HomeMy WebLinkAboutX2021-3037 - PermitsCity of Newport Beach - Building Division
II COMB Permit: X2021-3037
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
100 Civic Center Drive, Newport Beach, CA 92660
X 2 0 2 1 3 0 3 7 Project No : 2640-2021
j Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Issued Date : 11I08/2021
Combination Type - BLDG PLUM
Inspection Area : 2
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 1110812024 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: 411 N BAY FRONT NS
Description: DEMO SFR/GAR 2491 SF. 3 BEDROOMS. SEWER CAP INCLUDED
Legal Desc.: BALBOA ISLAND RESUB SEC 1 BILK 8 LOT 6
Owner: LYMAN BRAD Contractor:
DEVCO HOMES Architect: ,4
Address: 411 N BAY FRONT Address:
13 CORPORATE PLAZA #102 Address: !✓®
NEWPORT BEACH, CA 92662
NEWPORT BEACH CA 92660 /q,
Phone: Phone:
949-212-3262
Phone: C) State Lie:
Applicant: JEFF/DEVCO Con State Lie: 773220
Lie Expire: 01131/2022
Engineer: 2
Address; v
Address: 13 CORP PLAZA STE 102
;•//1
NEWPORT BEACH CA 92660 Bus Lie:
BT30001683
-
Phone: 714-313-9877 Lie Exp Date:
02/2812022
Phone. State Lic:
Code Edit: 2019 Worker's Compensation Insurance
Designer:�0
Address:
Type of Construction: V-B Carrier:
WC EXEMPT
Occupancy Group: R3/U Policy No:
0 Expire:
(NO EMPLOYEES)
Phone:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage: 0
No of Stories: 0 Building Setbacks
Rear. /
Special Condition%4OLEMO TO
No of Units : 1
Front: I
DEBRIS ®�,n
Bldg Height: 0
Left: I
Right: /
® V,
Bldg Sprinklers:
Flood Zone: Use Zone:
Parking Spaces:
0 Fire Hazard Zone : N e .mac, .� ,.,.
Construction Valuation: $20,000.00
9 �`u A `i►e tl
Building Permit Fee: $122.00 Excise Tax:
$0.00
Planning Department - Fire Department
Plan Check Fee: $223.00 Additional Fee :
$0.00
Plan check Fee : $104.00 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 : $0.00 Grading Permit Fee:
$0.00
In -lieu Housing Fee : $0.00 Building Dept Adm $27.00
Energy Compliance: $0.00 Grading PC Fee:
$0.00
Public Works Department - General Service $265.00
CA Seismic Safety: $0.00 WQ Insp. Fee:
$152.00
Park Dedication : $0.00 Refund Deposit $1,692.00
Disabled Access : $0.00
PAN Plan Check : $0.00 Grading Bond: $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
Plumbing %:
$10.98
- $0.00
TOTAL FEE : $2,596.98
Plan Check Fee
: $0.00 Fee Due at Permit Issuance : $2,596.98
PROCESSED BY:
PU?LIC 1PORKS APPROVAL: -_
ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
AP?RIVAL TO IDS UE:, '
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law forth a reasons) 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
ie 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
Irofessions 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
of 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,
lusiness 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
nprovements 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
nproved 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
pply 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).
I am exempt from Iicensure under the Contractors' State License Law for the following reason:
ly 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,
ell 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
'rofessions 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
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under 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 h full force
nd effect. License Class License No D e - Contractor Signature
VORKERS' COMPENSATION DECLARATION — ^�f
'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (6100,000), IN ADDITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
Id 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
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'
carrier and policy number are:
Policy Number Expiration Date
Agent
Yc Ify 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
I.
if I should become subject to the workers' compensati provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
ature of Applicant, Da)� /1-4 x
CLARATION REG�DWQ-CDMS?RUCT16N-LEr4DlNG AGENCY
=.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
3y 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 coun to enter th ve-identified pr Tty for inspection purposes.
Signature of Property Owner or Authorized Agen /./% t%Z , Print Property Owner's or Authorized Ag
ACTION I DATE I BY C RATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART 610E TITLE 40 AND AOMD RULE
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L.I I SUBMITTED ASBESTOS NOTIFICATION TO
EPA
PERMIT CANCELLED
PERMIT EXTENDED
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PERMITFINAL
CERTIFICATE OF
OCCUPANCY ISSUED
Z ZI
ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO
PROPOSED. DEMO[ I DON, �l
SIGNA TURE:S4% �9!/./A9/�
Date