HomeMy WebLinkAboutX2021-3319 - Permits„ City of Newport Beach - Building Division *X2021-3319`
COMB Permit: X2021-3319
100 Civic Center Drive, Newport Beach, CA 92660
Project No : 2877-2021
Permit Counter Phone (949)644-3288
is - fir Inspection Requests Phone (949)644-3255
INSPECTORur
au*` Combination Type - BLDG ELEC
Issued Date : 02/0712022 • ° ° °
°
Inspection Area : 1 ....
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0210712025 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: 16 BAY ISLAND NB
....
°
Description: SFR (1) ENERGY STORAGE SYSTEM
',... °
• °
Legal Desc.: S TWP 6 RGE 10 SEC 34
Owner: BAY ISLAND CLUB Contractor:
MAVERICK CONSTRUCTION Architect:
Address: 18 BAY ISLAND Address:
6233 CHERRY AVE Address:
NEWPORT BEACH, CA 92661
LONG BEACH CA 90805
Phone: Phone:
800.987-7785 Phone:
State Lic:
.
..
Applicant: MULLEN TOBY Con State Lic: 806493 Engineer:
MORALES DOUGLAS. •'
""° • °'
Address: 6233 CHERRY AVE Lic Expire:
04/3012022 Address:
20751 KELVIN LN
LAGUNA BEACH CA 90805 Bus Lic
BT30069454
HUNTINGTON BEACH CA 92656
Phone: 562-244-5230 Lic Exp Date:
11/30/2022 Phone:
949-285-5104 State Lic:C-069163
Code Edit : 2019 Worker's Compensation Insurance Designer:
Type of Construction: V-B-SPR Carrier:
STATE FUND Address:
y
Occupancy Group: U Policy No:
9049949
i'j1,
Added /New sq.ft. Bldg: 0 Expire:
04/0112022 Phone:
Added /New sq. ft. Garage: 0
Z
No of Stories: 3 Building Setbacks
Rear: I Special Conditions: HIGH DENSITY ZONE
No of Units : 1
Front: I
Bldg Height: 0
Left: /
W
Bldg Sprinklers: Y
Right: I
M
Flood Zone: AE Use Zone:
Parking Spaces: 0 Fire Hazard Zone : N
Construction Valuation: $15,000.00
Building Permit Fee: $331.00 Excise Tax:
$0.00 Planning Department-
Fire Department
Plan Check Fee: $287.97 Additional Fee :
$0.00 Plan check Fee:
$52.00 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: $16.00 Grading Permit Fee:
$0.00 In -lieu Housing Fee :
$0.00 Building Dept Adm $0.00
Energy Compliance: $0.00 Grading PC Fee:
$0.00 Public Works Department -
General Service $0.00
CA Seismic Safety: $0.00 WQ Insp. Fee:
$0.00 Park Dedication : $0.00
Refund Deposit $0.00
Disabled Access : $0.00
P/W Plan Check: $0.00
Grading Bond: $0.00
Hazardous Mat $0.00 Electrical %:
$23.17 San Dist: $0.00
Building Green Fee : $1.00 Mechanical %:
$0.00 NMUSD Fee: $0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE : $711.14
Plan Check Fee : $339.97 Fee Due at Permit Issuance : $371.17
PROCESSED BY:
PUBLIC WORKS APPROVAL:
ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
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 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
:he permit to file.a aimed 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
Drofessions C8cW 961llat 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
iot mo to than file hu.Vred dollars ($500).
I I, aS ownef 4JRe groperty, 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,
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
;mprpyements 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
mproyed for th);}JLFp'oce of sale).
owner of Ne property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
�.a pl%to an owrfprpFor'operty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
,I,api exempiirom licensure under the Contractors' State License Law for the following reason:
By myp mature 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)
ce V *twcture that I IlTe 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 Coh is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
9ignatat of Property Qwner or Authorized Agent Date
LK)BNSED CONXMCTOR'S DECLARATION
I hereby affirm under penalty of.gqerjury thaat I am licensed under provisions�}f apter 9 (commencing with Section 7000) of D}w�i n 3 of the Business and Professio ,grfJ�R�' ense is in full force
and effect. License Class /7 ��— 1 U License I 71� Y Yj Date Z! ! 2 Contractor Signature
WORKERS' 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 ($100,0001, 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
performance 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
Date
is of Agent ACT 'rep V t, ( rnone s
certify that, in the performs a 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
if I should become subj /tc/tf}e wg[I mpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. j
Iature of Applicant / < -H b `b� Date4 2,/ � Z Z
CLARATION REGA DIN ONSTRUCTION LENDING 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
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 or nces and sta laws relating to building construction.
I authorize representatives of this city or county tYo t( h above p erty for inspection purposes.
nature of ProDertV Owner or Authorized Agent /� U _y Print Property Owner's or Authorized Agent's Name
ACTION
PERMIT EXPIRED
PERMITC4NCELLED
PERMIT EMENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCY15SUED
DATE BY DECLXRA.TION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQM D RULE
1403
If
PROPOSED D
SIGNATURE:
ASBESTOS NOTIFICATION TO
IS NOT APPLICABLE TO
Civil Code).