ord nces a slat ws lacing to building construction.
I authorize representatives of this city or county to n = d Ie r inspection purposes.
;innahlre of PmDerty Owner or Authorized Anent _ Print Property Owner's or
PERMIT EXPIRED
DATE BY "/j DECLARATION OF C9MPLIANCE WITH CODE OF FEDERAL FOR
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
NOTIFICATION TO
PERMITFINAL OCCUPANCY ISSUED - •�� SIGNATURE:OSED S NOUTIIT' ON IS N TAP'
force
so as to become subject to the workers' compensation laws of California, and agre,
1 comply with those provisions. //
Date�Y!
this permit is issued (Section 3097, Civil Code).
USE ONLY
6 -17