HomeMy WebLinkAboutX2021-2320 - Permitsrk4! City of Newport Beach - Building Division IIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIII II COMB Permit: X2021-2320
100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 1 2 3 2 0 Project No : 2009-2021
�, 1f Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - SFP MECH ELEC PLUM GRAD Issued Date: Area
: 2011
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Inspection Area : 6
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0311112014 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: 31 CAMBRIA DR NB
Description: NEW SFR W/ATT GARAGE 4796/736 SF
Legal Desc.: N TR 7844 LOT 106
Owner: DG NEWPORT LLC
Contractor:
NICHOLSON CONSTRUCTION CO Architect: TEALE MARK
Address: 1 CORPORATE PLAZA OR 9110
Address:
1 CORPORATE PLZ #110 Address: 2900 BRISTOL ST BLDG A203
NEWPORT BEACH CA 92660
NEWPORT BEACH CA 92660 COSTA MESA CA 92626
Phone: 949-756-8393
Phone:
949-872-6637
Phone: 949-975-0123 State Uc:CO22162
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Applicant: TEALE MARK
Con State Lic:
660295
Engineer: HAKIM FADY
Address: 2900 BRISTOL ST BLDG A-203
Lic Expire:
12/31/2022
Address: 124 PEONY
COSTA MESA, CA 92626
Bus Lic:
BT98032850
IRVINE CA 92618�
Phone: 949-975-0123
Lic Exp Date: 0413012022
Phone: 310.422-1536 State Lic:C-075736
d
Code Edit : 2019
Worker's Compensation
Insurance
Designer:
Type of Construction: V-B-SPR
Carrier:
STATE FUND
Address:
Occupancy Group: R3/U
Policy No:
9074255
Added /New sq.ft. Bldg: 4796
Expire:
1010112022
Phone:
Added /New sq. ft. Garage: 736
No of Stories: 1
Building Setbacks
Rear: 40146
Special Conditions:
No of Units : 1
Front: 6
Bldg Height: 0
Left: 5
Bldg Sprinklers: Y
Right: 5
Flood Zone: X
Use Zone:
Parking Spaces:
0 Fire Hazard Zone : N
Construction Valuation: $922 160.00
Building Permit Fee: $7,371.00
Excise Tax:
$1,161.72
Planning Department - Fire Department
Plan Check Fee: $5,596.00
Additional Fee :
$0.00
Plan check Fee : $520.00 Fire Inspection:
$0.00
Overtime Plan Ck: $0.00
Grading Bonds Fee:
$0.00
Fair Share : $0.00 Fire Plan Rev
$0.00
Investigation Fee: $0.00
Grading PC Consultant :
$0.00
SJH Trans : $0.00 Demolition Fee
Record Management : $64.00
Grading Permit Fee:
$1,518.00
In -lieu Housing Fee : $0.00 Building Dept Adm
$0.00
Energy Compliance: $303.00
Grading PC Fee:
$1,856.58
Public Works Department - General Service
$0.00
CA Seismic Safety: $119.88
WQ Insp. Fee:
$1,220.00
Park Dedication : $0.00 Refund Deposit
$0.00
$0.00
Disabled Access : $0.00
P/W Plan Check : $304.50 Grading Bond:
Hazardous Mat $0.00
Electrical %:
$515.97
San Dist: $0.00
$0.00
Building Green Fee : $37.00
Mechanical %:
$294.84
NMUSD Fee: $3,956.00
Plumbing %:
$663.39
$0.00
TOTAL FEE : $25,501.88
Plan Check Fee :
$7,197.51 Fee Due at Permit Issuance : $18,304.37
PROCESSED BY:
__
Pt IBI.IC'WORKS APPROVAL:
ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
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 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 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).
❑ 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
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 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 legall)
sell a structure that I have 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/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0 Division 3 of the Business Sod Pr a Ions Cod a y license is in full force
and effect. License Class License No Date Contractor Signature
NORKERS' COMPENSATION DECLARATION
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUWECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUN ED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'$ FEES.
hereby affirm under penalty of perjury one of the following declarations:
7 I have 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
erfo c of the work for which this permit is issued. Policy No.
h and ni II 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' compensatiol
Isurance car er nd policy nu er re:
:artier y mber Expiration Date
lame of Age Phone #
s
]I certify that, in the performance o the work for which thi 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
iat, if I should become ssy/ ct to th wor ers' c(9mRensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
signature of Applicant
)FCI ARAT111N RFrA nlNri r�l ICTinN I f11N(: Ar:FNCV
)reby 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).
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 county ordinances and state laws relating to building construction.
I authorize representatives of this city or county, er the above-id�tif) pro erty for inspection purposes. ` _.a , C(
nature of Prooertv Owner or Authorized ADent X ee j( Print Prooertv Owner's or Authorized ADent's Nam 1
ACTION DATE BY r DECLARATION OF COMPLIANCE WITH CODE OF REGULATIONS PART 610 OF 40 AND AQMD RULE
�L FOR OFFICE USE ONLY
PERMIT EXPIRED
PERMIT CANCELLED
PERMIT EMENDED
SUBMITTED ASBESTOS NOTIFI'ATION 10
PERMITFINAL / AS TIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF �14'tlf POSED DEMOLITION
OCCUPANCY ISSUED SIGNATURE: