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HomeMy WebLinkAboutX2021-1930 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 ' / r Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 r:acrr�in+'�� Combination Type - MFP 'X2021 -1930* COMB Permit: X2021-19 Project No : Issued Date : 07/23/2021 Inspection Area : 2 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 07/23/2024 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: 280 CAGNEY LN NB St: 1 Ft 2 Unit: 205 Description: MFR (4) WINDOW CHANGE OUTS & (1) SLIDER *NO HEADER CHANGE' Legal Desc.: TR 8336 LOT 5 UNIT 116 OF PROJECT LOCATED ON AP 423-011-22 TOGETHER Owner: SHARE SHAREY Address: 280 CAGNEY LN #205 NEWPORT BEACH, CA 92663 Phone: Applicant: SHARE SHAREY Address: 280 CAGNEY LN #205 NEWPORT BEACH, CA 92663 Phone: 626-384-0263 Code Edit: 2019 Type of Construction: Occupancy Group: R2/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: $7 200.00 Building Permit Fee: $212.00 Plan Check Fee: $0.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management : $0.00 Energy Compliance: $0.00 CA Seismic Safety : $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $213.00 PROCESSED BY: ZONING APPROVAL: Contractor: O W NER/BLDR Address: Phone: Con State Lic: O/B Lic Expire: Bus Lic: Lic Exp Date: Worker's Compensation Insurance Carrier: Policy No: Expire: 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: / Front: / Left: / Right: / $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Architect: T^ Address: a IN S P IEV I V R Phone: 7State Lid: Engineer: Address: Phone: State Lic: Designer: Address: Phone: Special Conditions: Fire Hazard Zone : N Planning Department - Plan check Fee Fair Share SJH Trans In -lieu Housing Fee Public Works Department - Park Dedication : $0.00 P/W Plan Check: $0.00 San Dist : $0.00 NMUSD Fee: $0.00 Fire Department $0.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $213.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: _ APPROVAL TO ISSUE: LDER 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 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). ❑ 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 'mprova ants 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 raved 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 PP to an owner of o,operty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ I ar, exempt from licensure under the Contractors' State License Law for the following reason: By my 71gnature balow, 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 legall: sell a structure that I have built as an owner -builder if it as not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7944 of the Business and Professions Code, is available upon request when i applic On is submitted or at a following Web site:http://v�.leginfo.ca.gov/calaw,html. .leginfo.ca.gov/calaw,html. Signature of Property Owner or Authorized Agent �L o Date '-ICENSED CCNTRACTOR'S DECLARATIO mil/ I hereby affirm inderripenalty of perjury that I am li ensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Co e, andMy y license is in full force w.6 d,ect. Lic=nse Class License No Date Contractor Signature ERS' COUIPENSATION DECLARATION NGFAILURE -O SE-JRE WORKERS' 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 OF :OMPENLATIOA, DAMAGES AS PROVIDED FORM SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. ",eh7 affirm under penalty of perjury one of the following declarations: nave and 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 ormance of the work forwhich this permit is issued. Policy No. 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' compensa Trance carrier and policy number are: Policy Number of Agent Date JI certify that, in the performance of the work forwhich 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 agree let, if I should become s lect to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignature of ApplicantDate IECLARATION REGTDJING CONSTRUCTION LENDING AGENCY hereby affirm under penaltylat perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, ivil ode). Ender's Name Lender's Address y 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. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. //'' •�-/�'3� 1 authorize representatives of this city or county tp erffbr the above-ideroperty for inspection purposes. / ionature of Prooertv Owner or Authorized Aaent V / ntifie iti Print Prooertv Owner's or Authorized Aaent's Name X Date / ACTION DATE BY LARATION OF COMPLIANCE WITH CODE OF FEDERAL REG TIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 FOR OFFICE USE ONLY pvf H /V PERMIT EXPIRED LJ I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED LJEPA PERMIT EXTENDED QM D PERMITFINAL CERTIFICATE OF OCCUPANCYISSUED /6-20 Z / ,DA r— ro" e7 BESTOS N IFICATION IS NOT APPLICABLE TO p ROPO DE LITION /^` SIGNATURE: /`� — i, F a0 x z ao U N W Uo W c N M W � m 0 r - Q O m a Z F� ArF M o O V � U W �Am°(CIS zW�5ao O> F > c � y H c U 0 U U o 0 O m L c 9 J N L N o O m� =oN N N e � d @ C @ E H C L 3- d L " J aIm d oau) @ o m c E o rnnLp-�'vJc J J J T T d 9 R = Y CoE > 01 3 d R o J d >. ° >+ N W X = Ocn:4-:F•-Cd`o r 2 R N o 2) o @ T t N 0'U - @= y d c@ c 0. 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