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Home My WebLink AboutX2021-3096 - Permits,�JcMl.u7, City of Newport Beach - Building Division �11111111111p11111111 111111111111� JillCOMB Permit: X2021-3096 100 Civic Center Drive, Newport Beach, CA 92660 x 2 6 2 1 3 0 9 6 Project NO : 2684-2021 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Issued Date : 03/29/2022 J r4a�y�ar> Combination Type - SFP GRAD ELEC MECH PLUM Inspection Area : 4 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 03/29/2025 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: 2411 BAMBOO ST NB Description: NEW SFR W/ATT GAR 4530 & 676 SF, DECK 342 SF Legal Desc.: N TR 4893 LOT 48 Owner: LA21A LLC Address: 26940 ALSO VIEJO PKWY #100 ALSO VIEJO CA 92656 Phone: 9491481-7026 Applicant: ROSENE MARK Address: 26940 ALSO VIEJO PKWY #100 ALSO VIEJO CA 92656 Phone: 9491481-7026 Code Edit : 2019 Type of Construction: V-B-SPR Occupancy Group: R3/U Added /New sq.ft. Bldg: 4530 Added /New sq. ft. Garage: 676 No of Stories: 2 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Y Building Permit Fee: $7,371.00 Plan Check Fee: $5,528.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $158.00 Energy Compliance: $303.00 CA Seismic Safety: $117.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $36.00 TOTAL FEE: $25,554.90 PROCESSED BY: ZONING APPROVAL: Contractor: T J C HOME BUILDERS LLC Address: 26880 ALSO VIEJO PKWY #100 ALSO VIEJO, CA 92656 Phone: (949)481-7026 Con State Lie: 1025607 Lie Expire: 04/3012023 Bus Lie: BT30059037 Lie Exp Date: 05/31/2022 Worker's Compensation Insurance Carrier: NATIONAL FIRE & MARINE INS CO Policy No: 42HB615046601 Expire: 12/31/2023 Building Setbacks 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: 10 Left: 6 Right: 6 Parking Spacr $1,093.26 $0.00 $0.00 $0.00 $997.00 $867.39 $152.00 $515.97 $294.84 $663.39 0 Architect: Address: Phone: Engineer: Address: Phone: Designer: Address: Phone: NIEMERSKI KENNETH 2031 ORCHARD DR #100 NEWPORT BEACH CA 92660 949-553.9100 State Lic:CO23971 NGUYEN HUAN ' 15STUDEBAKER IRVINE CA 92618 " 949-752.1612 State Lic:C-064238 Special Conditions: Fire Planning Department - Plan check Fee Fair Share SJH Trans In -lieu Housing Fee Public Works Department - Park Dedication : $0.00 PAN Plan Check: $355.25 San Dist: $2,084.00 NMUSD Fee: $4,498.80 Fire Department $520.00 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 : $7,197.51 Fee Due at Permit Issuance PUBLIC WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: VUCX( I APPROVAL TO ISSUE: rCTOP $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $18,357.39 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). 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) 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). I am exempt from licensure under the Contractors' State License Law for the following reason: By my signature below [ 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, ;ell a s�,ucture 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 ?, ofess-ons Code, is w,ailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htm]. Signature of Proyehy Owner or Authorized Agent Date _ICENGED CONTRACTOR'S DECLARATION hereby affirm ul.der p, nalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 000jrof "vi a Business and ProPons ant lie se � full force vnd efrect. Liceire Class License No Dat ntractor SignatureNORKERS'COUIPENSATION DECLARATIONVARNING' FAILURE 7C =URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDREDOLLARS I$100,000I, IN ADDITION TO THE -CST J.7 COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. r.3.Ety affirm under penalty of perjury one of the following declarations: I have and wT 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 ;a,fo,n once of the work for which this permit is issued. Policy No. VI 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 rance carrier and policy number are: Policy Number Expiration Date of Agent I certify that, in the p rfor ante of thew for which this permit is issu , I shall not employ any person in any manner so as to become subject to the workers' compeR�ation laws of California, and agre d, if I should become ub ct to 1 wor r ' pensati rovi ' ns Section 3700 of the Labor Code, I shall forthwith comply with those provisions. n I1' �-7 mature of Applicant Da '``'ll (.� !CLARATION REGAR N NST MOVLENDING A NCY Breby affirm under penalty of perjury that there is a construction lendi gency for the performance of the work for which this permit is issued (Section 3096vil 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 owners behalf. I have read this application and the information eve provided is correct. I agree to comply with all applicable city and cou ordinanc state w g to building construction, authorize representatives of this city or9ou r t e b-identi prop rt for inspection purposes. g fr'p ,) I O a 3I 2 nature of Property Owner or Authorized A ent Print Property Owner's or Authorized Agent's Name U v (l(i(i TION DATE BY f CLARATION OF COMPLIANCE IT CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE AND AQMD RULE rcrcmll tAYIKLU I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED EPA PERMIT EXTENDED AQMD PERMIT FINAL CERTIFICATE OF 222 • 9, 2 7 A ESTOS PROPOS DE O IFICAT}QN IIS NO APPLI BLE TO LITIO.� \ A OCCUPANCY ISSUED / SIGNATURE; V( I /