HomeMy WebLinkAboutX2021-2574 - Permits�EWPORT City of Newport Beach
Community Development Department - BuildinDivision COMB Permit : X2021 -2574
li y . 100. Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 1 2 5 7 4 Plan Check No : 2234-2021
C, r� 0 Permit Counter Phone.: (949) 718-1888
newportbeachca.gov/civic Issued Date : 1110312021
Final Date: 09/24/2024
o Combination Type - SFP Permit Status: Final
Work Class - Addition Inspection Area : 4
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE
NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS
Job Address: 2901 ALTA VISTA DR Legal Desc : N TR 5018 BLK LOT 137
Description: NEW DETACHED ADU 451 SF. ALT DRAINAGE PER CITY STANDARD PLAN.
Owner:
Contractor :
Architect
Address :
Address:
Address
Phone:
Phone:
Phone:
Con State Lic :
State Lic
Lic Expire
Applicant :
Bus Lic :
Engineer : GAMINO DANIEL
Address :
Bus Lic Expire :
Address : 534 SANDY HOOK
AVE
LA PUENTE, CA 91744
Phone:
Workers' Compensation Insurance
Phone: (626) 890-2530
Carrier :
Owner/Builder :
Policy No:
Designer:
Address :
W. C. Expire:
Address
Phone:
Phone:
Code Edition :
2019
Fire Sprinklers : NO
Construction Valuation :
$68,000.00
Type of Construction :
V-B
Fire Hazard Zone : NO
Added/New/Ti sq. ft. Bldg :
0
Occupancy Groups :
R-3
No of Units : 1
Alteration sq. ft. Bldg :
0
Bldg Height:
No of Stories : 1
Add/New sq. ft. Garage :
0
TOTAL sq. ft.:
0
Building Setbacks :
Front: 6, Side: 6, Side: 6, Rear: 6
Flood Zone :
X
Use Zone :
R-1-6000 - Single -Unit Residential (6000 indicates minimum lot area)
PROCESSED BY:
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' Stale 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, after, 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 ficensure 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 (_) all of or L) 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).
❑ 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7D44, 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 ficensure under the Contractors' Slate 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:llwww.leginfo.Ga.govlcalaw.htmi.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full fame
and effect. License Class License No Date Contractor Signature
WORKERS' COMPENSATION DECLARATION
WARNING: 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 (6100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST. AND ATTORNEY'S FEES.
'l 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, for IN
(performance of the work for which this permit is issued. Policy No.
have 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'
rance carrier and policy number are:
Policy Number
Date
ie of Agent Phone N
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
, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
ignature of Applicant Date_
,ECLARATION REGARDING CONSTRUCTION LENDING AGENCY
hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
enders Name Lenders Address
y 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 county ordinances and state laws relating to building construction.
I authorize representatives of this city or county to enter the above -identified property for inspection purposes.
�ionature of PrODertV Owner or Authorized Agent Print Property Owners or Authorized Agent's Name
ACTION I DATE BY DECLARATIONGULATIONS OF COMPLIACE WITH
1OFFTNTLE 40ANODE OFVID FEDERAL I FOR OFFICE USE ONLY
PERMITEXPIRED I I I L-1 I SUBMITTED ASBESTOS
PERMIT EXTENDED L 1AQMD
PERMIT FINAL U ASBEST05 NOTIFICATION 15 NOT APPLICABLE TO
CERTIFICATE OF !_ / PROPOSED DEMOLITION
OCCUPANCY ISSUED L'Y SIGNATURE:
Date