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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 e•,<,ra,xH'' 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 _ [ L� 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: