HomeMy WebLinkAboutX2021-1513 - PermitsCity of Newport Beach - Building Division
*X2021-1513*
COMB Permit: X2021-151
100 Civic Center Drive, Newport Beach, CA 92660
Project No : 1325-2021
Permit Counter Phone (949)644-3288
,..
Inspection Requests Phone (949)644-3255
-..,
.Combination Type - BLDG PLUM
Ri�
Issued Date : 06/14I2021
N 3 1 E
Inspection Area : 2
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST
VALID INSPECTION, PROJECTS MUST SE COMPLETED BY 0611412024 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: 361 VIA LIDO SOUD NB
Description: DEMO EXISTING 4-PLEX 4625 SF (2), (2), (2) AND (1) BEDROOMS
Legal Desc.: TR 907 LOT 923 AND SELY 10 FT LOT 922 AND NWLY112 LOT 924 AND FOR
Owner: BETHEL JEFFREY Contractor:
OWNER/BLDR
Architect:
Address: NEWPORT Address:
NEWPORT BEACH, CA 92663
Address: NO
C
4e,J IM i 616J 1 V NOISE
CONSTRUCTION,
Phone: Phone:
Phone:
State Lic:
Applicant: BETHEL JEFF Con State Lic:
O/B
Engineer:
Address: 1930 PORT TOWNSEND Lic Expire:
Address:
'
NEWPORT BEACH CA 92660 Bus Lic:
ON §`fa TL URDAYS,
Phone: 949-294-5333 Lic Exp Date:
Phone:.
�e� _
Code Edit : 2019 Worker's Compensation Insurance
Designer:
- _ •
, -
Type of Construction: Carrier:
Address:
Occupancy Group: R2/U Policy No:
Added /New sq.ft. Bldg: 0 Expire:
Phone:
,
Added /New sq. ft. Garage: 0
'
No of Stories: 0 Building Setbacks
Rear: /
Special Conditions:
LIQUEFACTION _
No of Units : 4
Front: /
CERT MAIL RECIEPTS ... ,
Bldg Height: 0
Left: /
ATTACHED 5129/21
Bldg Sprinklers:
Right: /
Flood Zone: Use Zone: Parking Spaces:
0 Fire Hazard Zone
: N
Construction Valuation: $16,500.00
Building Permit Fee: $120.00 Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee: $227.50 Additional Fee :
$0.00
Plan check Fee : $92.50
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 : $4.00 Grading Permit Fee:
$0.00
In -lieu Housing Fee : $0.00
Building Dept Adm $26.00
Energy Compliance: $0.00 Grading PC Fee:
$0.00
Public Works Department-
General Service $219.00
CA Seismic Safety: $0.00 WQ Insp. Fee:
$0.00
Park Dedication : $0.00
Refund Deposit $1,692.00
Disabled Access : $0.00
P1W Plan Check : $0.00
Grading Bond: $0.00
Hazardous Mat $0.00 Electrical %:
$0.00
San Dist : $0.00
Building Green Fee : $1.00 Mechanical %:
$0.00
NMUSD Fee: $0.00
$0.00
Plumbing %:
$10.80
$0.00
TOTAL FEE : $2,392.80
Plan Check Fee :
$0,00 Fee Due at
Permit Issuance : $2,392.80
PROCESSED BY:
PUBLIC WORKS APPROVAL:
ZONING APPROVAL:
PLAN CHECK BY:
j\
GRADING APPROVAL:
APPROVAL TO ISSUE:
✓00 _
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) 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 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
Irofessions 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
lot 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,
3usiness 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
mprovements 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
oved for the purpose of sale).
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
pl o 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).
I am exempt from licensure under the Contractors' State License Law for the following reason:
3y 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 legally
ell a structure thz?t,l,have built as an owner -builder if t has not be constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Secti n 7 44 of the Business and
rrofessions Coda. is available upon request whe t is applicat' i fitted 9r�It thethe foT -Web site:http://www.leginfo.ca.gov/calaw,html.
Signature of Property Owner or Authorized Agent /� tom—, Date (P ?0 2-
JCENSED CO`NZRACTOR'S DECLARATI� ✓
h,ireb:; affirm under penalty of perjury that I am licensed u er ovisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, a d my license is in full force
Ind effect. License Class License No Date Contractor Signature
VORKERS' C':VP5NSATION DECLARATION
'4RNVIr: 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 ($100,000), IN ADDITION TO THE
:DST OF COMPENSATE:!, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under Fealty of perjury one of the following declarations:
I hPve 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 thl
erfurmance of the work for which this permit is issued. Policy No.
h M'E 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' compensatior
isurar:e carrier and policy number are:
Policy Number
of Agent
Date
I certify that, in the performance 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
t, if I should bec subject to the wor com ensation rovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /
.nature of Applicant Cat
CLARATION REG G CONS h ING AGENCY
:reby affirm under penalty of'er t is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civl Code).
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 courfy ordinances and state laws relating to building construction. y /'
I authorize representatives of this city or coup t enter ab ve-ide d or inspection purposes. % �� � ( v(
mature of Property Owner or Authorized Aoent Print Property Owner's or Authorized Aoent's Nam / Dat ���
PERMIT EXPIRED
PERMITCANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCY ISSUED
DATE BY v I W�TPN OF COMPT 61 LIANCE
E WITH
CODE OF FEDERAL I FOR OFFICE USE ONLY
EPA
NOTIFICATION TO
TION IS NOT APPLICABLE TO
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