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HomeMy WebLinkAboutX2021-2422 - Permits`fr City of Newport-Seach - Building Division i~ a 100 Civic Center Drive, Newport Beach, CA 92660 4 Permit Counter Phone (949)644-3288 .. i-spection Requests Phone (949)644-3255 Combination Type - SFP IIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit: X2021-2422 Project No : 0444-2020 Issued Date: 09/10/2021 Inspection Area : 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0911012024 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: 2161 MESA DR NB Description: DELTA DELTA 4 *ADDITIONAL SCOPE* NEW TRELLIS 200 SF (CHANGE OF CONTRACTOR) REPLACES X2020 Legal Desc.: TR 706 LOT 124 NWLY1/2 R i i yy,�7pp �� Owner: 2161 MESA DRIVE LLC or: f�WNERIBLDR 1,�[;CG`O'LSEN ERIC F Address: 660 NEWPORT CENT ess' r/ /CROWLEY KAITLIN Add ass: 2728 E CQ�-T/H1 FST NEWPORT BEACH, C 92660 �(/ l/ CCee tf��0�0 R N4 L/JH;r � 92625 p� Phone: Date, _...- RAL0 949-8B7-8856 State Lic:6,034489 NO Applicant: OLSEN ERIC S� n Stat c Engineer: FORBES DALE y Address: 2728 E COAST HWY, S A pir - _ddF¢,`30>'188B-E' H STT6T #B W°f' CORONA DEL MAR CA 262 Z_:1Bus Lic: ' ° ° .q �.. SANTA ANA CA 92701 °-'-1° ,p® Phone: 949-887-8856 .Lic-p Phone: 714-835-2800 State LiaC 30407 Code Edit: 2019 Worker's Compensation Insurance Designer: Type of Construction: VB Carrier: - Address: ° Occupancy Group: U Added /New sq.ft. Bldg: 0 E D' - Phone:- Added /New sq. ft. Garage: 0 a000 No of Stories: 1 Build s Rear: 25 Special Conditions: No of Units: 1 - Front: 20 ,e� Bldg Height: 0 t� Left: 5 ° g �j. n Bldg Sprinklers: Rig t: 5 � 9 0 0 ° Flood Zone: Zone: P 0 re Haz d Z �.a "o'". Construction Valuation: $0.00 '�" nQ ' t i � „ Y g o Building Permit Fee: $0.00 ase Tax b dt u� � Planning Department Fire De F Plan Check Fee: $0.00 Additional IF d . $38.00 Plan check Fee ire Insp $0.00 Overtime Plan Ck: Grading Bonds Fee: $0.00 Fair Sha $0.00 {,trgPd 7` $0.00 Investigation Fee: $0.$0.00 00 Grading PC Consultant : $0.0 H Trans : mvp- InIt i n ee Record Management: $0.00 1 in P $0.00 In -lieu Housing Fie-$0.00 m $0.00 Energy Compliance: $0.00 Grading PC Fee: $0.00------- PAgit rMr s Depart Depart General Service $0.00 CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Refund Deposit $0.00 Disabled Access : $0.00 P/W Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 $0.00 San Dist: - - $0.00 Building Green Fee : $0.00 Mechanical W $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $38.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $38.00 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 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 6f 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 Denalty 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 C_) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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 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 Fn� oved for the purpose of sale). 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 ply 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: k ly my signature below I acknowledge that, except for my personal residence in whic . one year prior to completion of the improvements covered y this permit, I cannot legal ell a structure that I have built as an ow - - - c e m its entirety by liters co a�jors. I understand that a gopy of khe,applicable law, Section 7 4"ofthe Business and 'rofessions Code, is available upon reques when thi p i lion is subm' ad or at he fo o ela' e;ht/I�aavrF�ginfo.ca.d,iv�bifUle. g signature of Property Owner or Authorized gent Date .ICENSED CONTRACTOR'S DECLA TI ai nn {{��rr''o// CCtrrr ❑ i 000% reTun 111 hereby affirmAtOr Iyenalty of perjury that am licensed under provisions of Chapter 9 (comme cin S 0 of Divis1ad3 OVEPEPE19slness and Professions Code, aria mylicense is in full force nd effgct. LICemtClass icense ate :. Contractor Signature g ., il;ERS' PCWP€NSATION DECL IWG: FAILURPRP,IECURE WORKERS' COMPE OF COMPENWION, DAMAGES AS PROVIDED by affirm Under penalty of perjury one • .will'•• ji'ave and will maintain a certificate t Smance of ih+ ork for which this Darn rave and Aff m•a stain workers' comp, ypce carrierland policy number are: e; • .. eof Agent* .ertify that,10performance of thew if I should become subject to the work atu re of Applicant AT[ N }Cj �yrh0lTl: �-- \TIO OVERAG UN UL,Afll%&NAES.' E ANOCIVI FINES UP TO ONE HUNDRED THOUSAND I R IN CTION 37 F THE the larations: :ons t to s -insure a c c p n, R M o strial Relations as provided for by SectioRolio ns arc as re Ire by n St 00 of t mance of the work for which this permit Is; mbar Expiration Date per 't is issued, I shall 1" I n: veby affirm under penalty of perjury that thE�r is a cohstructionNdi'ldthb'ag[ Ider's Name Sr my signature below, I certify to each of the Ilo,�^{Ing; I am the property owner or authorized to a o}I0Tywwpa4y-ewnersteha I have read this application and the inform on I have provided is correct. I agree to comply with all applicable city an county ordinanc Ddstata I authorize representatives of this city or co my to er the abov - `s9�r of ProOertv Owner or Authorized ACTION PERMIT EXPIRED PERMITCANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCYISSUED I DATE I ��jy' person in an man rs as -et,e vlarldels`Sa�I EAIb rCode, I sh ith pl ' s prowslons. 1_ ddd (no work started) Date_ r ormance of the work for which this permit is issued (Section 3097, Civil C Address __ Print REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE I SUBMITTED IJ ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO PROPOSED DEMOLITION SIGNATURE: Insp. in Owners or Authorized Anent's Name I FOR OFFICE USE ONLY 100,000), IN ADDITION TO THE the Labor Code, for the y workers' compensatior rsl,df California, and agret Date