HomeMy WebLinkAboutX2022-1821 - PermitsEWt�cs4.
City of Newport. Beach - Building Division
"X2022�1821`
COMB Permit: X2022-1821
100 Civic Center Drive, Newport Beach, CA 92660
Project No : 1682-2022
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - SFP MECH ELEC PLUM
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Issued Date : 0710112022
Inspection Area : 4
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: 52 CROOKED STICK DR NB
Description: SFR INTERIOR ALT 200 SF KITCHEN & BATHROOMS.
Legal Desc.: N TR 15391 LOT 54
Owner:
LANNI MICHAEL
Address:
52 CROOKED STICK DR
NEWPORT BEACH, CA 92660
Phone:
949-290-8053
Applicant:
PRIDY ALLISON
Address:
4659 PEPPERWOOD AVE
LONG BEACH, CA 90808
Phone:
562-746-2714
Code Edit : 2019
Type of Construction: V-B
Occupancy Group: R3/U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units : 1
Bldg Height: 0
Bldg Sprinklers:
Construction Valuation:
$
Building Permit Fee:
$212.00
Plan Check Fee: $184.44
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management :
$6.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access:
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $497.84
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Contractor PRO TEy^,(CO TRUCTION Architect:
Date:
Addr ss 2651 SAT SS1 Address: if a� ;:•r, ` -
Date.._-BREA-GA� .._
Phone 714-231-6104 Phone. State Lic:
❑ 80% al
Con State Lic: 485114 P ELie Lic Expire: 01/31/2024 AA
Bus Lic BT30068349, to whom, --
_- Lic Exp Date: 08/3112022 hone: State Lic:
..Worker's Compensation Insurance .•...Designer. PRIDY ALLISON
r=''� Carrier: ACE AMERICAN INSURANCE CO Address' 4659 PEPPERWOOD AVE
Pglicy No C70071368 - LONG BEACH, CA 90808
ire: 10101/2022 &- w .Y Phone{ 562-746-2714
mg etbacks Rear: I Special Conditions:
Front: I
Left: I ,(-l1 p
e ong'"„* Ri t:p/ a l�w,ram Fire Dis rd id40�
(works ted) (no work started)
,e Tax: Planning Department - Fire Department
ional Fee: $0.00 Plan check Fee : $52.00 Fire Inspection:
ing BDOds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev
LL(t�affbbii _On Demolition Fee /
Permit Fee:
PC Fee:
Electrical %:
Mechanical W
Plumbing %:
5N
$14.84
$8.48
$19.08
Plan Check Fee :
In -lieu Housing Fee
n Check : $0.00
San Dist : $0.00
NMUSD Fee: $0.00
Insp.
Grading Bond:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00 Fee Due at Permit Issuance : $497.84
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
Mk
OWNER -BUILDER
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 items) -
(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 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).
❑ 1, as owner of the property, am �jy�(j(1gSF_ntrasit4cs�tO Gousk�+�...'1he�r Professions Code: The Contractors' State License Law does not
apply to an owner of property who Is Has or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
LJ I am exemp' f-cm licensure deal
Ly Ini 3ignatu•e below I acknowledc
sell a structure that I have built as at
Professions Code, is available upon
Signature of Property Owner or Auth
LICENSED CONE RACTOR'S D
I h,_r Eby affirm uuoer penalty of peril
aiH effect. License --lass
✓JORKERS' COMPENSATION I
l.A,R II'IG: FAILURE TO SECURE WORKERS
COST JF COMPEtISATION, DAMAGES AS PF
hereby affirm ender penalty of perjl
71 ! have anu wili ,naintain a Berti-
oerforr.i aance cP:he work for which th
21 have and will maintain workers'
nsurance cipmer and policy number
ie of Agent
certify that, in the perform ncf
if I should becomesCsubj t to
iature of Applicant(
if it has not ben constructed In its entirety by licensed contractors. I understand that a co y of the applicable law, Section 7044 of the Business and
its appllcabgq is submitted or at the,fgllowlpg,YVeb sitehitpa{www.legl'Ff .0 a0V. tE �U 70 i =r
Date
y that I am licensed under provisions of Chapter 9 (commencing with Section 7q) t�0tWhiC he Business and Prof4uions Code, and my license is in full force
_ Lirense No _ Date Xi Contractor Signature iC
EC LA RATI O N �
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS I$100,0001, IN ADDITION TO THE
1VIDFD FOR IN SECTION 37DG OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
y one of the following declarations:
ate of ponsenb to self -insure 14'wodKeuliN compeAaH4n of Industrial Relations as provided for by Section 3700 of the Labor Code, for the
permit is issued. Policy No.
ation Insurance, as requiredbySection 3700 of the LaborCode, for the performance offtt�hee work for swhich
/this permit is issued. My workers' compen
�.P,dlloy"1N �I4H�"9C' 7^'1 S� { 1 {� �tKP(a[pn at
for which t� g I �F all not employ any person in any ',1y�I(I orWWk Gtafte4l)ct to the workers' compensation laws of California, and
a�em e�ns�ii6dro43ection 3700 of the Labor Code, I shall forthwith comply with those provisions.
a-Z
I hereby affirm under penalty of perju that there is a construction lending agency for the performance of the work for which this Qermit is igsugd (S coon 3093 o e.
Lender's Name Lender's Address 1nitIafis:
By my signature below, I certify to ea h i
I am the property owner or autho
1 have read this application and the information I have provided is correct. /�
I agree to comply with all applicable city and county or inances and state laws relating to building construction.
I authorize representatives of this city or county toe eI the abo erty for inspection purposes. ('�/((-� _J %� 7
Signature of Property Owner or Authorized Agent — Print Property Owner's or Authorized Agent's Name %C ` t5cv) �� D Date 3
ACTION DATE BY DE RATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED
PERMIT CANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCY ISSUED
LIASBESTOS NOTIFIC�ry ION IS NOT APPLICABLE TO
PROPOSED DEMOLITII�f�