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HomeMy WebLinkAboutX2021-2552 - Permits (2)w F : City of Newport Beach - Building Division `X2021-2552" COMB Permit: X2021-2552 ' dry 100 Civic Center Drive, Newport Beach, CA 92660 Project No: 2213-2021 Permit Counter Phone(949)644-3288 u'. Inspection Requests Phone (949)644-3255 Combination Type - SFP ELEC Issued Date : 09/24/2021 Inspection Area : 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 09/24/2024 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: 3015 CLIFF DR NB Description: SFR DEMO TWO FIREPLACES AND ONE CLOSET TO INSTALL ELEVATOR Legal Desc.: N TR 444 LOT 40 Owner: SMITH PAUL Contractor: ACCESS TO FREEDOM Architect: UPL►(; Address: 3015 CLIFF DR Address: 9272 JERONIMA RD #111 Address: NEWPORT BEACH, CA 92663 IRVINE, CA 92618 -,-. Phone: Phone: 949.472-4900 Phone: State Lic .. Applicant: HAHN PRYN Con State Lic: 786659 Engineer: BURKE LEO Address: 34167-D PCH Lic Expire: 10/3112022 Address: 34167 PACIFIC COAST HWY #D DANA POINT CA 92629 Bus Lic: BT30067117 DANA POINT CA 92629 Phone: 949-226-7130 Lic Exp Date: 04/30/2022 Phone: 949-226-7130 State Lic:C-067404 P 4A° Code Edit: 2019 Worker's Compensation Insurance Designer. mm.m �m.mmo Type of Construction: VB Carrier: AMGUARD INSURANCE CO Address: m ° ° emwm Occupancy Group: R3/U Policy No: ACWC301235 Added /New sq.ft. Bldg: 0 Expire: 03/01/2023 Phone: Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear: / Special Conditions: LANDSLIDE AREA No of Units : 1 Front: / A b O Om°CL Bldg Height: 0 Left: / Bldg Sprinklers: N Right: / mommo m Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $20,000.00 mm Amttl°: Building Permit Fee: $416.00 Excise Tax: $0.00 Planning Department - Fire Department f0 ® W Plan Check Fee: $361.92 Additional Fee : $0.00 Plan check Fee : $52.00 Fire Inspection: `$0.$8 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 : $16.00 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 %: $29.12 San Dist: $0.00 Building Green Fee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $876.04 Plan Check Fee : $876.04 Fee Due at Permit Issuance: $0.00 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 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, alter, 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 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 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 (_) 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-Builderwill have the burden of proving that it was not built or improved for the purpose of sale). ❑ I, as owner of the eroperty,.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,i6f 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 exemp) from: licensurke:under the Contractors' State 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://www.leginfo.ca.gov/calaw.htmi. Signature of Property Owner or Authorized Agent Dale LICENSED CONTRACTOR'S DECLARATION I 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 WORKERS' CbWriNSATION DECLARATION WARNING FAILUREIF8 4CURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE C0916OF+COMPENSAi01N, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm underpenalty of perjury one of the following declarations: I.4da ie and wilt 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 orpance of the work for which this permit is issued. Policy No. Wave 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' compensa 6Vce carrigrWWnplicy number are: Y Agent of Policy Number Expiration as 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 is subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date_ CLARATION REGARDING CONSTRUCTION LENDING AGENCY areby 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 BY DECLARATIONOF OAROOF 40ANDD AO MPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY REGULATIONS PERMIT EXPIRED LJ I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED EPA PERMIT EXTENDED UAQMD PERMITFINAL CERTIFICATEOF OCCUPANCY ISSUED r, �r l'/ /i -1 v� /// ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO PROPOSED DEMOLITION SIGNATURE: F✓� i 15� tL >TO�Ccl F h_ N t U p 16 O CO M Z d O _CT) N co H CO O r0. 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