HomeMy WebLinkAboutX2021-1904 - Permits'o City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
. ! Permit Counter Phone (949)644-3288
;. rp Inspection Requests Phone (949)644-3255
Combination Type - SFP ELEC
IIII�IIII�IIIIIII�IIIIIIIIIIII�IIIIIIill II COMB Permit: X2021-1904
Project No : 1370-2020
Issued Date : 07/30/2021
Inspection Area : 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 07/30/2024 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: 219 NORTH STAR LN NB
Description: SFR DELTA 4, CHANGE OUT WINDOW/DOOR, REPLACE DRYWALL, ELEC. ON 1ST 8: 2ND, NEW SLAB @ ENTRY (REV21-1139)
Legal Desc.: N TR 4224 LOT 104
Owner:
CARR TIMOTHY WALTER T
Address:
140 NEWPORT CENTER DR
NEWPORT BEACH, 92663
Phone:
949-230-8454
Applicant:
WOOLBERT CRAIG
Address:
5622 LITTLER DR
HUNTINGTON BEACH CA 92649
Phone:
714-856-2605
Code Edit:
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories:
No of Units : 1
Bldg Height:
Bldg Sprinklers:
Construction
Contractor:
O W N ER/BLD R
Address:
TIMOTHY CARR
Phone:
949.230-8454
Con State Lic:
O/B
Lic Expire:
Bus Lic:
Lic Exp Date:
2019
2
0
Worker's Compensation Insurance
V-B
Carrier:
R31U
Policy No:
0
Expire:
0
Building Setbacks
Rear: 6'
Front: 10'
Left: 6'
N
Right: 6'
X
Use Znne
Parkinn Anacpr
Building Permit Fee: $559.00
Plan Check Fee: $486.33
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$26.00
Energy Compliance:
$61.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$2.00
TOTAL FEE: $1,225.46
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Architect:
Address:
f
i
Phone:
State Lic:
Engineer:
SILVA CHRISTINA
Address:
24482 MUELA
MISSION VIEJO CA 92692
Phone:
949-795-6256 State Lic:C-037201
Designer:
0
Address:
Do
Phone:
Special Conditions: LIQUEFACTION AREA
Fire
Excise Tax:
$0.00
Planning Department -
Additional Fee :
$0.00
Plan check Fee:
Grading Bonds Fee:
$0.00
Fair Share :
Grading PC Consultant :
$0.00
SJH Trans :
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
PM Plan Check :
$0.00
Electrical %:
$39.13
San Dist:
$0.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
Plumbing %:
$0.00
Fire Department
$52.00
Fire Inspection:
$0.00
$0.00
Fire Plan Rev
$0.00
$0.00
Demolition Fee
$0.00
Building Dept Adm
$0.00
General Service
$0.00
Refund Deposit
$0.00
Grading Bond:
$0.00
$0.00
$0.00
Plan Check Fee : $538.33 Fee Due at Permit Issuance : $687.13
-
? UBLIC WORKS AP?R?jVAL:
PLAN CHECK BY
00 o APPROYAIp TP S$bE:
a o
0 o c
e o c a
0
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 U portions of the work, and the structure is not intended or offered for sale (Section 7044,
ess 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
menu 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
Im ove for the purpose of sale).
Iowner 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
to an owner of property who builds or improves thereon, and who contracts for the j cts with a licensed Contractor pursuant to the Contractors' State License Law).
I am exempt from I censure under the Contractors' State License Law for the folio Ing r ason:
By my signature below I acknowledge that, except for my perso sl nce in wh' I m t have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall).
sell a structure that I have built as an owner -builder if it as no een con tructe In its a irety by licensed contractors. I understand that a copy of the applicable law, Section 7044 e usines' and
Professions Code, is available upon request when i application is sub r at t following Web site:http://www.leginfo.ca.gov/calaw.html. q
Signature of Property Owner or Authorized Agent Dat
LICENSED CONTRACTOR'S DECLARATIO
I hereby affirm under penalty of perjury that am li nsed under Isions of er 9 (commencing with Section 7000) of Division 3 of the Business and Professions C e, and my license is in full force
and effect. License Class License No Date Contractor Signature
WORKERS' COMPENSATION DECLARATION
✓DARNING: 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 ($100,000(, IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
7 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
performance of the work for which this permit is issued. Policy No.
:1I 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' compensatiol
isurance carrier and policy number are:
;arrier Po
lic tuber Expiration Date
e of Agent / Phone #
ertity that, in the performan of the wok "h th' permit is issued, I shall not employ any person in any manner so as to become subject to the workers' �petio la�vfornia, and agre
iat, I I should become su ect o the work c pens Ion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
signature of Applicant
Nit
)ECLARATION REGA 1 CO T ION ND AGENCY
hereby affirm under p alty of pe at th construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
.ender's Name Lenders Address
my signature below, I certify to each of the following:
I am the property owner or authorized to act on the pro
I have read this application and the information I havp
I agree to comply with all applicable city and county ordi
I authorize representatives of this city or cgLlptito enter
DATE I BY
1403
PERMITEXPIRED
PERMITGINCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF S,'zl rl�l
OCCUPANCY ISSUED
qre laws relating to building construction.
dentified operty-for inspection purposes.
Print Property Owner's or Authorized Ag
OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
PART 61 OF TITLE 40 AND AQMD RULE
NOT