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Home My WebLink AboutX2021-0701 - Permits" 'rr City of Newport Beach - Building DivisionIIIIIIII III�III �II111111111111111111Jillll� II COMB Permit: X2021-0701 +� 100 Civic Center Drive, Newport Beach, CA 92660 X �' I' Project No : 0646-2021 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - SFP Issued Date: Area : 2021 AYiYY Inspection Area 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 03/31/2024 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: 414 EL MODENA AVE NB Description: SFR RAISING LIVING RM FLOOR AREA TO MATCH EXISTING FIRST FLOOR LEVEL 360 SF Legal Desc.: FIRST ADD TO NEWPORT HEIGHTS BILK 27 LOT 4 Owner: DIAMANT THOMAS JOSEPH Address: 414 EL MODENA AVE Record Management : NEWPORT BEACH, CA 92663 Phone: $0.00 Applicant: PARSI SAM Address: 24267 SANTA CLARA AVE #9 Hazardous Mat DANA POINT, CA 92629 Phone: 949-489.9392 Code Edit: 2019 Type of Construction: V -B Occupancy Group: R31U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: N Construction Building Permit Fee: $246.00 Plan Check Fee: $214.02 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management : $2.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access: $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $509.27 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Contractor: VAUGHN BUILDERS INC Address: 2815 RIACHELO Phone: SAN CLEMENTE CA 92673 Phone: 949-7424358 Con State Lie: 994745 Lie Expire: 07131/2022 Bus Lie: BT30074832 Lie Exp Date: 03131/2022 Worker's Compensation Insurance Carrier: NO EMPLOYEES Policy No: Expire: Building Setbacks Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: 1 Front: I Left: I Right: I $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Architect Address: Phone: State Lie Engineer: Fire Department Address: Fire Inspection: Phone: State Lie: Designer: PARSI SAM Address: 24267 SANTA CLARA AVE #9 Public Works Department - DANA POINT, CA 92629 Phone: 949-489-9392 Special Conditions Hazard Zone:N Planning Department - Fire Department Plan check Fee Fire Inspection: Fair Share Fire Plan Rev SJH Trans Demolition Fee In -lieu Housing Fee: Building Dept Adm Public Works Department - Park Dedication : $0.00 PAN Plan Check: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 Plan Check Fee : $260.27 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $249.00 PUBLIC WORKS APPROVAL: ccc oou i .n`o PLAN CHECK BY: APPROVAL TO ISSUE: Fire Department $46.26 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $249.00 PUBLIC WORKS APPROVAL: ccc oou i .n`o PLAN CHECK BY: 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) 1 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 ie 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 'rofessions 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 of 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 U portions of the work, and the structure is not intended or offered for sale (Section 7044, Wainess and Professions Code: The Contractors' Slate License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the nprovements 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 nproved 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 pply 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: ly 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: ell 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 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http:ttwww. leginfo.ca.govlcalaw.html. signature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section00 ).of ivisi n 3 f the Business and Profs Ions de icense is in full force nd effect. License Class License No Date 1 2 Contractor Signature VORKERS' COMPENSATION DECLARATION 'ARNING: 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 (5700,0001, IN ADDITION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: I 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 th erformance 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 Expiration Date ne of Agent certify that, in the performance of the work for which this if I should become subject to the workers' comp/epsat, iature of ADDhN" /Can YARVING CONSTRUCTION L not employ any person in any manner so as to become subject to the workers' compensatilaws f California, and agree 3700 of the Labor Code, I shall forthwith comply with those provisions. Daf 3 f 2 hereby affirm unde( penally 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). ender's Name Lender's 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 a law ting to building construction. I authorize representatives of this city or county enter the-ident` - roperty for inspection purposes. �� o 4v 7 V t0 ionature of Prooertv Owner or Authorized Acent )l , ® Print Property Owner's or Authorized Agent's Name]l. Ao W' ACTION DATE BY r DECLAPATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY EGULA}IIONS PART 61 OF TITLE 40 AND AQMD RULE 1401 \ ... .. ... . PERMITEXPIRED I U I SUBMjTTED ASBESTOS NOTIFICATION TO • ' • • • . • ` PERMITCANCELLED EPA .+ • •• •� a • + PERMIT EXTENDED D PERMIT FINAL qq y ASB TOS NO #ICATION IS NOT APPLICABLE TO CERTIFICATEOF p�� '� PROP SE OUTION ••� • ••e •�• •�e •.. OCCUPANCY ISSUED 5 A7U • ° • • • • _ _