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Home My WebLink AboutX2022-0970 - Permit ApplicationCity of Newport Beach - Building Division IIIIIIIII p 100 Civic Center Drive, Newport Beach, CA 92660 _ X 2 H u Permit Counter Phone (949)644-3288 .'. ".. Inspection Requests Phone (949)644-3255 Combination Type - MFP MECH ELEC PLUM NO CO { PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTICO.PROJEi Construction Hours: Monday -Friday 7:00 a.m. to 6:30 p.m. Satu Job Address: 1000 PARK AVE NB i' Description: DELTA 1, KITCHEN REMODEL, REMOVE/REPLACE LIGHTS @ _IV DOM,\IM �y Legal Desc.: BALBOA ISLAND SEC 2 BLK 7 LOT 18 'ii OO Owner: RICHARDSON JAMES H Address: 12674 ROSWELL AVE CHINO, CA 91210 Phone: 626-627-9997 Applicant: RICHARDSON JAMES H Address: 12674 ROSWELL AVE CHINO, CA 91210 Phone: 626-627-9997 Code Edit : Type of Construction: Occupancy Group: Added /New sq.ft. Bldg: Added /New sq. ft. Garai No of Stories: No of Units Bldg Height: Bldg Sprinklers: Flood Zone: Construction Valuatior 2019 V-B R3/U 0 0 �t��✓ 200 Building Permit Fee: $, Plan Check Fee: $435.87 Overtime Plan Ck: Investigation Fee: Record Management Energy Compliance: CA Seismic Safety Disabled Access Hazardous Mat Building Green Fee PROCESSED BY: St' Yrs Xa�pY'a' COMB Permit: X2022-0970 Project No : 2868-2019 Issued U l.r I I®�'7 VQ Inspection Area 62022 MPLETE Y 04/IV025 OR PERMIT WILL BE INVALID to 6:001P.m. No w3ll on Sundays or Holidays N i 3LDR O Architect: CRAWFORD JAY )SON JAMES -ter Address: 470 WALD No ' IRVINE CA 92618 larione: Con Si Lid: Lic,p. pire: s Lic`°` Lic Exp One on Insurance � 11. +? as $0.00,�4,ng nds Fee: $0.00 Con i $2.00 $0.00 Grading Permit PW Grading P e: ws $0.00 OI $0.00 $1.00 i_c lost %: mb %: TOTAL FEE : $1,092.07 ZONING APPROVAL: GRADING APPROVAL: Phone: 949-453-9893� Engineer: Address: XN IN Phone DM J 9 V cial Conditiop : LANWIDFs � nC'Srciry a ront. 10 Left. 3 Right: 3 $0.00 State I '� ment - Fee $52.00 Fire Department Fire Inspection: $0.00 : e : $0.00 Fire Plan Rev $0.00 s' $0.00 Demolition Fee XPIanningDee si ee: $0.00 Building Dept Adm $0.00 apartment- General Service $0.00 ication : $0.00 Refund Deposit $0.00 Check : $0.00 - Grading Bond: $0.00 $0.00 NMUSD Fee: $0.00 _ $0.00 $0.00 Fee : $487.87 Fee Due at Permit Issuance : $604.20 PU3LIC tVCRKS APPROVAL: PLAN ChE,CK BY: APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s)' Icated b- ow byG,d (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, impro , demolish, or repair, the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' Stat tense Law (Cho cc Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any vio on of Section 703t any not more than five hundred dollars ($500). Q1Q ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) all r L s of trk, and the Pushhess and Professions Code: The Contractors' State License Law does not apply to an owner of operty. wwJraj�{hrough r9lfployees' or en Mra ents are not intended or offered for sale. If, however, the building or improvement is so ithin o ar ofi letion, the Per. improve for the purpose of sale). O kmark(s) I have placed next to the applicable items) Clare, prior to its issuance, also requires the applicant for %cingwith Section 7000) of Division 3 of the Business and t for�a�permit subjects the applicant to a civil penalty of JreNded or offered for sale (Section 7044, effcfmproves the property, provided that the burden of proving that it was not built or ❑ I, a owner of the property, am exclusively contracting with licensed Contractors to CO uct the,,S�o ct n 7044, Bu ass and Professions Code: The to ap o an owner of property who builds or improves thereon, and who contracts for th rojects wit ha Iicce�e�n Coontracl rr rsuant to the Contractors' State LicensIN I am exempt from licensure under the Contractors' State License Law for the f ing reason: By my signature below I acknowledge that, except for my personal residence in Ich I must pave resided for at I ne year prior to completion of the improvements sell a structure that I have built as an owner -builder if i h not been cons d in enti y by I ensed colot rs. I understand that a copy of the applio, law, S Professions Code, is available upon request when h' ap 'Cali i ub d1or a e II ijjj, site: http771www.leginfo.ca.gov/calaw.html. RI3 I Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under visions of apter 9:(commencing with Section )ivision 3 of the 6 ess nd Professions and effect. License Class nse No Date . Cq�t c r Signature WORKERS' COMPENSATION DECLARATION iti -� ✓DARNING FAILURE TO SECURE WORKERS' COMPENSATION c0 GE IS FUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CI PIP E HUNDRED OjISP COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN S ION 3T 6 Eff E LABOR CODE, INTEREST, AND ATTORNEY'S FEES ' ((((((llllll hereby affirm under penalty of perjury one of t ollowi ions `:,✓ ,`t* 1\� ❑ I have and will maintain a certificate ons kG If -insure for workers' compensation issued by theDirect of trial ions as pr ided�y oerformance of the work for which this p it is issu . Policy No. 0 n \.• have and will maintain worker ' or \NL rance carrier and policy num are: is of Agent certify that, in the if I should becon lature of Applican State License Law does not m it, I cannot Is Business and .- 7n'2 and my liMnse is in full force ($100,0001, IN ADDITION TO THE 3700 of the Labor Code, for Isurance, as required by Section 3700 of the Labor Code, fo he orma a of the k fof,,,*ih permit is issued. My workers' Policy Number piration attee Is I* qed, I shall t employ any perscpin any manner so Io05/Of ;S O'if" 17jn of the Labor Code, I shall forthwith J=I !_AKA I IUIN KCU KUIINU UUINJ I K,11.NI INU A16 -T� hereby affirm under natty of perjury tha a co to _�; ding agency for bhe.performance-of the 'ere .ender's Name It . "r's A6tess 3y my signature below, I certify to each of I am the property owner or authorized to act Jie party owner' �{ I have read this application and the information ' ye vided 1 I agree to comply with all applicable city and count . din ce w ale i g't ui cons I authorize representatives of this city or co to rk "•the v tid r to ' Ion , signature of Property Owner or Authorized A Pint D ACTION DATE I B COMPLIA H COD F F RAL REG ULATI PA 610fa E 40 AND Q ULE PERMITEXPIRED 16—LZ--'i D' ❑I SUBMITTED ES NOTIE1A NTO PERMITCANCELLED EPA PERMITEXTENDED E1AQMD `. PERMIT FINAL SBESTOS N TIFI ATION IS T PU BL TO CERTIFICATEOF ROPOSEDD 'p��y,{[p'N OCCUPANCYISSUED SIGNATUR l� EJ• IIU Owner's or Direct to the workers' compensation laws of California, and provisions. S/ IVZr l�Z - — it is issued (Section 3097, Civil Code). FOR OFFICE USE ONLY ,19d