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Home My WebLink AboutX2021-2306 - Permitswro¢ City of Newport Beach - Building Division iIuII ¢ 100 Civic Center Drive, Newport Beach, CA 92660 IIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIII�IIiii IIll 3 IIIII��II�fi COMB Permit: X2021-2306 Permit Counter Phone (949)644-3288 Project No : 1998-2021 Inspection Requests Phone (949)644-3255 Combination Type - MFP PLUM Issued Date: 09/0112021 Inspection Area : (� PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST Construction Hours; Monday BE COMPLETED BY 09/01/2024 OR PERMIT WILL BE INVALID -Friday 7:00 a.m. Job Address: 520 1I21RIS AVE NB to 6:30 p.m. and Saturday from 8:00 a.m. fo 6:00 p.m. No work on Sundays or Holidays Description: MFR KITCHEN AND (2) BATHROOM REMODELS 300 SF Legal Desc.: Owner: MILLER THOMAS Contractor: Address: 520112 IRIS AVE SIKORSKI CONSTRUCTION LLC Architect:Address: NEWPORT BEACH, CA 92660 124 MELODY LN Address: Phone: COSTA MESA, CA 92627 Phone: 773-578-7963 Phone: Lic: (� Applicant: PETERS WILLIAM Con State Lic: Address: 33662 BRIDGEHAMPTON 1058853 Engineer: .:State Cs+ KHAEF ESMAIL - _U Lic Expire: DANA POINT, CA 92629 Bus Lic: 10/31/2021 Address: 4005 CALLE SONORA #2B SJ Phone: 949-412-4428 Lic Exp Date: BT30061790 01131/2022 LAGUNA BEACH CA Code Edit: 2019 Phone: 714504-8260 :State tale Lic:C-APO ° • ° ° ° ° Worker's Compensation Type of Construction: V-B Insurance Designer: °o o°B°°� Carrier. Occupancy Group: R3/U EXEMPT - NO EMPLOYEES Address: °°•° .... Policy No: Added /New sq.ft. Bldg: 0 Expire: Added /New sq. ft. Garage: 0 Phone: No of Stories: 2 • ° ° Building Setbacks of Units: 2 Rear: / Special Conditions: Bldg Bldg Height: 0 Front: / ° % Bldg Sprinklers: N Left: / ° Flood Zone: X Right: / Use Zone: Parkin Spaces: 0 ° ...... Construction Valuation: $25.000 00 Fire Hazard Zone : N ', ° ° Building Permit Fee: $501.00 Excise Tax: $0.00 ...... oca.a G O ° Plan Check Fee: $435.87 Additional Fee : Planning Department $0.00 - Fire Department Overtime Plan Ck: $0.00 Grading Bonds Fee: Plan check Fee : $0.00 $52.00 Fire Inspection: $0.00 Investigation Fee: $0.00 Grading PC Consultant : Fair Share : $0.00 $0.00 Fire Plan Rev $0.00 Record Management: $6.00 Grading Permit Fee: SJH Trans : $0.00 $0.00 Demolition Fee Energy Compliance: $0.00 Grading Fee: Housing Fee $0.00 : $0.00 Building Dept Adm $0.00 CA Seismic Safety: $0.00 WO Insp. Fee: . F Milieu Public Works Department $0.00 - General Service $0.00 Disabled Access : $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Hazardous Mat $0.00 Electrical %: P/W Plan Check : $0.00 $0.00 Grading Bond: $0.00 Building Green Fee : $1.00 Mechanical %: San Dist; $0.00 $0.00 Plumbing %: NMUSD Fee: $45 09 $0.00 $0.00 $0.00 TOTAL FEE: $1,040.96 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Plan Check Fee $487.87 Fee Due at Permit Issuance : $553.09 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 repair the checcture, prior 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 the Contractors' State cense Law Professions ofile a signed Code) or that hetement o she isat he or she exemptfromisicensu ed pursuant to the and the basis for he lsions allegedfexe exemption. Any violation lof Section 7031.5 ter 9 by any applicant forJa permiith f subjects the applicant t n 3 the Business o civil penalty oand not more than five hundred dollars ($500).7044, (� all of or L,) portions of;the work, and the structure is not intended or offered for sale (Section d ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do employees' or personal effort, builds that Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through, eimproves 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). the project (Section 7044Business and Professions Code: The Contractors' State License Law does not ❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct 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). ❑ 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 one year prior to completion of the improvements covered by this permit, I Cannot legall 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.htmi. Date Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 �o 3gf file Business and Prof ssi s de, a� Icef�ll force and effect. License.Class License No Date If G (Contractor Signatu7 WORKERS' COMPENSATION DECLARATION fff NINE: FAILUR910 SE6u RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OP COMPERMV,bAMAGEs AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 'hgrdby affirm under penalty of perjury one of the following declarations: I have and wi'I•rslaintain a certificate of consent to self -insure for workers' compensation, issued by the Director lof Industrial Relations as provided for by Section 3700 of the Labor Code, for th foFrpance oT tt v$dfk for which this permit is issued. Policy No. Jlave and �l maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the uance carrier and policy number are: Policy Number srtify that, "the �erformance of the work for which this permit is issued, I shall not employ any person in any 47 shoulr14P.cp;* subject t�the workers' omm sat provisio ection 3700 of the Labor Code, I shall of I CULAKAI IUN M=uAmvuw �.voo uw...,.... •- -- - hereby affirm under penalty of perjury that there is a construction lending agency for the Lender's Address of the work for Enders Name try 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 correct. I agree to comply with all applicable city and county ordinances and state I relating cope poses. I authorize representatives of this city or county t above-i a pro ert spection ur poses. -i,...er, nv of Prnnerty Owner or Authorized Agent --"� PrI t Prop@_Owner's DATE BY DECLAR7ION OF COMPLIANCE WITH CODE OF RFM ILATIONS PART 61 OF TITLE 40 AND AQMD PERMITEXPIRED ❑ SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED EPA PERMITEXTENDED QMD PERMITFINAL ESTOS NOTIFICATION IS NOT APPLICABLE CERTIFICATE OF ' PR OSED DE OLITION OCCUPANCY ISSUED SIGN TURE: 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 agre h comply with those provisions. Data Z h this permit is issued (Section 3097, Civil ode). FOR OFFICE USE ONLY Date