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HomeMy WebLinkAboutX2019-1488 - Permitswta,� City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2019-1488 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 1 4 e 8 Project No: 3040-2013 - 1 �':�^. Permit Counter Phone (949)644-3288 51 Inspection Requests Phone (949)644-3255. �tiarnit�`y Combination Type - MFP Issued Date: 05/08/2019 Inspection Area : 5 Code Edit: 2016 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Type of Construction: Carrier: 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: 312 DAHLIA PL NB $0.00 r r Description: DESCRIPTION CHANGE/DUPLEX TO CONDOS Added/New sq. ft. Garage: 0 CA Seismic Safety: Legal Desc.: CORONA DEL MAR LOT 14 BLK 232 ALL -INC POR ST & ALLEY ADJ- POR OF LOT Building Setbacks jf �( c No of Units: 2 Building Green Fee : Front: I 51 Owner: NSC. ENTERPRISES, INC Contractor: OWNERIBLDR Architect: $0.00 Address: PO BOX 982 Address: KAVIANI SHEILA Address:�a - CORONA DEL MAR CA 92625 Electrical %: $0.00 Phone: Phone: Phone: ••e• State Lie: •••••• �. X43 NMUSD Fee: $0.00 Plumbing %: $0.00 Applicant: NSC ENTERPRISES, INC Con State Lie: OIS Engineer. o �.•.. Address: PO BOX 982 Lie Expire: Address: . • • o CORONA DEL MAR CA 92625 Bus Lie: Phone: Lie Exp Date: Phone: State Lie: ' • • - • o° Code Edit: 2016 Worker's Compensation Insurance Type of Construction: Carrier: .Overtime Plan Ck: Occupancy Group: R31U Policy No: $0.00 Added /New sq.ft. Bldg: 0 Expire: Energy Compliance: Added/New sq. ft. Garage: 0 CA Seismic Safety: $0.00 No of Stories: 0 Building Setbacks Rear: I No of Units: 2 Building Green Fee : Front: I Bldg Height: 0 $0.00 Left:. I Bldg Sprinklers: $0.00 Right: I Construction Valuation: Building Permit Fee: .$0.00 Plan Check Fee: $0.00 Fire Inspection: .Overtime Plan Ck: $0.00 Investigation Fee: - $0.00 Record Management: $0.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access: $0.00 Hazardous Mat $0.00 Building Green Fee : $0.00 TOTAL FEE: $35.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Designer: Address: Phone: Special Conditions: Excise Tax: $0.00 Planning Department - Fire Inspection: Additional Fee : $35.00 Plan check Fee: Demolition Fee Grading Bonds Fee: $0.00 Fair Share General Service Grading PC Consultant : $0.00 SJH Trans Grading Bond: Grading Permit Fee: $0.00 In -lieu Housing Fee Grading PC Fee: $0.00 Public Works Department - WQ Insp. Fee: $0.00 Park Dedication : $0.00 P/WPlan Check: $0.00 Electrical %: $0.00 San Dist: $0.00 Mechanical %:. $0.00 NMUSD Fee: $0.00 Plumbing %: $0.00 Plan Check Fee: o a oa•m oa a c c o 00 O C C 0B006C � ou o c ongo• $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $35.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: + a n •• oa000 0 memoo OOOSCO i O p oenono 0 0 uv.o Fire Department $0.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: o a oa•m oa a c c o 00 O C C 0B006C � ou o c ongo• $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $35.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: + a n •• oa000 0 memoo OOOSCO i O p oenono 0 0 uv.o OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 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) Iction 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 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 Ifessions 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 more than five hundred dollars ($500). 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, s ass 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 )rovements 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 )roved 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 )ly 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). I am exempt from licensure under the Contractors' State License Law for the following reason: 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 legall! I a structure that I have built as an owner -builder if it hiss not _been construc d in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of t e Business and Ifessions Code iiisjavailable upon request when this ppikati ub d or at t ng Web site:http://www.leginfo.ca.gov/calaw.html. _ G'1 nature of Property ®caner or Authorized Agent Date 1 TENSED CdA fRACTOR'S DECLARATION 9rbf5Q affirm: Aaer penalty 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 force I effect. Lic@nsd'Class License No Date Contractor Signature 5Uj ERS' COMPENSATION DECLARATION iNlltp: FAILURI Td 99CORE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($700,0001, IN ADDITION TO THE V O COMPENSAWONf DAMAGES AS PROVIDED FOR IN SECTION 5708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. IrMy affirm under penalty of perjury one of the following declarations: I r§le and Will fh2intain 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 th %rmance of the -work for which this permit is issued. Policy No. 'havi and wilCmasllain 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' compensatioi jr;IVV carrier and policy number are: riP"r_ I " Policy Number Expiration Date of Agent "" 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 I, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant Date_ CLARATION REGARDING CONSTRUCTION LENDING AGENCY :reby 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). 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 county ordinances and state laws latin building construction. I authorize representatives of this city or county to� Identif ro y for inspection purposes. l / /� nahlre of Prnnarty Owner nr Aufhnrizad Anent / --� ��fJ A Print Prooertv Owner's or Authorized Acent's Name �S 110J / edZ� Date ACTION DATE BY X DECLARATION Of'COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMITEXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED OEPA PERMIT EXTENDED EIAQMD PERMITFINAL _lEl CERTIFICATE OF sl �j�'CI OCCUPANCYISSUED ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION SIGNATURE: E