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Home My WebLink AboutX2021-3017 - Permits�weipF City of Newport Beach - Building Division t4 100 Civic Center Drive. Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 -ep Inspection Requests Phone (949)644-3255-- `:,cy„w'`' Combination Type - MFP PLUM PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTIOP Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and., Job Address: 510 DAHLIA AVE NB Description: MFR *STOP WORK 121-2951* REPAIR DAMAGED D_RX L'r& REPLACE TOILET Legal Desc.: CORONA DEL MAR BILK 532 LOT 12 Owner: CIES W ANDREW Address: 1917 SEADRIFT D CORONA DEL MA Phone: Applicant: WOODS SEAN Address: 19 LAKEPINES IRVINE CA 92620 Phone: 714-925-4290 Code Edit: 219 Type of Construction: VB Occupancy Group: R3/U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: '0 No of Stories: 1 No of Units : 2 Bldg Height: 0 Bldg Sprinklers: N Flood Zone: X 11 Construction Valuation: $ Building Permit Fee: $110.00 Plan Check Fee: $95.70 Overtime Plan Ck: $0.00 Investigation Fee: $110.00 Record Management: $10.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access: $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 PROCESSED BY: *X2021-3017* :TS MUST BFi�C R6ft'ETED BY from $<,,,O" Yi. to 6:00nn ( li �y 1 =- a� tr JB & soys- Ru ress 11 W R K "?,0 ddress: 92625 �. ORaNt,C �<,I __R one r..' a :7a�$9 s � Phone: Con St ( e< ' 533 4 - Engineer: LiaSrt`r 05/31/2023 Address: Lic: BT3007 9 Lic Exp Date: Phone: Work p ion rant Designer: icA REDITED SURETY d� y ATCA160030491 E , nn: wilding Setbacks Rear. tfi S ecYaI Coned 9,\\ // pa*Parj(As: 0 ir/'F a Hazard TOTAL FEE : $388.60 ZONING APPROVAL: GRADING APPROVAL: Y1101� Excise Tax: $0.00 Planning De ant - dditional Fee : p ck F rading onds Fee' $0.00 Fai a�C sultan�0 H Trans: G ng Pennit Fee: 0.0 In -lieu Housing Fee: Gr ing PC Fe .00 Public Works Department - W I as : $0.00 Park Dedication : $0.00 PM Plan Check: $0.00 Electrical %: $0.00 San Dist: $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 Plumbing %: $9.90 Plan Check Fee COMB Permit: X2021-3017 PtNo: 2622-2021 Issued to _ 12/0312021 Inspecti n Area : 5 State Lic: HIGH Fire Department $52.00 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 $388.60 Fee Due at Permit Issuance : $0.00 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 check havill placed next to the applicable item(s) coon 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair cture, prior to issuance, also requires the applicant for permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (commencing with Sect n 7000) of Division 3 of the Business and fessions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of S 31.5 by any applicant for a permit ubjects the applicant to a civil penalty of more than five hundred dollars ($500). �.,\ $��w�'l^ {� I, as owner of the property, or my employees with wages as their sole wmpens(H�9Po�r U portions of tl�j`�ta`li�the struct brTded r offered for sale (Section 7044, iness and Professions Code: The Contractors' State License Law does not apply to a of property who, t $uf��'iployees' oype ullds or rim oves the property, provided that the rovements are not intended or offered for sale. If, however, the building or i ent is sold within one year o completio tta r- udder will have the bur n of proving that it was not built or roved for the purpose of sale). ��11 W— O I, as owner of the property, am exclusively contracting nsed ontractors to con a project (Section 71B4d, Business and Protessi ode: The Contra to State License Law does not ly to an owner of property who builds or improv n, p d 40po n acts f projects wit n* Contractor pursugWj ractors' State License L ). LJ I am exempt from licensure under tor StItsiderice r the followingVIA VN 1" By my signature below ackno that, except f in hic m ha e r or n year prior to completion of the improvements co erect by this permit, cannot legally yell a structure that I have built an owner- r n co ruct it n ty by ors. I understand that a copy of the applicable law, Sectl n 7044 of the Business and Professions Code, is availableu nre A t ap su d e e:hftp://www.leginfo.ca.gov/calaw.html. Signature of Property Owner or A horized Agent Cat LICENSED CONTRACTOR'S ECLA soma hereby affirm under penalty of per ry th am li dun s s of Chapter 9 (comTIViUOO Division 3 of the Business andProf Code, nd my license is in full force and effect. License Class Li a No ' DContractor Signat NORKERS' COMPENSATION CL l NARNING: FAILURE TO SECURE WORKERS' MPEN ON COVERAGE IS UL, HA JEC LOVER TO CRIMINAL PENALTIES AND CIVIL FIyC� �R NE D THOUSA D DOLLA S (E100,0001, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PRO ED FOR IN SEC TO6 O OR IN EST, AN ATTORNE' FEES. per• •�JfSSE �aMM/� hereby affirm under penalty of perjury a of o decla ons:.. �� 2�3 ❑ I have and will maintain a certificat of a to Ansu r workers' compensation, issued by th Dire r dustrial_P.&lat s provided -for b Cho 0 f the Labor Code, for the 3erformance of the work for which -this pe it is I y No. ❑1 have and will maintain workers' comp sati Insurance, as required by Sech Labor Code, for the perfDmlance of the work fo th workers' compensatior nsurance carrier and policy number are: 3arrier y ef° xpirationAat,P(1tit�a, .Name of Agent P iPhonVat' ❑I certify that, in the performance of the work r whV&AV#permitj%tycQL shall not employ any per any manner so eco c to the workers' compensation laws of California, and agree that, if I should become subject to the workers' mpensation provisions of Section 3700 of the r Code, I shall fo com ose provisions. Signature of Applicant Date_ DECLARATION REGARDING CONSTRUCTION IJENDING AGENCY I hereby affirm under penalty of perjury that there 440W ending agency foending agency fo a of ththe work for which this permit is issued (Section 3097, Civil Code). Lender's Name t'+" L�ddress By my signature below, I certify to each of the follow" I am the property owner or authorized to act on th P y o e alf. I have read this application and the information I h ve Ed 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 enter the above -identified property for inspection purposes. Signature of Property Owner or of property Owner or Authori�ent Print Property Owners or Authorized Agent's Name Date Property Owners or Authorized Agent's Name Date ACTION DATE DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE 1403 PERMITEXPIRED ry7j I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED DEPA PERMIT EXTENDED 0AQMD PERMIT FINAL DASBESTOS NOTIFICATION IS NOTAPPLICABLE TO CERTIFICATE OF PROPOSED DEMOLITION OCCUPANCYISSUED SIGNATURE: