HomeMy WebLinkAboutx2021-2771 - PermitsCity of Newport Beach - Building Division
3 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - SFP
IIII'IIIIIIIIIII�IIIIIII�IIIIIIIIIIII II COMB Permit: X2021-2771
Project No :
Issued Date: 10/1312021
Inspection Area : 6
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 1011312024 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: 1201 OUTRIGGER DR NB
Description: SFR T/O (E) 30 SQ, INSTALL COMP. SHINGLE, CLASS'B'MIN.
Legal Desc.: N TR 6634 LOT 48
Owner:
PRICE JAMESISANDRA
Address:
1201 OUTRIGGER DR
CORONA DEL MAR, CA 92625
Phone:
Applicant:
SEMPER SOLARIS CONSTRUCTION
Address:
10713 NORWALK BLVD
SANTA FE SPRINGS CA 90670
Phone:
619-715-4054
Code Edit :
2019
Type of Construction:
VB
Occupancy Group:
R3/U
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories:
2
No of Units :
1
Bldg Height:
0
Bldg Sprinklers:
N
Flood Zone:
X
Construction
Building Permit Fee: $351.00
Plan Check Fee: $0.00
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$0.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access:
$0.00
Hazardous Mat
$0.00
Building Green Fee :.
$1.00
TOTAL FEE: $352.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Contractor:
SEMPER SOLARIS CONSTRUCTION
Address:
10713 NORWALK BLVD
SANTA FE SPRINGS CA 90670
Phone:
619-715-4054
Con State Lic:
978152
Lic Expire:
1013112022
Bus Lic:
BT30075814
Lic Exp Date:
07/31/2022
Worker's Compensation Insurance
Carrier: MIDWEST INS CO.
Policy No: BNUWC0155108
Expire: 10/10/2022
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: I
Front: I
Left: I
Right: I
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
010
Architect:
73
Address:
���
Phone:
State Lic:
Engineer:
Address:
Phone:
State Lic:
Designer:
Address:
Phone:
Special Conditions:
Fire Hazard Zone : N
Planning Department -
Plan check Fee
Fair Share:
SJH Trans :
In -lieu Housing Fee
Publio Works Department -
Park Dedication :
$0.00
PAN Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Fire Department
$0.00
Fire Inspection:
$0.00
$0.00
Fire Plan Rev
$0.00
$0.00
Demolition Fee
$0.00
Building Dept Adm
$0.00
General Service
$0.00
Refund Deposit
$0.00
Grading Bond:
$0.00
$0.00
$0.00
Plan Check Fee : $0.00 Fee Due at Permit Issuance : $352.00
e a UBLIe WORKS APPROVAL:
0 00
PLAN 6HECK BY:
APPROVALL 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 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).
❑ 1, as owner of the property, or my employees with wages as their sale 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 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://Ww .leginfo.ca.gov/calaw.htmi.
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 Sectio 70 0) of DivisiQ 3 thg Business and Pro s p �rrCode, and my li 's7Fi full force
and effect. License Class License No Date ontractor Signatu
WORKERS' COMPENSATION DECLARATION
✓DARNING: 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 ($10 , 00(, IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th
perfory;hance of the work for which this permit is issued. Policy No.
have and will mamtai 1v ers' compen insurance, as require by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatio
nsurance carrier and poli nurgber are:
Carrier E o cy en Expiration Date
Name of Agent - _ I r Phone #
I certify that, in the performan of the work for w 'c rmit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,{,and afire
that, if I should become sub' o the workers' com ion provisions of 00 of the Labor Code, I shall forthwith comply with those provisions. / -//
Signature of Applicant Dale �l qZ1 ��7
DECLARATION REGA I ON I N L DI G NCY
I hereby affirm under enalty 6f perjury that there is a struction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
co
Lender's Name Lender's Address
By my signature below, I certify to each of the followin :
I am the property owner or authorized to act on the property owners behalf.
I have read this application and the information I have provided is correct.
I agree to comply with all applicable city and county ordinances and Ste relating to building construction.
I authorize representatives of this city or county toe r the above-ide propert Inspection purposes.
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's N e
ACTION DATE BY DE,gARATIWOPrC0JPUANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
CATION$ PART 61 OF TITLE 40 AND AQMD RULE
140
PERMIT EXPIRED 15UBM EDASBESTOSIrIFR•A=IONTO • • • • ••
PERMITCANCELLED EPA •• • • • • s•
PERMITEXTENDED QMD�
PERMITFINAL 2v��2 DL $T �$N0 IF[ IS NOTAPPLICABL TO
CERTIFICATE OF ROPO D O
OCCUPANCY ISSUED SIG URE: • a
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