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Home My WebLink AboutX2022-0870 - Permitsxtrrrr¢ City of Newport Beach - Building Division �� ,: 100 Civic Center Drive, Newport Beach, CA 92660 r. `> Permit Counter Phone (949)644-3288 „,,. Inspection Requests Phone (949)644-3255 ^.,r,,,�u,eT A Combination Type - SFP ELEC MECH PLUM GRAD Il i iiiiii iiiii iiiii iioi iiii iiiii iiiii iiiii 0 II COMB Permit: X2022-0870 Project No: 0796-2022 Issued Date : 06/0312022 Inspection Area : 3 PERMIT EXPIRES 160 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, PROJECTS MUST BE COMPLETED BY OR PERMIT WILL BE INVAL 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: 2018 NAUTILUS LN NB Description: SFR REMODEL 650 SF & NEW ATT CABANA 255 SF (CONDITIONED SPACE) & PATIO COVER 400 SF W/YARD DRAIANGE Legal Desc.: N TR 3763 LOT 74 Owner: EKEDAL RYAN Address: 2018 NAUTILUS LN NEWPORT BEACH, CA 92660 Phone: Applicant: SAMSAMI ALI Address: 1401 QUAIL ST #120 NEWPORT BEACH CA 92660 Phone: 949-851-8345 Code Edit : 2019 Type of Construction: V-B-SPR Occupancy Group: R3IU Added /New sq.ft. Bldg: 255 Added /New sq. ft. Garage: 0 No of Stories: 1 No of Units : 1 Bldg Height: 29 Bldg Sprinklers: Y Flood Zone: X 11 Construction Valuation: $400,000.00 Building Permit Fee: $2,537.00 Plan Check Fee: $2,031.83 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management : $72.00 Energy Compliance: $280.00 CA Seismic Safety: $52.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $16.00 TOTAL FEE : $7,198.98 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Contractor: BLACK PETE CONSTRUCTION INC Address: 1788 MONROVIA AVENUE COSTA MESA CA 92627 Phone: 714-612-7678 Con State Lic: 692383 Lic Expire: 0813112022 Bus Lic: BT00003226 Lic Exp Date: 0413012023 Worker's Compensation Insurance Carrier: EXEMPT Policy No: Expire: Building Setbacks Use Zone: Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: 6 Front: 20 Left: 6 Right: 6 'Eking Spaci $0.00 $0.00 $0.00 $0.00 $237.00 $199.00 $152.00 $177.59 $101.48 $228.33 0 Architect: LIGHT CHRISTIAN R Address: 1401 QUAIL ST#120 NEWPORT BEACH CA 92660 Phone: 949-851-8345 State Lic:CO22334 Engineer: SKUDLARSKI JASON Address: 9751 OLYMPIC DR HUNTINGTON BEACH CA 92646 Phone: 949-752-1612 State Lic:C-067712 Designer: Address: Phone: Special Conditions: Fire Hazard Zone : Planning Department - Plan check Fee: Fair Share SJH Trans: In -lieu Housing Fee Public Works Department - Park Dedication : $0.00 PM Plan Check, $50.75 San Dist: $0.00 NMUSD Fee: $0.00 Fire Department $208.00 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 : $2,449.83 Fee Due at Permit Issuance PU.3L,CWORY.S APPROVAL: PLAN CHECK BY: APPROVAL TC ISSUE: $0.00 $0.00 $27.00 $265.00 $564.00 $0.00 $0.00 $0.00 $4,749.15 I 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 L) all of or L) portions of the work, and the structure is dot 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 improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner-Builderwill 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). ❑ 1 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.html. Signature of Property Owner or Authorized Agent Dale LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0 ) of Division 3 of the Business and Pr IDns Code, an license is in full farce and effect. License Class License No Date �2 Contractor Signatur WORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TG ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES As PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and 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 th performance of the work for which this permit is issued. Policy No. JI have and will maintain 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 nsurance carrier and policy number are: carrier Policy Number Expiration Date Jame of Agent Phone # 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 t, 1f I should become su ject to the orkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. signature of Applicant p b 7 Z2 )ECLARATION REGA I G CONSTRUCTION LENDING AGENCY hereby affirm under p nalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). -ender's Name Lender's Address 3y 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 laws relating to building construction. I authorize representatives of this city or county a er the ove-identified property for inspection purposes. signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name �Da '7 2�_ ACTION DATE BY DECLAWINN OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIO PART 61 OF TITLE 40 AND AO.MD RULE 1403 PERMITEXPIRED I SUBMITT D A5B[STJS NOTIFICATIOV TO PERMITCANCELLED OEPA PERMIT EXTENDED MD PERMITFINAL SBESTO NOTIFIC ON IS NOT APPLICABLE TO CERTIFICATE OF Z PROPOSED E L N _ " _ OCCUPANCYISSUED �' SIGNATU .� __�_