HomeMy WebLinkAboutX2021-1651 - Permits,�'�� City of Newport Beach - Building Division
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COMB Permit: X2021-1651
J �, 101D Civic Oenter Drive, Newport Beach, CA 92660
X 2 0 2 1 1 6 5 1
Project No : 0495-2021
Permit Counter Phone (949)644-3288
L.. ,y�.r.. fi Inspection Requests Phone (949)644-3255
`'tira w w Combination Type - SFP MECH ELEC PLUM N® CONSTRUCTION
tICTION NOISE
Issued Date: 08126/2021
Inspection Area 1
ICMOMI
:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS BE PVLETE`D7BY
08/26/2024 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: 208 36TH ST NB " /ky/ p'
Description: SFR ADD 75 SF TO CONVERT EXISTING 250 SF STUDIO TO ACCESSORY D A(jre�®, E-EKEIY®
Legal Desc.: LAKE TR BLK 135 LOT 5
Owner: 208 36TH STREET LLC Contractor: OWNER/BLDR Architect: HARRISON ADRIAN
Address: 2962 JUPITER AVE Address: KATIE THOMPSON Address: 28131
CARPENTERIA CT
CENTRAL POINT, OR 97502
LAGUNA NIGUEL CA 92677
Phone: 323.646-2662 Phone:
Phone: 949-322-3702 State Lic:C031104
Applicant: HARRISON ADRIAN Con State Lic: O/B
Engineer:
Address: 28131 CARPENTERIA CT Lic Expire:
Address:
LAGUNA NIGUEL CA 92677 Bus Lic:
M
Phone: 949-322-3702 Lic Exp Date:
Phone:
State Lic:
_ W
Code Edit : 2019 Worker's Compensation Insurance
Designer:
Type of Construction: V-B Carrier:
Address:
Occupancy Group: R3/U Policy No:
Added /New sq.ft. Bldg: 75 Expire:
Phone:
Added/New sq. ft. Garage: 0
No of Stories: 2 Building Setbacks Rear: 5'
Special Conditions:
LIQUEFACTION R HIGH
No of Units : 1 Front: 5'
DENSITY AREA
Bldg Height: 24 Left: 3'
Bldg Sprinklers: N Right: 3'
Flood Zone: X Use Zone: R-2 Parking Spaces:
0 Fire Hazard Zone :
N
Construction Valuation: $29,000.00
Building Permit Fee: $1,252.00 Excise Tax: $0.00
Planning Department-
Fire Department
Plan Check Fee: $1,003.92 Additional Fee : ($3,028.32)
Plan check Fee : $260.00
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 $0.00
Energy Compliance: $61.00 Grading PC Fee: $0.00
Public Works Department -
General Service $0.00
CA Seismic Safety: $3.77 WQ Insp. Fee: $0.00
Park Dedication : $0.00
Refund Deposit $0.00
Disabled Access : $0.00
PM Plan Check: $203.00
Grading Bond: $0.00
Hazardous Mat $0.00 Electrical %: $87.64
San Dist: $0.00
Building Green Fee : $2.00 Mechanical %: $60.08
NMUSD Fee: $0.00
$0.00
Plumbing %: $112.68
$0.00
TOTAL FEE : $7.77 Plan Check Fee
: $0.00 Fee Due at Permit Issuance : $7.77
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ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
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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 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
imoMements 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
'F
for the purpose of sale). ._
s 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
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).
m 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 lega11,
sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed asters. I understand that a copy of the applicable law, Section 7044 of the Business and
Professions Code, is available upon request when th' pp c ion is submitte ng eb site:http://www.leginfo.ca.gov/calaw.html. D
Signature of Property Owner or Authorized Agent
LICENSED CONTRACTOR'S DECLARAT N
I hereby affirm under penalty of perjury that I am licensed der provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
and effect. License Class License No Date Contractor Signature
COMPENSATION DECLARATION
NARNING: 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 ($100,000), IN ADDITION TO THE
COST 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:
❑ 1 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
oerformance of the work for which this permit is issued. Policy No.
have 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'
rance carrier and policy number are:
Policy Number
ie of Agent
certify that, in the performance of the work for which this permit is issued, I shall not
, if I should become sybjec( to the workers' compensation provisions of Section 37
of Applicant
Date
person in any manner so as to become subject to the workers' compensation laws of California, and agre
r Code, I shall forthwith comply with those provisions.
areby affirm unde(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 cou er the above -identified property for inspection purposes. ty '
nature of Prooertv Owner or Authorized ADen --------------------------- Trr—inTProperty Owner's or Authorized Agent's Nam P
ACTION
PERMIT EXPIRED
PERMIT CANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCY ISSUED
DATE I BY
LA
OF COMPLIANCE WITH CODE OF FEDERAL
PART 61 OF TITLE 40 AND AQMD RULE
DI••• ••• • ••• •
ES OTIF 'filONi'E i
• • H
NO •IF ATION IS NOT APPLIS,081F
FOR OFFICE USE ONLY
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