HomeMy WebLinkAboutX2021-0493 - Permits'g0v,¢r City of Newport Beach - Building Division II IIII II IIIIII� III II III III II II COMB Permit: X2021-0493
100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 1 0 4 9 3 Project NO : 0454-2021
Permit Counter Phone (949)644-3288
4z Inspection Req,zests Phone (949)644-3255
°=,,t t„ Combination Type - SFP MECH ELEC PLUM Issued Date : 03107/2022
Inspection Area : 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 03✓0712025 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: 19241RVINE AVE NB
Description: SFR REMODEL KITCHEN, NEW FIREPLACE, WINDOWS, LIGHTING, PANEL UPGRADE, ELECTRICAL VEHICLE CHARGING STATION (350 SF)
Legal Desc.: N TR 3801 LOT 56
Owner: TORRES KATHLEEN
Contractor:
OTTY'S CONSTRUCTION Architect:
MASON WILLIAM
Address: 1924 IRVINE AVE
Address:
623 E CENTRAL AVE Address:
824 VIA ALHAMBRA #D
r �,
NEWPORT BEACH, CA 92660
SANTA ANA CA 92707
LAGUNA WOODS CA 92637
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Phone:
Phone:
949-514-3522
Phone:
7141427-0688 State Lic:CO23759
Applicant: MASON WILLIAM
Con State Lic: 1026166
Engineer:
ROHRER PAUL DUANE
Address: 824 VIA ALHAMBRA #D
Lic Expire:
04/30/2023
Address:
1527 E. AUTUMRIDGE CT
LAGUNA WOODS CA 92637
Bus Lic:
BT30076373
ORANGE CA 92866
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Phone:
Lic Exp Date:
0813112022
Phone:
714.272-9579 State Lic:S-004340
J
Code Edit: 2019
Worker's Compensation Insurance
Designer:
0
Type of Construction: VB
Carrier:
NO EMPLOYEES Address:
Occupancy Group: R3/U
Policy No:
Added /New sq.ft. Bldg: 0
Expire:
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 1
Building Setbacks
Rear: /
Special Conditions:
No of Units : 1
Front: /
Bldg Height: 0
Left: /
Bldg Sprinklers: N
Right: /
Flood Zone: X
Use Zone:
Parking Spaces:
0 Fire Hazard Zone : N
Construction Valuation: $180 000.00
Building Permit Fee: $1,717.00
Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee: $1,561.79
Additional Fee :
$68.00
Plan check Fee :
$52.00 Fire Inspection:
$0.00
Overtime Plan Ck: $0.00
Grading Bonds Fee:
$0.00
Fair Share :
$0.00 Fire Plan Rev
$0.00
Investigation Fee: $0.00
Grading PC Consultant :
$0.00
SJH Trans :
$0.00 - Demolition Fee
Record Management : $38.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee :
$0.00 Building Dept Adm
$27.00
Energy Compliance: $126.00
Grading PC Fee:
$0.00
Public Works Department -
General Service
$265.00
CA Seismic Safety : $0.00
WQ Insp. Fee:
$0.00
Park Dedication : $0.00
Refund Deposit
$564.00
Disabled Access : $0.00
PAN Plan Check: $50.75
Grading Bond:
$0.00
Hazardous Mat $0.00
Electrical %:
$120.19
San Dist: $0.00
Building Green Fee : $8.00
Mechanical %:
$63.60
NMUSD Fee: $0.00
$0.00
Plumbing %:
$154.53
$0.00
TOTAL FEE : $4,820.94
Plan Check Fee
: $1,666.04 Fee Due at Permit Issuance : $3,154.90
PROCESSED BY:
bVBLIC WCR:,S APFROb AL:
ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
APPROVAL TO 18SUE:
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 Diirision 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 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
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).
❑ 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 legally
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,ieginfo.ca.govlcalaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with SectioXALPENAL/TIES
) of Divisio 3 of the Business and Pr es s-Co d my license is in full force
and effect. License Class License No DaContractor Signatur
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI AND CIVIL FINES UP TO 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 the
performance of the work for which this permit is issued. Policy No.
❑I 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' compensatiol
insurance carrier and policy number are:
Carrier Policy Number Expiration Date
A of Agent
certify that, in the performance of the work
, if I should become suJIject to the worker
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
ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant/���' 7
DLARATION REG D G L-6N§fRUCTION LENDING AGENCY
:reby affirm under ifenalty 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).
ider's Name Lender's Address
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 st laws relating to building construction.
I authorize representatives of this city or county enter the above -I tlfied property for inspection purposes. ` �-
nature of Prooertv Owner or Authorized Agent �j Print Property Owner's or Authorized Agent's Name Y a II, O
DATE
OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
PART 61 OF TITLE 40 AND AClMD RULE
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