HomeMy WebLinkAboutX2021-3200 - Permits�'.r.rnUQ".
, City of NGwpert Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
CCombination Type - SFP ELEC
Job Address
Description:
Legal Desc.:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS M
Construction Hours: Monday- Friday 7:00 a.m. to 6:30 p.m. and Saturday from
COMB Permit: X2021-3200
Project No : 2773-2021
Issued Date : 1112412021
Inspection Area : 2
E2 / ED BY 11/24/20V OR PERMIT WILL BE INV)
6:00 p.m. No workvin Sundays or Holidays
501 VIA LIDO NORD NS �e
SFR INSTALL ELEVATOR 64 SF ADDITION �R1(S �[ p ra
Owner:
STRUCK HAROLD
Address:
501 VIS LIDO NORD
NEWPORT BEACH CA 92663
Phone:
Applicant:
TERRY MICHAEL
Address:
3419 VIA LIDO #455
NEWPORT BEACH CA 92663
Phone:
949-466-0900
Code Edit:
2019
Type of Construction:
V-B-SPR .-
ftuI
Occupancy Group:
1"r
Added /New sq ft Bldg. 64
Added /New sq. ft. Garage: ,,0
No of Stories.
2
No of Units :
-
1 ,N `
Bldg Height:
0'
Bldg Sprinklers:
Y BXs'
Flood Zone:
X
II Construction Valuation:
Building Permit Fee: $836.00
Plan Check Fee: $642.00
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$30.00
Energy Compliance:
$0.00
CA Seismic Safety :
$1.50
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE : $1,777.02
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Contractor: GRAYSTONE CUSTOM\RL§e%INC AA�ff�pOct, O
Address: 3419 VIA LIDO STE 455 ple Woress:
NEWPORT BEACH CA 92$6S a�
Phone' 949-466 g900' v fPh ne: St e
Con State Lic;/97�85,� x O �jip-Eneer. FORBES DALE L
Lic Expire: i' 0313112022 �' k. Address: 1800 E 16TH ST #B
us _ 3;n � SANTA ANA CA 92701
/ c Exo Date: vA 311202 's .� Phone: 714.835-2800 State
IV L*
moo, I
TATE FUND
216106
081151
r
Left
® fight: 1.5' � ,
v � q�
',. ax: $0 �•�
tonal Fee : ,6J�
Grading Bonds Fee: ` $
Grath P n i " $0. al
Gra Pe
(XraC 1( 5�$0.00
Fee: I\Al�� $0.0=7�/'/
%: 52
al %:
Check Fee
Planning Dep
Plan checlill
v Share .
J Tran '
ous
is Works
Park D
P la
an
SD Fee:
Designer:
Address
i
Phone:/!,'�
Sped apa f!Vs�LI% EFA
®®���pc�fS (jl
YA e4ard7) N i
� �t1
WJ � ire
$206.0:099 ®rl
$0.00
$0.00
$0.00
$0.00
C/)
rn
)
\C1
030407
0
Fire Plan Rev
Demolition Fee
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
:J
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00 Fee Due at Permit Issuance : $1,777.02
PUBLIC WORKS APPROVAL: -
PLAN CHECK BY:
APPROVAL' :O 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 y t checkmark(s) I have placed next to the applicable item(s)
action 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, d s , or repair a 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' Stat - se Law (Chapter 9 (c mencing with Section 7000) of Division 3 of the Business and
,fessions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. An Ion of Section 7031.5 by any plicant 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 (_) all of or yt�1,&Tons of the or,a4KQstr lure is not intended or offered for sale (Section 7044,
5iness and Professions Code: The Contractors' State License Law does not ap an owner of p q t iWHO, throu oy or person effort, builds or improves the property, provided that the
)rovements are not intended or offered for sale. If, however, the building or improvement is std- one year cdf`c ion, the Owner-Buil r will have the burden of proving that it was not built or
(roved for the purpose of sale). r� 01 ()� Vl
I, as owner of the property, am exclusively contractin 'tensed Contractors onstruct t��ee��pp�jbCt $ection 7044, Busi and Professio Code: The Contractors' State License Law does not
rly to an owner of property who builds or improv-a '- on, an ho contr or the projects wlittia licensed Contract rsuant to the Contract 'State License Law).
I am exempt from licensure under the, actorsSt e n w for the fo vgin Eason:
my signature below I acknowle_d,�e.a , ce f er al residence in I m have reds at least one year prior to completion of th improvements covered by this permit, I cannot legal
a structure that I have bui)tZn owr�Er-b III not been cqr �°`n 'j ntl censed contractors. I understand that a copy of the a licable law, Section 7044 of the Business and
Ifessions Code, is available upon regfi¢5 is app catloMAS itted or th II " gg Web site:http://www.leginfo.ca.gov/calaw.html. i\
nature of Propartv Owner or Authors q nt " * `•%A at �g
LICENSED' ONTR ,CtTPR� OECIL RATIO a
hereby affir undeI� IiAhy of thIlce 'ed,',tsnd ro ns of Chapter 9 {commenang with Section 0 ) of ivi n 3 f the Business and
1
o Code and my II en full farce
perjury
and effect. Li nse Class se No Date / or�rl�r Signet
NORKERS' C MPE Oitj: EC ' R b - '' !('�j►`,
NARNING: FAILURE SEC E WORKE COMPE yN COVERAGE IS. UNLAWFUL AND SHALL SU DJECYAJ EMPLOYER TO CRIMINAL PENALT,$6�CI SUP TO ONE
R THOUSA D DOLLARS ($'I OO,E00), IN ADDITION TO THE
ii
30ST OF COMPENSA N, DA GES AS VIDEO FOR IN SECTION JT,gSj OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. `\``
hereby affirm and pen one of the foYlowing declarations - G�
Relations
"",
have and will intain a certifi of cpnsent to self-yrtgre^for workers' compensat' edWy /rector o as
�,,�,(1
or Section 3700 of the Labor Code, for the
rmance of the w for w s met Is sued.., P11cy o.
�0
I -I ave and will in w er at insurance, as required by Section 3700 o abor qac for th e e work
Is it is issued. My workers' compensatior
nsurance carrier a po y nu e r " `5,
Darner Polic - u Zion
Vame of Agent
:1I certify that, in the perto ane of the orI)c rmit,�,i�� d, I shall y a on any m so ecome subject to the workers'
compensation aws of alifornia, and agree
.hat, if I should become su 'e "t F F anon wbA9ibTl's o ec " abor Code, I ort omply with those provisions.
_
//� ZP2-/
signature of Applicant
[
)ECLARATION REG RDI/ UCTION LE G A NCY
hereby affirm under penalty of p j that there i co r Ing agency fo pe ce of the work for which this permit is issued (Section 3097,
Civil Code).
-ender's Name L s Address
3y my signature below, I certify to c of that low
I am the property owner or auth iz 3 on the prope ner'� alf.
I have read this application and t information I h prov' correct.
I agree to comply with all applicab city a unt ances and state laws relating to building construction.
-�
authorize representatives of this cl or co an eobove-identified property for inspection purposes.
signature of Property Owner or Authoriz gent Print Property Owners or Authorized Agent's Nam
Z
ACTION
DATE
ECLA ION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLYC
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REELLATI0 PART 610E TITLE 40 AND AOMD RULE
1403
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PERMIT EXTENDED
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PERMITFINAL
AS�ESTO5N IFIC N S OTAPPLICABL TO
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