HomeMy WebLinkAboutX2021-0456 - Permits�IIIIII�III�II�II�llllll�llll�llIIIIII��I�� COMB Permit: X2021-0456
City of Newport Beach - Building Division Project No : 0428-2021
Drive, Newport Beach, CA 92660 I X 2 0 2 1 0 4 5 6
100 Civic Center Dn p
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255 Issued Date: 03/22/2021
��. Combination Type - SFP ELEC MECH PLUM Inspection Area: 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
SaturdayCT S M 8S00 a.m. 0 T BE LET D Bp.mY 0312212024 work on Sundays or R PERMIT L B INVALID
NV ALID
Construction Hours- Monday - Friday 7.00 a.m. to 6:30 p.m
Job Address: 1325 MARINERS DR NB
Description: SFR INTERIOR REMODEL OF KITCHEN, BONUS ROOM, AND LAUNDRY, NEW POCKET DOOR SYSTEM @ THE KITCHEN AND REMOVE & REPLACE WINDOWS 386 S
Legal Desc_: N TR 4981 LOT 15
Owner NORTON M DARRIN Contractor. TRUE HOME BUILDERS INC Architect:
Address: ° ° ° °
1325 MARINERS DR Address: 67 EDGEWOOD ° °
IRVINE, CA 92618 ° ° ° °
Address:
NEWPORT BEACH, CA 92660 Phone: State Lic:
Phone: 310-465-4586
Phone:
00 00
Con State Lie: 1073280 Engineer: WILSON KALEN
Applicant: ULLMAN TOBY 2023 Address: 23152 VERDUGO DR #102
Address: 9138 RESIDENCIA Lie Expire: BT30
LACUNA HILLS CA 92653
NEWPORT BEACH CA 92660 Bus Lie: T30074726
0 0 0
Lie Exp Date: 03/30/2022. Phone: 714-576-6524 State LiaC-083753
Phone: 949-350-6758
` Designer:
Code Edit: 2019 Worker's Compensation Insurance
Type of Construction: VB
Carrier: ACCREDITED SURETY Address:
Policy No: IATCA16004567
Occupancy Group: R3/U Phone:
Added /New sq_ft. Bldg: 0 Expire: 03/01/2022
IL
`AA' °000.00
Added /New sq. ft. Garage: 0 Special Conditions:
No of Stories: 1 Building Setbacks Rear: /
Front: /
No of Units. 1 °
Left: I
Bldg Height: 0
Right: /
Bldg Sprinklers: N
Flood Zone:
X Use Zone: Parkin Spaces: 0 Fire Hazard Zone: N
uConstruction Valuation: $40,000.00
Building Permit Fee: $679.00 Excise Tax: $0.00 Planning Department -
Fire Department
Plan Check Fee: $590.73 Additional Fee: $0.00 Plan check Fee: $46.25 Fire Inspection: $0.00
0.00 Fire Plan Rev $0.00
Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Demolition Fee
Investigation Fee: $0.00 Grading PC Consultant : $0.00 SJH Trans: $Building
Record Management: $38.00 Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 General Service dm i e$0.00
Grading PC Fee: $0.00 Public Works Department -
Energy Compliance: $61.00 g Park Dedication: $0.00 Refund Deposit $0.00
CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Grading Bond: $0.00
P/W Plan Check: $0.00 9
Disabled Access: $0.00
Hazardous Mat $0.00 Electrical %: $47.53 San Dist: $0.00 $0.00
Building Green Fee: $2.00 Mechanical %: $27.16 NMUSD Fee: $0.00 $0.00
Plumbing %: $61.11
TOTAL FEE : $1,552.78 Plan Check Fee: $697.98 Fee Due at Permit Issuance : $854.80
PUBLIC WORKS APPROVAL:
PROCESSED BY:
L PLAN CHECK BY:
ZONING APPROVAL: '
APPROVAL TO ISSUE
GRADING APPROVAL:
OWNER-E UULDER 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 signet{ 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 pro,erty, or my employees with wages as their sole compensation, will do L) 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).
1 am exempt from licensure under the Contractors' State License Law for 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, 1 cannot legall
sell a structure ii t i neve 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/Galaw.htmi.
aig,9,?WFe of Preperty�Q er or Authorized Agent
LICENSED TR4CTOR'S DECLARATION Rate
60
I l areb�y'affirm und- n penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0) of ivision 3 of the Business and Prof' sions Code, and my licens�in l force
�ndre#fact. License Gloss License No
Date -s �` )a? contractor Signature
NJRF:ERS' C1M1PEASATION DECLARATION /
x1RN17G: FAILURE TO SEC
VRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND Si4ALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL/TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
,OAST , COMPEN-AT]O', EnMIAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
here¢v affirm underlpenalty of perjury one of the following declarations:
r
�rlr✓✓? and will merrtain 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 thi
i�rforma'hce of the wark'farwhich this permit is issued. Policy No.
k�liav`a'and will mainteiri'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' compensatior
? ra carrier�nO puGcy number are:
Uainer Policy Number Expiration Date
Name of Agent I Phone #
1:31 certify that, in the performance of the work for which this permit is issued I shall
that, if I should become''s,ub'ect to p not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
J pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of TION Ica Da � DECLARATION RE 9!IdG CONSTRUCTION LENDING AGENCY ` �
1 hereby affirm under enalty 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).
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.
I have read this application and the information 1 have provided is correct.
I agree to comply with all applicable city and county ordinances and state laws relating to building construction.
I authorize representatives Of this city or cou to enter the ab9ye:-mhwMfied property for inspection purposes. �1n A
ACTIOure of Property Owner or Authorized Agent Print Property Owners or Authorized Agent's Name J r t cl-k k e
ACTION DATE BY J DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULA PART 61 OF TITLE 40 AND AQMD RULE
PERMIT EXPIRED
PERMIT CANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCY ISSUED
I SUBMITTED ASBESTOS NOTIFICATION TO
SIGNATU
NOTIFICATION IS NOTAPPLICABLE TO