HomeMy WebLinkAboutX2022-0134 - PermitsCity of Newport Beach - Building Division ������������������������I����������������������������COMB Permit: X2022-0134
r Project No : 0317-2018
p c 100 Civic Center Drive, Newport Beach, CA 92660
r Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255 Issued Date : 01/20/2022
Combination Type - SFP ELEC MECH PLUM Inspection Area : 2
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 01/20/2025 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 Holidi
Job Address: Ill VIA LIDO SOLD NB I''
Description: SFR **RPLC EXPRD X2019.0371** ADD 264 SF,RMDL 400 SF (KITCHEN, (2) BATHS) *STOP WORK -117-3737-
Legal Desc.: TR 907 LOT 881(AND SELY1/2 LOT 880(AND NWLY 9.25 FT LOT 882'`-`'��
Owner: COFFRE JOETS Contractor: R D M S INC Architect: SMITH BRADFORD
Address: ill VIA LIDO SOUD Address: 250 E BAKER ST # 300 Address: 425 30TH ST #22
SA CA 92626 NEWPORT BEACH CA 92663
NEWPORT BEACH CA 92663
COSTA ME
Phone:
949-631-3682 State Lic:C014146
'
Phone:
714448-9835
Phone:
Con State Lic:
815872
Engineer:
GHOULI RAID ASAD
Applicant: KRAEMER KEVIN
Lic Expire:
p
12/31/2022
Address:
26040 ACERO #100
Address: 250 E.BAKER ST #300
Bus Lic:
BT326
MISSION VIEJO CA 92691
COSTA MESA CA 92626
Lic Exp Date:
0113112021/2022
Phone:
949-855-2300 State Lic:C-070882
Phone: 714-448-9825
Code Edit : 2016
Worker's Compensation
Insurance
EVERSTREMIER
INS CO
Designer:
Address:
Type of Construction: V-B
Carrier:
Policy No:
7600015443211
,
Occupancy Group: R31U
Expire:
09/01/2022
Phone:
Added /New sq.ft. Bldg: 264
Added /New sq. ft. Garage: 0
Building Setbacks
Rear: /
Special Conditions:
P
No of Stories 2
Front: I
No of Units : 1
Left: /
Bldg Height: 0
Right: /
Bldg Sprinklers:
Use Zone: Parkin
Spaces:
0
Fire Hazard Zone : N
Flood Zone:
tion Valuation: $0.00
Permit Fee: $0.00
Excise Tax:
Planning Department -
Plan check Fee :
Fire Department
$0.00 Fire Inspection:
$0.00
ck, Fee: $0.00
Additional Fee :
38.00
$38.00
$0.00
Fair Share :
$0.00' Fire Plan Rev
$0.00
Plan Ck: $0.00
FFRecord
Grading Bonds Fee:
$0.00
ans
0.00' Demolition Fee
tion Fee: $0.00
Grading PC Consultant:
$0.00
In -lieu eurHousin Fee
g
:
$0.00 Building Dept Adm
$0.00
anagement : $0.00
Grading Permit Fee:
$0.00
Public Works Department -
General Service
$0.00
$0.00
Compliance: $0.00
$0.00
Grading PC Fee:
WQ Insp. Fee :
$0.00
cation
Park plan
$0.00
Refund Deposit
Grading Bond:
$0.00
mic: Safety :
Check:
$0.00
Disabled Access : $0.00
$0.00
Electrical %:
$0.00
San Dist:
$0.00
$0.00
Hazardous Mat
Building Green Fee : $0.00
Mechanical W
$0.00
NMUSD Fee:
$0.00
$0.00
Plumbing %:
$0.00
TOTAL FEE: $38.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Plan Check Fee
$0.00 Fee Due at Permit issuance: $38.00
PUBLIC WORKS APPROVAL: 1
PLAN CHECK BY:
APPROVAL TO ISSUE:
I hereby affirm under penalty of perjury that lam 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'I
(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) u that he ll 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 U all of or
U Portions of the work, Business and Professions Code: The Contractors, State License Law does not apply to an owner of property who, through emp oyees'lortPersonal effort, buildshe structure is not orimproves the fpro ele (Section 7044,
improvements are not eof intended or offered for sale. If, however, the building or improvement is Soo within one year of completion, the Owner -Builder will have the burden of Provingthat it was not th built o r
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 Lawfor 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 stmuwe that I have built as an owner -builder if it has not been Constructed in its entirety by licensed contractors. 1 understand that a copy of the applicable law. Section 7044 of the Business and
Professiors Ccde, is available upon request when this application is submitted or at the following Web site:http:/hwnN.leginto.ca,govlcalaw.htrnl.
iignature, of Property Owner or Authorized Agent
_ICENSED CLNTRACTOR'S DECLARATION Date
hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 700 of Division 3 of the Business and Profess s e
and effect License Class
VO effect ' License
yMP lass ON DECLARATION License No Date z o'er —a0�el li a is in full farce
Contractor Signature
TANNING OMPFp S TI SECURE DAMAGES
ASWORKERS' COMPENSATION S COVERAGE IS UNLAWPIIL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 13100,000), M ADDMON'r0 THE
OST OF COMPFjrSATON, DAMAGES AS PROVIDED FOR IN SECTION 3T06 OF THE LABOR CODE. INTEREST, AND ATrO LOM FEES.
hereby affirm us der penalty of perjury one of the following declarations:
1 31 have Pnd 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 th
�fprnance of the work for which this permit is issued. Policy No.
10av0 oho win maintain workers' compensation insurance, as surance carrier and policy number are: required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compelrsatio
artier ame of Agent Policy Number
Expiration Date
b certify that, in the performance of the work for which this permit is issued, I shall not employ I an Phone #
St. 'rf I should become sub act to p P oy y person in any manner so as to become subject to the workers' compensation laws of California, and agrecomps ati n rovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
;nature of Applicant tt
•—•- ^� w�uuvaa autos URUCTION LENDING-.--.,—. Date / _r _ a a �% at
oars Name
areby 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, /Civil Code).
my signature below, I certify to each of the following: Lender's Address
10171 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 ordin nce.s and stat la relating to building Construction.
I authorize representatives of this city or county to ante b "�y
nature of Pro a Owner orquthonzed Agent - emii d car arty for inspection purposes.
nON DALE lL Print Prope I— —
DE or AuthorizedA ent's Name L)(� IC1L/}EMEf� Da 01i
BY CLARATION OF COMPLIANCE WLr}f CODE OF FEDERAL FOR OFFICE USE ONLYeSEEI
REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE --
CERTLFICATE OF '� �ZZ ,ZJ4 J),I 4JJLS8ESTOS NOTIFICATION IS NOTAPPUCABLE TO