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Home My WebLink AboutU2024-5021 - Permits,;EwvOk City of Newport Beach III III IIII I II II III IIII II II I II I II COMB Permit : U2O24-5021 6 Community Development Department- Building Division U 2 0 2 4 5 0 2 1 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2022-2421 75 >� ¢ Permit Counter Phone: (949) 716-1888 Issued Date : 06/12/2024 newportbeachca.gov/civic Final Date: r'""gw Combination Type - Permit Status: Issued Work Class - New Inspection Area : 7 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS Job Address : 2280 NEWPORT BLVD Legal Desc : N TR 16594 BLK LOT 1 UN HOLD LOT 1 OF TRACT 16594, Description: COMM -DETACHED TRELLIS (2) *BLDG A* 400 SF **ADD'L SCOPE TO PERMIT XC2022-1972** Rt, t r.� Owner: PENINSULA VILLAGE LLC Contractor: MIKE ROVNER CONST Architect Address : 220 NEWPORT CENTER DR, 11 Address : 5400 TECH CIRCLE Address NEWPORT BEACH, CA 92660 MOORPARK, CA 93065 Phone: (714)818-8034 Phone: (805)584-1213 Phone: „ Con State Lic : 795729 State Lic: , Lic Expire : 05/31/2025 - Applicant: PENINSULA VILLAGE LLC Bus Lic: BT30041026 Engineer: ALLANA KARIM Address : 220 NEWPORT CENTER DR, 11 Bus Lic Expire : 10/31/2024 Address : 990 COMMERCIAL ST NEWPORT BEACH, CA 92660 PALO ALTO CA 94303„CA 94303 ' Phone: (714) 818-8034 Workers' Compensation Insurance Phone: Owner/Builder : Address : Phone Code Edition : Type of Construction Occupancy Groups: Bldg Height: Building Setbacks Flood Zone Use Zone : Carrier: BENCHMARK INS CO Policy No: CST5025772 W. C. Expire : 7/15/2024 2022 Fire Sprinklers : Fire Hazard Zone U No of Units : No of Stories AF, 8 FT: X MU-W2 - Mixed -Use Water PROCESSED BY: SPECIAL CONDITIONS: REV2023-0 27 Designer: Address Phone : NO Construction Valuation : NO Added/New/TI sq. ft. Bldg Alteration sq. ft. Bldg : Add/New sq. ft. Garage: TOTAL sq. ft. : $7,500 111; 0 0 0 0 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 dpplicar';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 (_) all of or (_) 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 lcensure under the Contractors' Stale 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 7000 of Di 'sion 3 of the Business nil Profess) C e. my license is in full force and effect. License Class License No ate �/TJ`� Contract Ignature WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO FECI IRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1E100,0001, IN ADDITION TO THE COST Of COMPENSATION, DA'MGES AS PROVIDED FOR IN SECTION 3703 OF THE LABOR CODE, INTEREST, ANO ATTORNEY'S FEES. f.ereby affirm under penalty of perjury one of the following declarations: 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 Tydnce of the work for which this permit is issued. Policy No. 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 carrierand pu6cy number are: Policy Number of Agent __ Date �I certifv that, in tha 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 .at, if I s iould beromv-ubject to the workers' mpensalion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. _\ / t;ra'-�•c of A_ppnt _ __ _ _ ___ __ �EC L ARATIOr,ii ,AR IN NSTRl1CT10N LENDING / C hereby affirm under pzonalty 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). 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. I authorize representatives of this city or county to%�ter tth/' abob Identified property for inspection purposes. \ ,/� �/� /� x �j ionature of PrODertV Owner or Authorized�lDent / //i Z 2 Print Prooertv Owner's or Authorized Aaent's N\111 a {�lv/I�CL a,$J� B l / \ Date c ACTION DATE Ja', OrCLARATION OF COMPUAREE WTrH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE / 1403 PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED I _ EPA PERMITEXTENDED L3AQMD PERMITFINAL C(j-Zi 'lkt Ja ❑ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO CERTIFICATE OF PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: PERMIT FEE DETAILS FOR PERMIT U2024-5021 Fee Name Fee Amount Fee Paid Amount Transaction Date Payment Method Trans. Paid Amount Paid By Building Building Permit Fee -Valuation $218.82 $0.00 Green Building Fee $1.00 $0.00 Hourly Plan Check Fee - Planning $53.75 $0.00 Number of Drawings Fee $128.00 $0.00 GRAND TOTAL: $401.57