HomeMy WebLinkAboutX2021-2833 - PermitsCity of Newport Beach - Building Division *X2021 -2833*
p'�z ffi 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
COMB Permit: X2021-2833
Project No : 2476-2021
b Inspection Requests Phone (949)644-3255
5'� Issued Date
Combination Type - SFP R �'y' � P .: T i
t � � 3 FL_ Inspection Area : 4
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 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: 2300 ARBUTUS ST NB
Description: SFR REROOF W/ COMP SHINGLE, FASCIA/SIDING REPLACEMENT, CHANGE OUT WINDOWS AND CHANGES TO ARCHES /CHIMNEY
Legal Desc.: N TR 4705 LOT 84
Owner:
WOLONSKY KARL S
Address:
2300 ARBUTUS ST
NEWPORT BEACH, CA 92660
Phone:
949-867-7721
Applicant:
COUSENS PAUL
Address:
1943 PORT TOWNSEND CIR-
NEWPORT BEACH, CA 92660
Phone:
949-522-8080
Code Edit : 2019
Type of Construction: V-B
Occupancy Group: R3/U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units : 1
Bldg Height: 0
Bldg Sprinklers:
Flood Zone: X
Construction Valuation: $85
Building Permit Fee:
$1,089.00
Plan Check Fee: $947.43
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$14.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$4.00
TOTAL FEE: $2,106.43
PROCESSED BY:
ZONING APPROVAL:
mstN
Contractor:
COUSENS CONSTRUCTION INC
Architect:
Address:
1943 PORT TOWNSEND CIR
Address:
NEWPORT BEACH CA 92660
Phone:
818-522-8080
Phone: State Lie:
Con State Lic:
535683
Engineer:
Lic Expire:
11/30/2022
Address:
Bus Lic:
BT20052603
Lic Exp Date:
05/31/2022
Phone: State Lic:
Worker's Compensation Insurance
Carrier: WIC EXEMPT
Policy No:
Expire:
Building Setbacks
Use Zone:
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: /
Front: /
Left: /
Right: /
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Designer:
TIMOTHY J FRANCIS & ASSOCIATES
Address:
15761 HUMMINGBIRD LN
HUNTINGTON BEACH, CA 92649
Phone:
714-230-6416
Special Conditions:
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
Plan Check Fee : $999.43
.I
Fire Department
$52.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Fee Due at Permit Issuance : $1,107.00
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) indict
(Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, dem
the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License L
Professions Code) or that he or she is exempt from Iicensure and the basis for the alleged exemption. Any violation of Secti�
not more than five hundred dollars ($500).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) portions of tt
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through a
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of comp)
improved for the purpose of sale).
❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044,
apply to an owner of property who builds or improves thereon., and who contracts for the projects with a licensed Contractor
❑ 1 am exemp' `mm li:ensure under the Contractors' State License Law for the following reason:
Ry my signature below i acknowledge that, except for my personal residence in which I must have resided for at least one y
sell a sh acture that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I un1
Professions Code, is available upon request when this application is submitted or at the following Web site: http://www.leginf
Signature of Property Owner or Authorized Agent
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm Lnde, penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of
end coact. License Class License No Date
vYGf.KERS' COMPENSATION DECLARATION
,iAR,J,Nd: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALI
r0S1 �_ �OMPENSAI'ION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm Linder penalty of perjury one of the following declarations:
nape and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of
oerfrnance of'hs wcri: for which this permit is issued. Policy No.
❑1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the pe
insurance carrier and policy number are:
Carrier Policy Number
a of Agent
;ertify that, in the p,
if I should become
re of Applicant
d below by the checkmark(s) I have placed next to the applicable item(s)
;h, or repair any structure, prior to its issuance, also requires the applicant for
(Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
work, and the structure is not intended or offered for sale (Section 7044,
ployees' or personal effort, builds or improves the property, provided that the
on, the Owner -Builder will have the burden of proving that it was not built or
and Professions Code: The Contractors' State License Law does not
to the Contractors' State License Law).
to completion of the improvements covered by this permit, I cannot
that a copy of the applicable law, Section 7044 of the Business and
Date
'ision 3 of the Business ro es force
lY-dl Contractor I
AND CIVIL FINES UP TO ONE HUNDR THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
ustrial Relations as provided for by Section 3700 of the Labor Code, for
of the work for which this permit is issued. My workers'
Date
work for which this permit is issued, I shall not employ any person in any manner as to become subject to the workers' compensation laws of California, and agree
c oc of Serfnn 3700 of the Labor Code, I shall forthwith I
omply with those provisions.
Date
hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which his permit is issued (Section 3097, Civil Code).
-ender's Name Lender's Address
3y 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 construction.
I authorize representatives of this city or count es.
3i nature of Property Owner or Authoriz - g erty Owner's or Autl orized Agent's Name �4CiCe-D ✓irr✓J
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE SE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERMIT EXPIRED
LJ I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED
EIEPA
PERMIT EXTENDED
LJAQMD
CERTIFICATE OF
OCCUPANCY ISSUED
PROPOSED-D IILIIIUNN A2
SIGNAT off. l
8^ZY z�