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Home My WebLink AboutX2021-3236 - PermitsCity of Newport Beach - Building Division ��wrc4n d 100 Civic Center Drive, Newport Beach, CA 92660 H , 11+ Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 °at,rhu�"g Combination Type - BLDG PLUM IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2021-3236 Project No : 2798-2021 Issued Date : 1113012021 Inspection Area : 2 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, PROJECTS MUST BE COMPLETED BY 1113012024 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: 1015 DOLPHIN TER NB Description: DEMO SFR 2810 SF 3 BEDROOMS. SEWER CAP INCLUDED Legal Desc.: N TR 5130 LOT 4 Owner: FOLDS PETER Contractor: LEGACY CUSTOM HOMES INC Architect: TOBLESKY KENNETH Address: 2 HERMITAGE LN Address: 1000 QUAIL ST, STE 220 Address: 1450 W 6TH ST NEWPORT BEACH CA 92660 NEWPORT BEACH CA 92660 CORONA CA 92882 Phone: Phone: 949-887-4750 Phone: 909-217-1866 State Lic:CO23571 Applicant: RIELLY BRUCE Con State Lic: 986194 Engineer: Address: 1000 QUAIL ST#220 Lic Expire: 0813112023 Address: NEWPORT BEACH CA 92660 Bus Lic: BT30045036 Phone: 949-887.6233 Lic Exp Date: 1013112022 Phone: State Lic: Code Edit : 2019 Worker's Compensation Insurance Designer: Type of Construction: Carrier: OAK RIVER INSURANCE Address: Occupancy Group: R3 Policy No: LEWC117490 Added /New sq.ft. Bldg: 0 Expire: 12102/2021 Phone: Added /New sq. ft. Garage: 0 No of Stories: 0 Building Setbacks Rear: / Special Conditions: BC HAULING & DEMO No of Units : 1 Front: I Bldg Height: 0 Bldg Sprinklers: Left: / Right: / Flood Zone: - Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $19,000.00 Building Permit Fee: $122.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $223.00 Additional Fee : $0.00 Plan check Fee : $104.00 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 : $0.00 Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $27.00 Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department - General Service $265.00 CA Seismic Safety: $0.00 WQ Insp. Fee: $152.00 Park Dedication : $0.00 Refund Deposit $1,692.00 Disabled Access : $0.00 PAN 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 %: $10.98 $0.00 TOTAL FEE : $2,596.98 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $2,596.98 J I PUBLIC lh`ORKS APPROVAL: PROCESSED BY: _ ZONING APPROVAL: V PLAN CHECK 6Y: 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 the 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 Professions 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 not more than five hundred dollars ($500). ❑ I, as owner of the property, 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 improvements 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 improved for the purpose of sale). ❑ I, 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 apply 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). ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason: By 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 sell 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 applicable law, Section 7044 of the Business and Professions 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 Date LICENSED CONTRACTOR'S DECLARATION \ I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectiom 000) of iv;sion 3 of the Business and Pro ion de and ;dense is force and effect. License Class License No D Contractor Signatu WORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$ 00,0001, 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, forth D'L'Y$prmance of the work for which this permit is issued. Policy No. OH?Cv—eand 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' compensatiol sura ce carrier and policy number are: 'arrier Policy Number Expiration Date game of Agent Phone # ❑I certify that, in the performance of the wor for which this permit is issygd, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre hat, if I should become Subic t to the wor s' compen Pn provisi - f Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant Dae� // ��iU/2 / )ECLARATION REGARDING C CTION LENDI AGENCY hereby affirm under penalty of perjury that there is a co struction lending agency for the performance of the work for which this 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. 1 have read this application and the information I have provided is correct. J I agree to comply with all applicable city and county ordinances nd state law relating building construction. I authorize representatives of this city or county to enter th ove-ide 'rope or inspection purposes. Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name f Date ACTION DATE BY LARATION OF COMPUANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED LJ I SUBMITTED ASBESI33 NOT'�ICATION TO PERMITCANCELLED —� ErA PERMIT EXTENDED IV1� PERMITRIVAL p/�.a- ASBEST05 NOTIFICATI0N15 TAPPLIC E TO CERTIFICATE OFF;111� PROPOSED DEMOLITION OCCUPANCYISSUED O SIGNATURE: A c