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Home My WebLink AboutX2022-1077 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 sr Inspection Requests Phone (949)644-3255 YP r., Combination Type - MFP MECH ELEC PLUM ll�1111111111111111111111111111111111111111111111111 ilCOMB Permit: X2022-1077 x 2 9 2 2 1 e 7 7 Project No : 0991-2022 I P ECTO F-1 Issued Date : 04/19/2022 Inspection Area : 4 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLEItu By U4/79/ZuZ3 UK PenMr r WILL b= Iry V, 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: 2111 VISTA ENTRADA NB Description: MFR REMODEL 1834 SF & REPLACE WINDOWS.'STOPWORK 122-0369• Legal Desc.: TR 6878 (L.L.84-214031) PAR 18 Owner: MILIK MICHAEL Contractor: OWNER/BLDR Address: 2111 VISTA ENTRADA Address: NEWPORT BEACH, CA 92660 Phone: 310-822-3770 Phone: Applicant: HENDERSON JOHN DAVID Con State Lic: O/B Address: 4199 CAMPUS DR #550 Lie Expire: IRVINE CA 92612 Bus Lie: Phone: 949-509-6567 Lie Exp Date: Code Edit: 2019 Worker's Compensation Insurance Type of Construction: V-B-SPR Carrier: Occupancy Group: R2/U Policy No: Added /New sq.ft. Bldg: 0 Expire: Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear: I No of Units : 3 Front: / Bldg Height: 0 Left: / Bldg Sprinklers: Y Right: I Flood Zone: X Use Zone: Parking Spaces: Construction Valuation: $146,000.00 Building Permit Fee: $1,513.00 Excise Tax: $0.00 Plan Check Fee: $1,316.31 Additional Fee : $0.00 Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Investigation Fee: $1,513.00 Grading PC Consultant: $0.00 Record Management: $34.00 Grading Permit Fee: $0.00 Energy Compliance: $102.20 Grading PC Fee: $0.00 CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Electrical W $105.91 Building Green Fee : $6.00 Mechanical %: $60.52 Plumbing %: $136.17 TOTAL FEE : $4,839.11 Plan Check Fee PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Architect: HENDERSON JOHN DAVID Address: 4199 CAMPUS DR #550 IRVINE CA 92612 Phone: 949-509-6567 State Lic:C017283 Engineer: HOUSHMAND MOHSEN Address: 15 STUDEBAKER IRVINE CA 92618 Phone: 949-752-1612 State Lic:C-042283 Designer: Address: Phone: Special Conditions: Ole FORM ATTACHED 0 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 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: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $886.43 Fee Due at Permit Issuance : $3,952.68 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;'P' (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 Iicensure 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 L) portions of the work, and the structure is not intended or offered for sale (Section 7044, "ness and Professions Code: The Contractors' State License Law does not apply to an owne D party 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 7044, 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). I am exempt from Iicensure under the Contractors' State License Law for the following reason: By my signature :1:-z W 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 legally sell a structureth�t 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 Cnde. is available upon request whe Is applicat�i fn/is�ubmitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. .SignatLre of Property Owner or Authorized Agent " Dat V— o�Z ILICENSED CONTRACTOR'S DECLARATI — °I he.cby 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 (land effect. Lir,�Pse (.lass License No Date Contractor Signature jWCPKERS' COMPENSATION DECLARATION I\"f PNI, FAILURE TO SECURE 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 IICOST 0.' COMPEN_F T -N, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNETS FEES. I hereby affirm under penalty of perjury one of the following declarations: I hive anri will 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 IN performance of`d e wurk for which this permit is issued. Policy No. I Lave and will mamtain 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 carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # I certify that, in the performance of the work 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 agre that, if 1 should become �u'Bct to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. [� Signature of Applicant l /\ "�f��'-� Da DECLARATION REGAAA�� TRUCTION LENDING AGENCY I 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 3097, Ci i1 Code). Lenders Name Lender's Address By 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. �/G I have read this application and the information I have provided is correct. !N' I agree to comply with all applicable city and co my rdinances and state laws relating to building construction. I authorize representatives of this city or county ter the a e-identified property for inspection purposes. /� Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name 6� Date "! -/9 A ACTION DATE BY '/DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED EPA PERMIT EXTENDED AQMD PERMITFINAL SBESTOS OT ICATION IS NOTAPPLICABLE TO CERTIFICATE OF OSED DE ITION OCCUPANCYISSUED SIGNA RE: -