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HomeMy WebLinkAboutX2021-1834 - Permitsx*sfv City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 .. - .+ Inspection Requests Phone (949)644-3255 t:°tta rug`' Combination Type - SFP PLUM ELEC PLUM IIIIIIIIIIIII0 II I�III� IIIII I�3IIIII4 II COMB Permit: X2021-1834 Project No: 0220-2021 Issued Date : 08/13/2021 Inspection Area : 1 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0811312024 OR PERMIT WILL BE INVALID Construction Hours: Monday- Friday 7.00 a.m. to 6:30 p.m. and Saturday from 800 a.m. to 6:00 p.m. No work on Sundays or Holidays Job Address: 1600 E BALBOA BLVD NB Description: SFR DELTA 3, LOWER (E) RAISED FLOOR TO MATCH (E) LIVING RM, FAMILY RM INTIAM E THROOM 918 SF (REV21-1083) Legal Desc.: BALBOA TR EAST SIDE ADD BLK 25 LOT 12 Owner: GALVEZ KRISTINA & OSCAR Address: 1600 BALBOA BLVD E NEWPORT BEACH, CA 92661 Phone: 562/686-1188 Applicant: MOSSMAN ERIC Address: 2025 W BALBOA BLVD STE B NEWPORT BEACH CA 92663 Phone: 949-675-1252 Code Edit: 2019 Type of Construction: V-B-SPR Occupancy Group: R3/U Added /New sq.ft. Bldg: 32 Added/New sq. ft. Garage: 0 No of Stories: 3 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Y Building Permit Fee: $799.00 Plan Check Fee: $695.13 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $22.00 Energy Compliance: $61.00 CA Seismic Safety: $6.50 Disabled Access: $0.00 Hazardous Mat $0.00 Building Green Fee : $2.00 TOTAL FEE : $1,816.22 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Contractor: CARHARTT DEVELOPMENT INC Address: 11511 GARFIELD AVE SOUTH GATE CA 90280 Phone: 323-997-3282 Con State Lic: 1038854 Lie Expire: 05/31/2022 Bus Lie: BT30075117 Lie Exp Date: 04/30/2022 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: 5' Front: 5' Left: 3' Right: 3' irking Spac $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $55.93 $0.00 $71.91 0 Architect: MOSSMAN ERIC Address: 2025 W BALBOA BLVD STE B NEWPORT BEACH CA 92663 Phone: 949/500-7212 State Lie C019718 Engineer: GOUVIS GEORGE A Address: 3831 BIRCH ST M� NEWPORT BEACH CA 92660 _A - -`l Phone: 949-756-1525 State Lic:C-029211 Designer: Address: Phone: Special Conditions: Planning Department - Plan check Fee: Fair Share SJH Trans In -lieu Housing Fee Public Works Department - Park Dedication : $0.00 P/W Plan Check : $50.75 San Dist: $0.00 NMUSD Fee: $0.00 Fire Department $52.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: Plan Check Fee : $747.13 Fee Due at Permit • o P.118LIC WORKS APPROVAL: o a PLAN CHECK BY: ..41PROVAL TO ISSUE: f 6 C [ Q i Q qa0 [.L uIJO G [ GOG (�C $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $1,069.09 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 :he 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 -Builder will have the burden of proving that it was not built or improved 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). ❑ I am exempt from licensure 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.govlcalaw.htmi. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectiorli,7,900) of i)'si n 3 f the Business and o ssions Cod ipnd y license is in full force and effect. License Class License No Dat �6 Contractor Signatur WORKERS' COMPENSATION. DECLARATION.. - - NARNING: 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 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 the 3erformance of the work forwhich this permit is issued. Policy No. ❑I 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' compensation nsurance carrier and policy number are: Policy Number Date ie of Agent rnune n 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 agree if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. latu re of Applicanvt_, � )reby affirm under �enalty 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. 1 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 tth entert ab -ide 'fietl'property for inspection purposes. \v .�7 7 .,.,., ,a o..... n,.,�o...� n,av,..�hon A�o�r XX Print Prooertv Owner's or Authorized Acent's Na �J " DATE BY VQ DEC�ARAK101 COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REG T N PART 61 OFTITLE 40AND AQMD RULE PERMITEXPIRED ❑I SUBMITTE ASBESTOS NOTIFICATIOD TO .• • • . .0 • • • -. i e e • • • e PERMIT CANCELLED EPA e • a • �•• PERMIT EXTENDED • QM D PERMIT FINAL C 23 D n 1` ASBESTO NOTIFICATION IS NOTAPPLICABLE TO CERTIFICATE OF PROPOSEVDEJMUTION •• ••s • • . ••s OCCUPANCYISSUED SIGNAT : i i . . • .