HomeMy WebLinkAboutX2021-1296 - Permits-- r
City,of Newport Beach - Building Division *X2021 -1296` COMB Permit: X2021-1296
100 Civic Center Drive, Newport Beach, CA 92660 PfOJBCt NO : 7133-2021
r. Permit Counter Phone (949)644-3288
' Inspection Requests Phone (949)644-3255 Issued Date: 0512012021
Combination Type - SFP I 'S3 P F1 0 R Inspection Area : 4
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0512012024 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: 1433 HIGH BLUFF DR NB
Description: SFR REMOVE (E) DOORS/WINDOWS AND REPLACE W/ (N) DOOR SYSTEMS IN LIVING RM, KITCHEN, DINING RM 8: M. BEDRM
Legal Desc.: N TR 15243 LOT 6
Owner: KENDZIORSKI ROBERT 8 ANNETTE
Contractor: ucvVt,e
Architect:
Address: 1433 HIGH BLUFF DR
Address:
Address:
NEWPORT BEACH, CA 92660
Phone: Q 411
- 6 7 7 -
I °l
Phone:
State Lic:
Phone:
Applicant: HOHN PRYN
Con State Lic:
Engineer:
Address:
BURKE LEO
34167 PACIFIC COAST HWY #D
Address: 34167-D PCH
Lic Expire:
DANA POINT CA 92629
DANA POINT, CA 92629
Bus Lic:
Phone:
949-226-7130 State Lic:C-067404
,
Phone: 949-226-7130
Lic Exp Date:
Code Edit : 2019
Worker's Compensation
Insurance
Designer:
,
Type of Construction: V-B
Carrier:
Address:
Occupancy Group: R3/U
Policy No:
Phone:
Added /New sq.ft. Bldg: 0
Expire:
Added /New sq. ft. Garage: 0
Building Setbacks
Rear: I
Special Conditions: OIB FORM ATTACHED
No of Stories: 2
No of Units : 1
Front: I
Bldg Height: 0
Left: I
Bldg Sprinklers:
Right: /
Use Zone: Parkin S aces:
0
Fire Hazard Zone : N
,
Flood Zone:
Construction Valuation: $18,000.00
Building Permit Fee: $382.00
Excise Tax:
$0.00
$0.00
Planning Department
Plan check Fee :
-
Fire Department
$46.25 Fire Inspection:
$0.00
Plan Check Fee: $332.34
$0.00
Additional Fee :
Grading Bonds Fee:
$0,00
Fair Share:
$0.00 Fire Plan Rev
$0.00
Overtime Plan Ck:
Investigation Fee: $0.00
Grading PC Consultant :
$0.00
SJH Trans :
$0.00 Demolition Fee
$0.00 Building Dept Adm
$0.00
Record Management : $14.00
Grading Permit Fee:
$0.00
$0.00
In -lieu Housing Fee :
Public Works Department -
General Service
$0.00
Energy Compliance: $0.00
Grading PC Fee:
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00 `
Refund Deposit
$0.00
CA Seismic Safety: $0.00
PNV Plan Check:
$0.00
Grading Bond:
$0.00
Disabled Access : $0.00
Hazardous Mat $0.00
Electrical %:
$0.00
San Dist:
$0.00
$0.00
Building Green Fee : $1.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
$0.00
Plumbing %:
$0.00
TOTAL FEE: $775.69
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Plan Check Fee
$0.00 Fee Due at Permit Issuance : $775.59
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE: ��
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 applicable9Sem(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 Iicensure 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, 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
k1lovaos,
for the purpose of sale).
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
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).
exempt from Iicensure 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, I cannot Iega[l,
sell a structure that I have built as an owner-builde If Yhas not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 701 4 of the Business and
Professions Code, is available upon request when t1le application is su6mittg{i or at the follow'I�,g Web site http://www.leginfo.ca.gov/calaw.html.
Signature of Props-t;, Owner or Authorized Agent Dat S-
LICENSED COYTPACTOR'S DECLARATION
I heety affirm IPrd=r penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
and effect. Licrnsa Class License No Date Contractor Signature
NORKERS' COMPENSATION DECLARATION
NARNING: FAILURE TO SEC'IRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
:CST 0- COMPEN^ATICN, CAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
I nape 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 th
.er�o.mance of the work for which this permit is issued. Policy No.
t havi and will ma'rtain 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'
urance carrier,and pplicy number are:
farrier . _
lame of Agent'
Policy Number
Date
I certify that, in the performance of the work for which 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 agre
It, if I should becomeKNIG
bject to the workers' compensation provisions of Section 3700 of/the Labor Code, I shall forthwith comply with those provisions.
(nature of Applicant ,.�� / ���.� ,1 Date �' 20 —L1
:CLARATIL; REGgCONSTRUCTION LENDING AGENCY
Drably affirm under penalty of perjury that there is a construction lending gency for the performance of the work for which this permit is issued (Section 3097, Civil 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 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 coun ordinances and state laws relating to building construction. )))
I authorize representatives of this city or coun enter the above -identified property for i spection purposes. ` / i5w V/'4 d'72�r J
nature of Property Owner or Authorized Agent - .L- 2 �-� , rint Property Owner's or Authorized Agent's Name x /ll�Y1i 7-rd ✓LS/GI ni. _ -L0 -v
ACTION I DATE I BY
PERMIT EXPIRED
PERMIT CANCELLED
PERMITEXTENDED
PERMIT FINAL
CERTIFICATEOF
OCCUPANCY ISSUED
t\ 6
1403
OF COMPUAN ITH CODE OF FEDERAL
PART 610E TI E40 AND AQMD RULE
NOTIFICATION TO
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FOR OFFICE USE ONLY
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