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Home My WebLink AboutX2022-0721 - PermitsCity of Newport Beach - Building Division 1111111111111111111111111111111111111111111111111111111COMB Permit: X2022-0721 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 2 0 7 2 1 Project No : 0766-2022 r. s„ Permit Counter Phone (949)644-3288 C Inspection Requests Phone (949)644-3255 Issued Date : 05/04/2022 Combination Type - SFP ELEC PLUM a CtYU6 Inspection Area : 3 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: 70 CORMORANT CIR NB Description: SFR INSTALL GAS LINE AND ELECTRICAL FOR (N) PREFAB SPA, FIRE PIT, & BBQ & DRAINAGE Legal Desc.: N TR 12212 LOT 16 Owner: DEVINCENTIS ANTHONY Contractor: GOLDENLINE CONSTRUCTION INC Architect: Address: 70 CORMORANT CIR Address: 1812 W BURBANK BLVD #201 Address:, NEWPORT BEACH, CA 92660 BURBANK, CA 91506 Phone: V •� Phone: 949-973-5169 Phone: 818-339-9444 ' Applicant: PIVKU TAR Con State Lic: 989378 Engineer: Address: 1812 W BURBANK BLVD Lic Expire: 12/31/2023 Address: BURBANK, CA 91506 Bus Lic: BT30078657 Phone: 954-669-4303 Lic Exp Date: 05/30/2023 Phone: State Lic: Code Edit: 2019 Worker's Compensation Insurance Designer: NISSIM-ROZNER YUVAL ,,,, Type of Construction: Carrier: STATE COMP Address: 17351 GRESHEM ST Occupancy Group: U Policy No: 9143317 NORTHRIDGE, CA 91325 Added /New sq.ft. Bldg: 0 Expire: 12/21/2022 Phone: , Added /New sq. ft. Garage: 0 No of Stories: 0 Building Setbacks Rear: / Special Conditions: ' No of Units: 1 Front: I " Bldg Height: 0 Left: / Bldg Sprinklers: Right: / Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $17 000.00 Building Permit Fee: $365.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $0.00 Additional Fee : ($365.00) Plan check Fee : $0.00 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: $8.00 Grading Permit Fee: $237.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 Energy Compliance: $0.00 Grading PC Fee: $199.00 Public Works Department - General Service $0.00 CA Seismic Safety : $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access : $0.00 PM Plan Check : $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $25.55 San Dist : $0.00 Building Green Fee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $32.85 $0.00 TOTAL FEE: $503.40 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Plan Check Fee $199.00 Fee Due at Permit Issuance : $304.40 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 reasons) 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 (_) all of or (_) 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). I am exempt from licensure under the Contractors' State License Law for the following reason: By my signature,t=h'v 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'chat 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. 41gnatune of Prnce rty Owner or Authorized Agent Date LICENSED COW FACTOR'S DECLARATION hernhy affirm Linear penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0 of Division 3 of the Business and to s ode, and my license is in full force and effect. Liceiibe Class License No Date _V ti Contractor Signal r WORKERS' CUMPENSATION DECLARATION FAILUR'e i U SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS IE100,000t, IN ADDITION TO THE :OMPENSAT'CN. rAMAGES AS PROVIDED FOR IN SECTION 37M OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. affirm under penalty of perjury one of the following declarations: and will ma -main 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 a of tr a wort; for which this permit is issued. Policy No. I have and wiG mvmain 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' urance carriecaud policy number are: me of Agent I certify that, in the pl it. if I should become Policy Number Date 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 workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. //////[ /I; IV Signature of Applicant Datef�✓ I —1 DECLARATION REGA D UCTION LENDING AGENCY Y/ \\11 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, Civi Code). Lender's 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. have read this application and the information I have vide s correct. I agree to comply with all applicable city and county rain nc s and state laws relating to building construction. I authorize representatives of this city or cou y o bove-identified property for inspection purposes. �, Lv Signature of Property Owner or Authorized A ant Print Property Owner's or Authorized Agent's Name, �'/ Dat ACTION DATE BY1--DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE All required alarms,latches 1403 a n_____...u..�. ......... PERMIT EXPIRED I SUBMITTED ASBESTOS N TIFICATION TO J as part of a pool 1 spa barrier, shall be in place prior to approval to fill poollspa & shall remain in placebe ainSdpfor 23 PERMITCANCELLED EPA PERMIT EXTENDED AQMD PERMITFINAL CERTIFICATE OFOCCUPANCY SUED '1 f1-� BESTO IFI ION IS NOTAPPLICABLE TO FRCPCrSED N