HomeMy WebLinkAboutX2021-0336 - Permitsw City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIII�IIIIIII II COMB Permit: X2021-0336
't 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 1 0 3 3 e Project No : 0881-2020
ii Permit Counter Phone (949)644-3288
u. +<C Inspection Requests Phone (949)644-3255
Issued Date : 02/16/2021
r:'irratir?.* Combination Type - BLDG PLUM
Inspection Area : 5
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0211712024 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: 434 GOLDENROD AVE NB
Description: DEMO FRONT UNIT OF DUPLEX 1008 SF. 2 BEDROOM. SEWER CAP INCLUDED
Legal Desc.: CORONA DEL MAR BLK 434 LOT 18
Owner: INJEV VAL
Address: 16 SILVERFERN
IRVINE , CA 92603
Phone:
Applicant: INJEV VAL
Address: 16 SILVERFERN
IRVINE CA 92603
Phone:
Code Edit : 2019
Type of Construction: V-B
Occupancy Group: R311.1
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 1
No of Units : 1
Bldg Height: 0
Bldg Sprinklers:
Construction Valuation:
Building Permit Fee: $120.00
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: $1,603.80
PROCESSED BY:
ZONING APPROVAL:
Contractor:
Address:
Phone
Con State Lie:
Lie Expire:
Bus Lie:
Lie Exp Date:
GRAYSTONE CUSTOM BLDRS INC Architect:
3419 VIA LIDO STE 455 Address:
NEWPORT BEACH CA 92663
949466-0900 Phone:
971085
0313112022
BT30040057
03131/2021
Worker's Compensation Insurance
Carrier: STATE FUND
Policy No: 9216106
Expire: 08/15/2021
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: I
Front: I
Left: I
Right: /
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$10.80
State Lie:
Engineer:
Address:
Phone: r.p�® \V State Lic:
O �n st'9t \4.Yy 44
NPhone: i*v (�'^�'
Spe�t4(9Ps lag
QUARTERS TO
HAUL DEBRIS
Fire
Planning Department -
Plan check Fee
Fair Share
SJH Trans
In -lieu Housing Fee
Public 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
$26.00
General Service
$219.00
Refund Deposit
$1,127.00
Grading Bond:
$0.00
$0.00
$0.00
Plan Check Fee : $0.00 Fee Due at Permit Issuance : $1,503.80
PUBLIC WORKS 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 items)
ction 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
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
cessions 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
more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or `) portions of the work, and the structure is not intended or offered for sale (Section 7044,
iness 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
rovements 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
roved for the purpose of sale).
1, 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
ly 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).
J I am exempt from licensure under the Contractors' State License Law for the following reason:
ly 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 impro
ell 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 applicat
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
'signature of Property Owner or Authorized Agent
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 of ivi5ion 3 of the Business and Pro
nd effect. License Class License No Date Contractor Signature
VORKERS' COMPENSATION DECLARATION / / I i
'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDR)=
DST 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:
law, Section 7044 of the Business and
is in full force
($100,000), IN ADDITION TO THE
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
ce of the work for which this permit is issued. Policy No.
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' compensa
carrier and policy number are:
Ie of Agent _
certify that, in
if I should bE
of Applicant
Policy Number
Date
Ice of thA work fAr which � I Is issu , I shall not employ any person in any manner so as to become subject to the workers' compel ation laws of California, and agree
7
tot r nsation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 11
^1
Date/ b f�
TRUCTION LENDING AGENCY
I hereby affirm under p al rjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Lender's Name Lender's Address
By my signature below, I Certify to ach of the follbaveprovide
I am the property owner or auth rized to act Aco
elf.
I have read this application and he informatit.
I agree to comply with all applicable city and ws relating to building construction.I authorize representatives of this city or counified property for inspection purposes. /9
Signature of Property Owner or Authorized Agent Print Pro a Owners or Authorized Agent's Name
ACTION DATE BY RATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY ✓'
REGU TIONS PART 61 OF TITLE 40 AND AOMD RULE
1403
PERMIT EXPIRED [SUB ITTED ASBESTOS NOTIFICATION TO _
PERMIT CANCELLED UFPO
PERMIT EXTENDED qnA
PERMITFINAL STOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF OPOSED DEMOLITION
OCCUPANCYISSUED SIGNATURE: