HomeMy WebLinkAboutX2021-1268 - PermitsCity of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
' Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - MFP ELEC MECH PLUM
IIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit: X2021-1268
Project No : 1111-2021
Issued Date : 07119/2021
Inspection Area : 4
LONG BEACH CA 90808
Phone: 562-420-1035
Code Edit : 2019
Type of Construction: V-A
Occupancy Group: R2
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 2
No of Units : 4
Bldg Height: 0
Bldg Sprinklers: N
Flood Zone: X
Building Permit Fee: $246.00
Plan Check Fee: $214.02
Overtime Plan Ck:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 07/19/2024 OR PERMIT WILL BE INVALID
Investigation Fee:
$0.00
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
$2.00
Job Address:
1520 PARK NEWPORT DR NB
CA Seismic Safety:
$0.00
Disabled Access :
Description:
MFR CONVERT CLOSET INTO LAUNDRY ROOM (13 SF)
$0.00
Building Green Fee :
$1.00
Legal Desc.:
N TR 6947 LOT 8
Fire Inspection:
-
ooxoa
Owner:
PARK NEWPORT LAND LTD Contractor:
GREYTHON CONSTRUCTION LLC
Architect: GRISAFE MARK
Address:
201 FILBERT ST 0700 Address:
31 WATER ST
Address: 5618 E. CONANT ST
In -lieu Housing Fee :
SAN FRANCISCO, CA 94133
MYSTIC CT 06355
LONG BEACH CA 90608
e
Phone:
Phone:
8601571.4600
Phone: 562-480-1035 State Lic:CO28845
*�
Applicant:
FULLER RACHEL Con State Lic:
1032199
Engineer:'
`
Address:
3750 SCHAUFELE AVE #150 Lic Expire:
10/31/2021
Address: -
,_..
0'
LONG BEACH CA 90808
Phone: 562-420-1035
Code Edit : 2019
Type of Construction: V-A
Occupancy Group: R2
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 2
No of Units : 4
Bldg Height: 0
Bldg Sprinklers: N
Flood Zone: X
Building Permit Fee: $246.00
Plan Check Fee: $214.02
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management :
$2.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $607.02
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Bus Lic: BT30075953
Lic Exp Date: 07/31/2022
Worker's Compensation Insurance
Carrier: STATE FUND
Policy No: 9235544
Expire: 09/15/2021
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: /
Front: /
Left: /
Right: /
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$32.20
$18.40
$41.40
Phone:
State Lic:
OBc.
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Designer:
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Address:
o00 o
Uoeaor
Phone:
LO
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Special Conditions:
0
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Fire Inspection:
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$0.00
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Fire Hazard Zone: N
SJH Trans :
Plan Check Fee : $303.07
Fee Due at Permit Issuance : $303.95
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
a °
° OOn JO°E
Planning Department -
Fire Department
o °
Plan check Fee:
$52.00
Fire Inspection:
Fair Share :
$0.00
Fire Plan Rev
$0.00
SJH Trans :
$0.00
Demolition Fee
In -lieu Housing Fee :
$0.00
Building Dept Adm
$0.00
Public Works Department -
General Service
$0.00
Park Dedication :
$0.00
Refund Deposit
$0.00
P/W Plan Check :
$0.00
Grading Bond:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
$0.00
$0.00
Plan Check Fee : $303.07
Fee Due at Permit Issuance : $303.95
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 applicable items)
(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 licensure 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 L) all of or L) 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 licensure 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 7000�) f Division 3 of the Business and Professions ode, and my license is in full force
and effect. License Class License No Date 7�F ),k Contractor Signature
WORKERS' CGVP.ENSATION DECLARATION
NARNING: FAILURE 7Q $FFCIJRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED TH USAND DOLLARS 5100,0001, IN ADDITION TO THE
QST OFCOMPENSATION, DAMAGES As PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
•.•
Fhereby-affirm ander penalty of perjury one of the following declarations:
®.l 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 IN
Serfdrrrlance of tre work for which this permit is issued. Policy No.
ava and llemai'ptain 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' compensation
��ance carne& and olicy number are:
8 , � 9L 3-5�4'�ao P 94(V zl
-arrier. a E'2.. J.Tww�cC. iNN+T4 Z�C. Policy Number Ex iration Date
ie of Agent
cei.ify that. in tD8
. ifJ should bepcon
of
Ice 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
to the wworkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Dat i/Il f dui
CLARATION REGIMQDICONSTRUCTION LENDING AGENCY
;reby affirm under penalW 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 owners 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 a ter the above -identified property for inspection purposes.
nature of PrODertv Owner or Authorized ADent 11 J Print Property Owner's or Authorized Agent's Name /J�ha�{`An /o'dfon
ACTION
PERMIT EXPIRED
PERMIT CANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATEOF
OCCUPANCYISSUED
DATE I BY/ (OECLARATION OF COMPLIANCE WITH REGULATONS PART 61 O TIITLE 40A ND RU LOF E
FOR OFFICE USE ONLY
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I SUBMITTED ASBESTOS
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