HomeMy WebLinkAboutX2021-0871 - PermitsCity of Newport Beach - Building Divisionlllllllllllllllll�llllllllllllllllllllllllllllu
100 Civic Center Drive, Newport Beach, CA 92660
rw Permit Counter Phone (949)644-3286
i. Inspection Requests Phone (949)644-3255
txw a+s Combination Type - SFP MECH ELEC PLUM
0.2
COMB Permit: X2021-0871
Project NO :2087-2018
Issued Date: 04/1412021
Inspection Area : 1
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST
BE COMPLETED BY 0411412024 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: 1703 PLAZA DEL SUR NB
Construction Valuation:
Description: SFR *CHANGE OF OWNER OF RECORD* ADD 3RD STORY 396 SF & REMODEL 800 SF *C2018-0149*
(X2018-3778)
Legal Desc.: N TR 518 BLK K LOT 31
Owner: ONE ASSOCIATES Contractor: OWNER/BLDR
Architect:
Building Permit Fee:
Address: 2020 E ORANTHORPE AVE #210 Address: DITOLLA JODI
Address:
$0.00
FULLERTON CA 92831
Phone: Phone:
Phone:
- State Lie:
Applicant: ZICKEFOOSE DAVID Con State Lie: O/B
Engineer:
XIAO WANG
Address: 1525 MIRAMAR DR Lie Expire:
Address:
1520 BROOKHOLLOW DR #45
NEWPORT BEACH CA 92661 Bus Lie:
$0.00
SANTA ANA CA 92705
Phone: 909-224-6367 Lie Exp Date:
Phone:
714-662.0510 State Lic:C-066510
Code Edit: 2016 Worker's Compensation Insurance
Designer:
$0.00
Type of Construction: V -B -SPR Carrier:
Address:
Investigation Fee:
Occupancy Group: R31U Policy No:
Grading PC Consultant:
$0.00
Added /New sq.ft. Bldg: 396 Expire:
Phone:
$0.00
Added /New sq. ft. Garage: 0
Record Management:
No of Stories: 2 Building Setbacks Rear: 15'
Special Conditions: 3 YEAR DATELINE
No of Units : 1 Front: 15'
In -lieu Housing Fee :
12/14/2021
Bldg Height: 0 Left: 2'
Building Dept Adm
LIQUEFACTION AREA
Bldg Sprinklers: Y Right: 2'
$0.00
Grading PC Fee:
Flood Zone:
0.2
Use Zone:
Parking Spaces:
0
Fire Hazard Zone : N
Construction Valuation:
$0.00
Building Permit Fee:
$0.00
Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee: $0.00
Additional Fee :
$35.00
Plan check Fee :
$0.00
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
$0.00
Energy Compliance:
$0.00
Grading PC Fee:
$0.00
Public Works Department-
General Service
$0.00
CA Seismic Safety:
$0.00
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Refund Deposit
$0.00
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 :
$0.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE: $35.00
Plan Check Fee:
$0.00
Fee Due at Permit Issuance :
$35.00
PROCESSED BY: PUBLIC WORKS APPROVAL:
ZONING APPROVAL:
PLAN CHECK BY:
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 mason(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
he permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' Stale License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
3rofessions 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
iot 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 (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
3usiness 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
mprovements 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
m roved for the purpose of sale).
1, 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:
3y 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
3rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/colaw.html.
31gnature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
hereby affirm under 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
and effect. License Class License No Date Contractor Signature
NORKERS' COMPENSATION DECLARATION
YARNING: 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 ($100,0001, IN ADDITION TO THE
:OST 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, for IN
Rarformance 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:
ier Policy Number Expiration Dale
ne of Agent enone m
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.
of
Date
CLARATION REGARDING CONSTRUCTION LENDING AGENCY
Ireby 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 relating to building construction.
I authorize representatives of this city or county to enter the above -identified property for inspection purposes.
nature of Prooertv Owner or Authorized ADent Print Property Owner's or Authorized Agent's Name
ACTION DATE I BY DECLARATION OF IREGULATIONS PA T061 OF IIT E 40 AND AQMD RULECE WITH CODE OF FOR OFFICE USE ONLY
PERMIT EXPIRED i i I U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED EPA
PERMITFINAL C U ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO
CERTIFICATE OF V PROPOSED DEMOLITION
OCCUPANCYISSUED SIGNATURE:
Date